What is the first-line treatment for a burn patient with elevated carboxyhemoglobin levels?

For a burn patient with elevated carboxyhemoglobin levels, the first-line treatment is administration of 100% oxygen therapy. The rationale behind this approach lies in the mechanism of carbon monoxide (CO) poisoning. Carbon monoxide has a higher affinity for hemoglobin than oxygen, which means it competes with oxygen for binding sites on hemoglobin, forming carboxyhemoglobin and preventing adequate oxygen transport to tissues.

By administering 100% oxygen, you help to displace carbon monoxide from hemoglobin more effectively than if a patient is breathing room air. The increased partial pressure of oxygen in the lungs speeds up the elimination of carbon monoxide by increasing the gradient for its diffusion out of the blood and back into the lungs for exhalation. This treatment significantly reduces the half-life of carboxyhemoglobin, providing rapid improvement in oxygen delivery to the body's tissues.

While high-flow oxygen therapy could also be beneficial, especially in cases of respiratory distress, 100% oxygen therapy is the definitive treatment for CO poisoning and is specifically recommended because it maximizes the elimination of carbon monoxide from the bloodstream. Intravenous fluids and IV antibiotics, while important in the management of burn patients and in addressing fluid resuscitation and potential infections, do not address the