Some victims of carbon monoxide poisoning have a reddish coloration or ruddy complexion, but most patients do not.
Mechanism: Carbon monoxide binds tightly to hemoglobin, forming carboxyhemoglobin. This has a reddish color which may affect the skin, mucous membranes, viscera and skeletal muscles.
Facts about the reddish color of carbon monoxide:
(1) It tends to be seen in people who have died of carbon monoxide poisoning.
(2) Many patients with carbon monoxide poisoning do not show a visible change in color, so the absence of color change does not exclude the diagnosis.
Reasons why some people show the reddish color and others do not:
(1) A person who dies from carbon monoxide poisoning may have a higher carbon monoxide concentration resulting in greater color.
(2) The reddish color may be obscured by skin pigmentation or cyanosis.
(3) Perfusion of the skin may be reduced.
(4) With adequate resuscitation the amount of carbon monoxide may decline.
