In this episode of "PICU Doc on Call," pediatric intensivists Dr. Rahul Damania, Dr. Pradip Kamat, and Dr. Monica Gray discuss a critical case involving a 16-year-old male who experienced severe carbon monoxide poisoning after being found unresponsive in a garage. They chat about the pathophysiology, clinical manifestations, diagnostic workup, and management of carbon monoxide toxicity. Furthermore, they cover the importance of early oxygen administration, recognizing potential delayed neurological sequelae, and keeping an eye out for cardiac complications. Tune in and hear more about a comprehensive approach to treatment and the significance of multidisciplinary support for achieving the best patient outcomes.

Show Highlights:

• Case presentation of a 16-year-old male with severe carbon monoxide poisoning
• Pathophysiology of carbon monoxide toxicity and its effects on hemoglobin
• Clinical manifestations and symptoms associated with carbon monoxide poisoning
• Diagnostic workup for suspected carbon monoxide exposure
• Management principles for treating carbon monoxide poisoning in pediatric patients
• Sources and scenarios leading to carbon monoxide poisoning
• Complications arising from carbon monoxide exposure including neurological injuries
• Importance of early oxygen administration and monitoring in treatment
• Discussion of hyperbaric oxygen therapy and its indications
• Key takeaways for clinicians regarding the management and follow-up of carbon monoxide poisoning cases

We welcome you to share your feedback, subscribe & place a review on our podcast! Please visit our website picudoconcall.org.

References:

• Tapking, C., et al. (2021). Burn and inhalation injury. In J. J. Zimmerman & A. T. Rotta (Eds.), Fuhrman and Zimmerman’s Pediatric Critical Care (6th ed., pp. 1347–1362). Elsevier.
• Nañagas KA, Penfound SJ, Kao LW. Carbon Monoxide Toxicity. Emerg Med Clin North Am. 2022 May;40(2):283-312. doi: 10.1016/j.emc.2022.01.005. Epub 2022 Apr 5. PMID: 35461624.
• Smollin C, Olson K. Carbon monoxide poisoning (acute). BMJ Clin Evid. 2010 Oct 12;2010:2103. PMID: 21418677; PMCID: PMC3217756.
• Palmeri R, Gupta V. Carboxyhemoglobin Toxicity. [Updated 2023 Apr 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan.