Carbon monoxide and organic solvent intoxications

1. Big picture

This topic has two major exam patterns:

1. Carbon monoxide (CO) poisoning A patient has headache, dizziness, confusion, syncope, chest pain, or coma after exposure to fire, faulty heating, exhaust, or a closed-space combustion source. Pulse oximetry may look normal, but the patient is hypoxic at tissue level.

2. Organic solvent intoxication A patient has acute central nervous system (CNS) depression, dizziness, euphoria, ataxia, arrhythmia, chemical pneumonitis, liver injury, renal injury, or chronic neuropsychiatric and hematologic toxicity after inhalation, ingestion, dermal exposure, or deliberate “sniffing.”

Core emergency logic:

Suspected CO/solvent exposure
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Remove from exposure + protect rescuers
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ABCDE: airway, breathing, circulation, disability, exposure
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Give high-flow oxygen if CO/smoke/respiratory symptoms
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Check ECG, blood gas, lactate, COHb/metHb if relevant
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Treat complications: coma, seizures, arrhythmias, acidosis, aspiration, hepatic/renal injury
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Consider hyperbaric oxygen for severe CO poisoning

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