The red discolouration of mucous membranes caused by the presence of carboxyhaemoglobin is a post-mortem oddity, NOT a clinical sign. You need more than 40% or so COHb to make this colour visible to the human eye, by which time the victim will probably be unconscious.
The absorption spectrum of COHb does affect the way
pulse oximeters behave, but it cannot, and must not, be used as a clinical “rule-out” sign for possible exposure.
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