How should suspected carbon monoxide exposure be managed in flight?

• A. Isolate from exposure, administer high-flow 100% oxygen, and seek medical assessment.
• B. Continue flight and monitor symptoms.
• C. Use only standard cabin oxygen.
• D. Ventilate cabin air without addressing exposure.

Answer: (A)

When carbon monoxide exposure is suspected in flight, the priority is to remove the person from the exposure source and treat with high-flow 100% oxygen, followed by medical assessment. Carbon monoxide binds tightly to hemoglobin, forming carboxyhemoglobin, which drastically reduces the blood’s oxygen-carrying capacity and can cause tissue hypoxia even if the air seems normal. Because CO is colorless and odorless, the safest and most effective immediate action is to get the person away from the source and supply pure oxygen to hasten the displacement of CO from hemoglobin and improve oxygen delivery. Providing high-flow 100% oxygen speeds up CO clearance compared with ambient air, lowering the risk of hypoxic injury. Medical evaluation is essential to assess severity, monitor for potential neurological or cardiac complications, and determine if further treatment, such as hyperbaric oxygen, is needed after the flight. Continuing flight or using only standard cabin oxygen would not adequately address CO poisoning, and ventilating cabin air without removing the source would not resolve the problem.