Elevated troponin or ischemic ECG changes in CO exposure
Observation pathway criteria
Mild symptoms improving
Normal mental status
Stable vitals for several hours
Reliable follow up and return ability
Discharge criteria
Discharge requirements
No stridor
No progressive hoarseness
SpO2 at baseline on room air or home oxygen
Ambulatory oximetry without desaturation
Symptom improvement after bronchodilators if used
No concerning lab abnormalities
Safe home environment
Discharge Instructions
Copy discharge instructions
Summary
You were seen for symptoms after breathing smoke
Your breathing and oxygen level improved in the emergency department
Medications
Use your inhaler as prescribed if you have one
If you were given an inhaler today follow the instructions on the label
Activity
Avoid smoke exposure
Rest and drink fluids
Follow up
Primary care within 1 to 2 days
Return earlier if symptoms worsen
Return to emergency department now for any of the following
Trouble breathing
Noisy breathing
Worsening hoarse voice
Chest pain
Fainting
Confusion
Severe headache
Blue lips
Vomiting that prevents fluids
Fever with worsening cough
References
Guidelines and key sources
American Burn Association
Advanced Burn Life Support course materials and inhalation injury guidance
Burn center referral criteria guidance
ATLS
Advanced Trauma Life Support
Airway and inhalation injury principles
Undersea and Hyperbaric Medical Society
Hyperbaric oxygen indications for carbon monoxide poisoning
Local protocol dependent thresholds
CDC
Carbon monoxide poisoning clinical guidance
Prevention and exposure considerations
Goldfrank
Toxicologic Emergencies
Cyanide poisoning recognition and hydroxocobalamin treatment
European Resuscitation Council
Toxic causes of cardiac arrest considerations
Post resuscitation care considerations
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.