But how would this be administered to a patient? I assume it would be injected in the blood. Could it be an inhaler?
Good question. I'm decidedly dubious too, from the point of view of being a diver who has personally suffered a carbon monoxide hit from an incautiously-set-up portable compressor. (Insufficiently-cautious - the wind changed direction between starting and finishing the filling session.)
Let's see - human air consumption is highly variable with stress etc, but when planning shallow depth (but high penetration) dives we estimate with about 30L/minute of air. And Exhaled air is about 18% O2. Which makes O2 consumption around 1L/minute at NTP. Oh, goody, Wiki agrees. That would be about 1.4 g/minute, or 0.088 moles per minute.
What size of molecule is this Great New Treatment? No indication, except that it's a peptide. Guess at 100 amino acids, averaging 120 AMU per residue, which would make 12,000 AMU per molecule and 12kg per mole. It's a number ; it might even be correct.
If you're going to displace half the O2 content of the blood stream in a minute (the inverse of the amount of CO they talk of displacing), then you need to get about 0.088 * 12 kg per minute into the body. Which is just over 1kg. Per minute.
Let's take that number down a bit. If it's a tiny peptide - 10 amino acids, not 100 - you'd need to get 100g of peptide into the human blood stream in a minute. That's a pretty steep ask for something you'll need to deliver in a solution that doesn't dehydrate and destroy every blood cell it meets (read up on "isotonic" solutions).
There are a lot of caveats in that. But it looks to me as if injection into the blood stream is the only credible solution (... sorry!). Which is actually in TFS - but hidden as "a rapid, intravenous antidote".
My caveats after reading TFS is about the first mile of treatment, not the last mile. It's all very well having this in the A&E (EN_US : ER) drug cabinet, but it's not much use if the patient died before the ambulance got within 10 miles of A&E.
So, will it be on every ambulance? Doubtful - CO poisoning is quite uncommon.
Will it be on every fire engine? Only if fire engines start having a paramedic on every "shout" - which they don't (here ; I don't know about US practice, but I doubt it will be meaningfully different).
Will it be on every dive boat? Very unlikely - using an electrical or chemical test on every bottle fill would be vastly cheaper (this drug will have a shelf life). And there are enough people who have had bad fills (in various parts of the world) that most divers know to be wary of it and check every fill. It's very bad publicity for a fill-centre, and news spreads.
The current first aid for suspected CO poisoning is to supply oxygen at sufficient to relieve the patient's respiratory distress - because oxygen is already a standard part of the ambulance/ fire engine/ dive boat load-out. It's a routine consumable, with an existing supply (and resupply) chain.
For really bad cases, assuming the patient makes it to hospital without major brain damage, there is the option of going to hyperbaric oxygen - which again, many hospitals are already equipped for. (My local hospital has a 10 patient hyperbaric spread, but that's because we have 3 major commercial diving companies in town, and up to 50 divers "in sat" at any one time, within steaming distance of town.) But you don't need huge steel tanks - because of the physiology of oxygen metabolism, the maximum pressure you can apply to a patient on pure oxy is 1.8 atmospheres absolute, or 0.8 atmospheres above sea level pressure. Which is well within the "plastic inflatable treatment chamber" territory. Emergency use inflatable chambers have been on the market and in use (saving lives, regularly) for decades. The first person I personally knew who brought one (for a remote exploration expedition was fundraising for it in the mid-1990s.
I've got to ask, how much of a problem is this? It's a well-known poison (in the emergency medicine world) with a well-known treatment with a fairly good success rate. I think their sales people are going to struggle to make a sale.
This could be a lifesaver, but there's a lot of questions that need answers first.
I'm not so sure about a significant "lifesaver". Sure, a few people per country per year. What is the cost of achieving that? The normal price-per-life-saved criterion for industry is order of a couple of million dollars/ pounds/ Euros per life. And would that money save more people by buying an expensive, expiry-dated drug, or ensuring that every fire engine in the country carries oxygen equipment identical to that used by ambulance paramedics (because an ambulance almost always gets dispatched to a fire shout, until stood-down by the shout commander)?