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BHOT and CO Poisoning

Discussion in 'Marine Science and Physiology' started by Akimbo, Aug 24, 2017.

  1. Akimbo

    Akimbo Lift to Freedom Volunteer Staff Member ScubaBoard Supporter

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    This article got me wondering: Why Are Fewer Chambers Available for Emergencies?

    OK, I get it. Emergency chamber treatment is too expensive for divers (explained in article), but what do hospitals do when the EMTs drop off a CO (Carbon Monoxide) poisoning victim? Make them wait until the HBOT crew starts the next morning?
     
    Last edited: Aug 24, 2017
    klausi likes this.
  2. Duke Dive Medicine

    Duke Dive Medicine Medical Moderator Staff Member

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    Akimbo,

    EMS agencies usually know which chambers in their areas will do emergency treatments and which won't. Duke Health Raleigh, UNC Chapel Hill and Wake Med in Raleigh all have wound clinics with monoplaces, but all of the emergencies come to Duke main campus since the others operate only during business hours. There are entire states without emergency chambers.

    Best regards,
    DDM
     
    Akimbo likes this.
  3. Akimbo

    Akimbo Lift to Freedom Volunteer Staff Member ScubaBoard Supporter

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    I don't know how many CO poisoning cases could be treated but my impression is it is it is a much bigger number than diving accidents. This site says there are about 5K cases/year in the US but I couldn't find how many were treatable (not DOA).

    Average Annual Number of Deaths and Death Rates from Unintentional, Non–Fire-Related Carbon Monoxide Poisoning,*† by Sex and Age Group — United States, 1999–2010

    I also wonder how many more cases could be treated that were fire-related? It wouldn't be that complicated to put a computer-controlled emergency CO treatment mode on a monoplace chamber.
     
  4. 2airishuman

    2airishuman Solo Diver

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    Location: Greater Minnesota
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    We have one emergency hyperbaric facility in the region that I believe has two chambers. CO poisoning accounts for nearly all of its use with but a handful of diving emergencies a year (sometimes none).

    I understand that CO cases were declining for quite some number of years but have gone back up with the increased popularity of portable electric generators.
     
  5. Duke Dive Medicine

    Duke Dive Medicine Medical Moderator Staff Member

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    We're one facility and I'm sure the patient population changes with geographic location, but our CO poisoning patients far outnumber our divers. We see bursts during power outages due to improper generator use like @2airishuman mentioned. We've had some small clusters that involved hookah smoking which generated this paper:

    Research report: Charcoal type used for hookah smoking influences CO production. - PubMed - NCBI

    We figured out that quick-light hookah charcoal gives off quite a bit more CO than natural hookah charcoal.

    @Akimbo, there are computer-controlled chambers out there, but they also need staff who understand what to do in the event of an emergency and who can take care of critically ill patients. Some of our CO patients come intubated.

    Best regards,
    DDM
     
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