06-20-2007, 05:12 PM
A 32-year-old firefighter was traversing a burning apartment building and suffered an inhalation injury
after failure of his respiratory equipment. On arrival to the emergency department, he is weak and
somnolent and is complaining of nausea and severe headache. He has black soot on his face, lips, and
nares. His vital signs are stable but he has audible inspiratory stridor. The patient is stabilized and is
placed on the appropriate intravenous therapy. A 12-lead electrocardiogram shows sinus tachycardia
with occasional premature ventricular complexes. His oxygen saturation is 40%, and inspired oxygen is
98%. After discussion by the team, the diagnosis of carbon monoxide poisoning is considered. The
most appropriate next step in evaluation is to
 A. do arterial blood gas sampling to measure PaO2
 B. place a co-oximeter on the patient
 C. sample end-expiratory carbon monoxide levels
 D. send for a methemoglobin level
 E. send venous blood gas to measure PvO2
after failure of his respiratory equipment. On arrival to the emergency department, he is weak and
somnolent and is complaining of nausea and severe headache. He has black soot on his face, lips, and
nares. His vital signs are stable but he has audible inspiratory stridor. The patient is stabilized and is
placed on the appropriate intravenous therapy. A 12-lead electrocardiogram shows sinus tachycardia
with occasional premature ventricular complexes. His oxygen saturation is 40%, and inspired oxygen is
98%. After discussion by the team, the diagnosis of carbon monoxide poisoning is considered. The
most appropriate next step in evaluation is to
 A. do arterial blood gas sampling to measure PaO2
 B. place a co-oximeter on the patient
 C. sample end-expiratory carbon monoxide levels
 D. send for a methemoglobin level
 E. send venous blood gas to measure PvO2