Adverse Effects and Toxicology Complete Practice Test 2026

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What is the standard initial treatment for carbon monoxide poisoning and the diagnostic test?

Observe without oxygen therapy if asymptomatic.

Administer 100% oxygen; measure carboxyhemoglobin with co-oximetry.

High-flow oxygen is the immediate treatment because carbon monoxide binds tightly to hemoglobin, preventing oxygen delivery. Giving 100% oxygen (usually via a non-rebreather mask) accelerates CO release from hemoglobin, dramatically shortening the COHb half-life and reducing tissue hypoxia.

For diagnosis, measure carboxyhemoglobin with co-oximetry. Standard pulse oximetry can’t distinguish CO-bound hemoglobin from oxyhemoglobin and may be misleading, so co-oximetry on a blood sample is needed to quantify COHb and assess severity. Hyperbaric oxygen therapy may be considered in severe cases or certain patients, but the initial steps are 100% oxygen and COHb measurement by co-oximetry.

Administer 50% oxygen and perform ABG only.

Hyperbaric oxygen therapy is never indicated.