Critical Issues in the Evaluation and Management of Adult Patients Presenting to the Emergency Department With Acute Carbon Monoxide Poisoning

Official 2025 guideline from the American College of Emergency Physicians.

These guideline summaries are shared for educational purposes only and are not intended to direct patient care. For detail on the specific recommendations and information about the evidence considered by the guideline developer, we encourage you to go to the original guideline statement cited below.

Strength

Recommendations

Intervention

Level C

In symptomatic CO poisoning, selected patients may benefit from HBO₂ treatment based on severity of symptoms and availability (distance and time).

Literature

Original/Primary Reference

Shih, R. et al. A critical issue in the management of adult patients presenting to the emergency department with acute carbon monoxide poisoning. Annals of Emergency Medicine, 85(4), e45–e59.

Summary By

Eric Steinberg, DO, MEHP

What do the ratings mean?

Level A

Generally accepted principles for patient care that reflect a high degree of clinical certainty (eg, based on evidence from 1 or more Class of Evidence I or multiple Class of Evidence II studies).

Level B

Recommendations for patient care that may identify a particular strategy or range of strategies that reflect moderate clinical certainty (eg, based on evidence from 1 or more Class of Evidence II studies or strong consensus of Class of Evidence III studies).

Level C

Recommendations for patient care that are based on evidence from Class of Evidence III studies or, in the absence of any adequate published literature, based on expert consensus. In instances where consensus recommendations are made, “consensus” is placed in parentheses at the end of the recommendation.