病人因疑似一氧化碳中毒被送至急診。哪項措施是優先級？
A patient with suspected carbon monoxide poisoning is brought to the ED. Which action is the priority?
- AAssess for burn injuries評估燒燙傷
- BStart a peripheral IV line建立周邊靜脈通路
- CAdminister 100% oxygen✓ 正解給予 100% 氧氣
- DObtain an arterial blood gas取得動脈血液氣體分析
一氧化碳（CO）中毒的核心病理機制在於其與血紅素的親和力比氧氣高出約 200 倍，形成碳氧血紅素（COHb），導致血紅素無法攜帶氧氣至組織，造成嚴重的細胞缺氧。臨床處理應遵循 ABC（呼吸道、呼吸、循環）原則，優先給予 100% 氧氣，以縮短 COHb 的半衰期，並透過競爭性機制置換血紅素上的 CO。ABG 雖能評估酸鹼平衡與氧合狀態，但非搶救生命的優先處置；燒傷評估與靜脈路徑建立固然重要，但需在確保氣體交換穩定後進行。
The core pathophysiology of carbon monoxide (CO) poisoning lies in CO's affinity for hemoglobin, which is approximately 200 times that of oxygen. This forms carboxyhemoglobin (COHb), preventing hemoglobin from carrying oxygen to tissues and causing severe cellular hypoxia. Clinical management follows the ABC (Airway, Breathing, Circulation) principle, with priority given to administering 100% oxygen to shorten the half-life of COHb and competitively displace CO from hemoglobin. Although ABG can evaluate acid-base balance and oxygenation status, it is not the priority for life-saving intervention; assessment for burn injuries and establishment of IV access are important but should follow stabilization of gas exchange.
台美臨床在處理 CO 中毒皆強調 100% 給氧，但美國急診常會評估是否需轉診至高壓氧治療中心（Hyperbaric Oxygen Therapy），這是台灣較少見的跨院轉診流程。