ACEP Clinical Policy — Carbon Monoxide Poisoning Evaluation and Treatment (2025)

The ACEP 2025 Clinical Policy on evaluation and management of carbon monoxide (CO) poisoning in adult ED patients provides evidence-based guidance on diagnosis, carboxyhemoglobin (COHb) threshold interpretation, neurological injury prediction, indications for hyperbaric oxygen therapy (HBOT), and mandatory safety actions (environmental investigation). CO poisoning affects ~50,000 Americans per year requiring ED visits, with approximately 430 unintentional CO poisoning deaths annually. CO is the 'silent killer' — odorless, colorless, and capable of producing COHb elevations without warning device activation in mild exposures.