Monitoring
There are no specific guidelines regarding the discharge of patients. However, patients with mild symptoms that resolve with high-flow oxygen therapy (usually those patients with carboxyhemoglobin <10%) and no loss of consciousness are often discharged from the emergency room. At the time of discharge, source identification is important to prevent and eliminate recurrent exposures. It is important for emergency physicians to involve the local poison control and hyperbaric oxygen team if needed. All patients should be advised about the possibility of delayed neurologic complications, and given instructions on what to do if these occur.[27] Some studies support the use of neuropsychometric testing during the recovery period.[16] All patients treated for acute accidental CO poisoning should be seen for follow-up 1 to 2 months after the event. Any patient that hasn't recovered to their baseline neurocognitive function by that time should be referred for formal neuropsychiatric evaluation and symptom-directed evaluation treatment.[2]
Additionally, there is an association between cardiac complications in CO poisoning and worsened long-term mortality, particularly cardiac-related deaths. Hence, patients who demonstrate cardiac involvement (e.g., troponin elevation) should be followed closely by their primary care provider and undergo cardiology assessment upon follow-up.[75][76]
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