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CO poisoning should be diagnosed in the presence of the triad of:
Symptoms of CO poisoning
History/evidence of CO/smoke exposure
Elevated COHb levels
However, it is important to remember that in the clinical environment the presentation can be ambiguous and CO poisoning should remain on the differential list of diagnoses for patients admitted with reduced GCS. If in any doubt these patients should be treated with 100% oxygen regardless of oxygen saturations.