I. Conventional treatment 1. On-site treatment Enter the poisoning site and quickly open the doors and windows for ventilation and air exchange, cut off the source of gas, quickly grab the patient and place him in a place with fresh air. Mild patients should be given fresh air and symptomatic treatment (pain relief, anti-emetic, etc.), and they can recover quickly. Serious patients should be placed in a flat position, unbutton their clothes, loosen their belts, keep their airways open, and pay attention to keeping warm. If breathing and heartbeat have stopped, external cardiac compressions and mouth-to-mouth artificial respiration should be performed immediately. Immediately send to the hospital to continue the comprehensive treatment of hyperbaric oxygen. 2, conventional treatment (1) accelerate the elimination of carbon monoxide, improve the body hypoxia immediate oxygen inhalation as far as possible to wear a mask high flow oxygen. (2) Reduce the intracranial pressure of severe carbon monoxide poisoning are accompanied by cerebral edema intracranial pressure is increased, you can use dehydrating agent mannitol, glycerol fructose and diuretic tachyphylaxis. (3) Correct the acid-base imbalance with small doses and repeated use of sodium bicarbonate. (4) Adrenocorticosteroid flumethasone (5) Expand blood volume Most patients with severe acute carbon monoxide poisoning have dehydration, insufficient blood volume and poor peripheral microcirculation, especially when accompanied by shock. Therefore, blood volume should be replenished in a timely manner. (6) Antioxidants (free radical scavengers) Recently, there are many drugs for scavenging free radicals, but at present, vitamin E, C, mannitol and ginkgo preparations are mainly used for rescue. (7) Brain cell energizers include ATP, coenzyme A, cytochrome C (C), vitamin B1, B6, B12, arginine, γ-aminotyrosine, brain rejuvenation, etc. (8) Calcium blocking agents can prevent Ca2+ from entering the cells, reduce calcium overload, and have the effect of vasodilatation. (9) Sedation and hibernation For patients with continuous convulsions and difficult to control high fever, sedatives should be used promptly, such as diazepam (Valium), luminal, hibernation spirit, sodium isoxobarbital, paraldehyde, etc. (10) Prevention and control of infections deeper poisoning, older, with decubitus ulcers or catheter placement should be used to prevent infection with broad-spectrum antibiotics. If lung, urinary tract or decubitus ulcer infection has occurred, adequate amount of broad-spectrum antibiotics should be used first, and bacterial culture should be done at the same time, and then antibiotics should be adjusted according to the infecting bacteria and drug sensitivity test. (11) Wake up drugs such as chloroester and cytarabine. 3.Extracorporeal counterpulsation therapy Extracorporeal counterpulsation device is to use a tourniquet to compress the limb during heart contraction and block the passage of blood. It can raise the aortic pressure, increase cerebral blood flow and promote brain cell repair. 4.Treatment of complications Including: treatment of cerebral edema, pulmonary edema, heart failure, shock, acute renal failure, extrusion syndrome, fascial interval syndrome, secondary infection, decubitus ulcers, etc. 5.Nursing Strengthen nursing care to prevent decubitus ulcers and aspiration pneumonia. Patients with high fever can be cooled by ice caps, ice packs, ice-cold water, cold saline enemas and other methods. Patients who are bedridden for a long time should strengthen the functional care of limbs and joints. The higher the partial pressure of oxygen in arterial blood, the faster the dissociation of carboxyhemoglobin and the faster the discharge of carbon monoxide. (2) Accelerate the dissociation of carboxyhemoglobin, restore the activity of cytochrome a and a3, and improve the biological oxidation of cells. (3) Rapidly corrects hypoxia in the body. Under 0.3MPa hyperbaric oxygen, the dissolved oxygen in the blood alone can meet the oxygen demand of tissues, and hemoglobin is not required. (4) Rapidly improve the metabolic acidosis of tissues due to increased tissue oxygen supply, improved aerobic oxidation, re-oxidation of acidic metabolites gathered in tissues, reduction of organic acids, and complete correction of acidosis. (5) Reduction of intracranial pressure Hyperbaric oxygen therapy constricts the systemic vasculature (but the vasculature of the vertebrobasilar artery and the liver is dilated). The intracranial blood vessels are constricted, the vascular bed is reduced, and the intracranial pressure is lowered. The effect is obvious and without the side effects of drugs. (6) Control and treatment of pulmonary edema (7) Reduce cellular edema due to correction of hypoxia, recovery of aerobic oxidation of sugar, increased energy production, and resumption of work of Na+, K+-ATPase (pump) on the cell membrane to pump out excess Na+ from the cytoplasm; turn K+ from the tissue to the cytoplasm, restore intracellular osmotic pressure, and reduce edema. (8) Reduce calcium overload hyperbaric oxygen therapy immediately corrects hypoxia and acidosis, increases energy, cell membrane permeability improves, membrane calcium pump (Ca2+, Mg-ATPase) restarts, sarcoplasmic reticulum’s ability to take up and store calcium is restored, allowing intracellular calcium overload to return to the extracellular or sarcoplasmic reticulum, restoring intracellular calcium Ca2+ concentration, and reducing tissue damage from calcium overload. (9) Repair of vascular endothelium and restoration of nitric oxide production Due to the repair of damaged vascular endothelial cells with adequate oxygen supply, nitric oxide production increases and endothelin decreases, which relaxes vascular smooth muscle and improves microcirculation. (10) Stabilize platelets and reduce secondary thrombosis because hyperbaric oxygen therapy can rapidly correct hypoxia, repair vascular endothelium, restore NO production, stabilize activated platelets, and reduce secondary thrombosis. (11) Stabilize neutrophils and reduce the inflammatory response. The mechanism is similar to that of platelet stabilization. Enhanced expression of neutrophil adhesion factors is often used in the laboratory to indicate that neutrophils are activated. (12) Reduce excessive apoptosis. There have been numerous experiments demonstrating that excessive apoptosis occurs in the hippocampus of experimental animals after acute carbon monoxide poisoning. (13) Other high concentration of oxygen also has a certain inhibitory effect on aerobic bacteria, and with antibiotics, can increase the antibacterial ability of antibiotics; hyperbaric oxygen also has an anti-shock effect.