In a patient with smoke inhalation, what oxygen device and concentration should be used?

• A. 2 L/min Nasal Cannula
• B. Venturi Mask 50%
• C. Bilevel Positive Airway Pressure
• D. 100% NRB

Answer: (D)

When smoke inhalation is suspected, the priority is to maximize oxygen delivery to displace carbon monoxide from hemoglobin and treat hypoxemia. Administering 100% oxygen as soon as possible raises the oxygen partial pressure in the blood and speeds the elimination of CO from the body. A nonrebreather mask with a reservoir can deliver near–100% FiO2 at high flow, making it the best choice in this scenario.

Lower FiO2 options, like a nasal cannula at a low flow, provide only about a quarter of inspired oxygen and won’t effectively displace CO. A venturi mask at 50% delivers a fixed, mid-range FiO2 that’s insufficient for CO poisoning. Bilevel positive airway pressure offers airway support but does not guarantee the highest possible oxygen concentration and is not the first-line choice for initial smoke-inhalation management.