〔Abstract〕 Objective To explore the effect of emergency nursing process optimization on the rescue effect of patients with acute carbon monoxide poisoning (ACMP) and the nursing satisfaction of their family members. Methods A total of 58 ACMP patients admitted to the Third People's Hospital of Zhengzhou from January 2017 to June 2020 were selected, and they were divided into different groups according to the order of admission, with 29 patients in each group. The control group received routine emergency nursing, and the observation group implemented emergency nursing process optimization. The first aid situation (first aid response time, hospital rescue time and the disappearance time of poisoning symptoms), rescue effect (organ function damage, vital signs recovery, consciousness recovery and poisoning symptoms) and nursing satisfaction of family members of the two groups were compared. Results The time of emergency response, hospital rescue and symptoms of poisoning in the observation group were shorter than those in the control group, and the differences were statistically significant (P < 0.05). The scores of vital signs recovery, consciousness recovery and organ function impairment in the observation group were higher than those in the control group, and the differences were statistically significant (P < 0.05). Scores of nursing satisfaction of family members in the observation group were higher than those in the control group, and the differences were statistically significant (P < 0.05). Conclusion Emergency nursing process optimization can shorten the rescue time of ACMP patients, improve the rescue effect, and the rescue effect of family members with high satisfaction.