This protocol addresses the acute management of carbon monoxide (CO) poisoning specifically in paediatric patients under 18 years of age, where prompt recognition and immediate intervention are essential.
In school-aged children and adolescents, the symptoms of acute CO poisoning range from headache, nausea, and vomiting through to neurological symptoms and coma — a presentation comparable in pattern to that seen in adults. Severity varies, and the management approach must reflect the child's age and clinical status.
The cornerstone of management is the earliest possible initiation of high-flow oxygen therapy. The specific delivery method depends on the child's clinical condition; the complete protocol defines the approach for both spontaneously breathing and intubated children, along with the applicable escalation criteria.
The clinical goal is the child becoming fully symptom-free with carboxyhaemoglobin (COHb) returning to normal levels. Specific monitoring thresholds and end-points are defined in the full protocol.
The symptoms of acute CO poisoning in school-aged children and adolescents are comparable to those in adults, ranging from headache, nausea, and vomiting to neurological symptoms and coma.
HBOT for CO poisoning in children can only be considered in specific individual cases.
The earliest possible administration of 100% high-flow oxygen by mask or via high-flow nasal cannulae (HFNC) is mandatory; intubated children should be ventilated with a fraction of inspired oxygen (FiO2) of 1.0 until they are symptom-free and their COHb value has dropped to normal levels (<3%).
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