Physician Sets the Record Straight on Hyperbaric Medicine

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Inaccurate portrayal minimizes necessity of hyperbaric oxygen therapy after any level of carbon monoxide exposure

Hyperbaric oxygen therapy should be considered after any level of carbon monoxide exposure, not just in extreme situations, notes physician Richard W. King Jr., medical director of one of the nation’s largest hyperbaric medical facilities. Dr. King of Atlanta-based HyOx Medical Treatment Center disputes a recent depiction of this important treatment for carbon monoxide poisoning in the popular NBC series ‘ER’.

Hyperbaric oxygen therapy rapidly infuses the body with a high concentration of pure oxygen to rid the body of toxins and promote healing. This treatment is used for many medical conditions, ranging from carbon monoxide poisoning to wound healing and is administered in a pressurized chamber.

In the ‘ER’ episode, which aired Feb. 19, a family is brought into the emergency room after a pregnant woman finds her husband and two children unconscious in their home. The woman gives birth and learns that the infant has high levels of carbon monoxide in his blood.

The newborn is rushed to a hyperbaric chamber in the hospital, while the other family members are treated for carbon monoxide exposure with oxygen administered through a mask in the
emergency room.

“Every member of that family should have had hyperbaric oxygen therapy,” Dr. King said. “Unfortunately, the ‘ER’ physicians’ chose not to recommend it for the entire family.”

Long-Term Risks of Carbon Monoxide Poisoning Under-recognized

Once a person is removed from the source of poisoning, tests of blood oxygen levels typically administered in an emergency room do not reveal the true level of exposure the person may have experienced, Dr. King notes. And there is no formula for what level of exposure can pose long-term health risks.

“Numerous medical studies have demonstrated permanent mental impairment resulting from carbon monoxide exposure,” Dr. King said. “The person who has been exposed can feel fine, while carbon monoxide is still causing significant cognitive damage over the weeks following the initial exposure.”

Dr. King cited a study from the New England Journal of Medicine (October, 2002), that demonstrates substantial reduced risks of cognitive damage if hyperbaric oxygen treatments are administered within 24 hours of exposure.

The study showed that the incidence of impaired mental function in patients given emergency hyperbaric oxygen therapy immediately after they breathed in excess carbon monoxide was nearly 50 percent lower than in patients who received “normal pressure” oxygen, administered through a mask in the emergency room. Patients who received hyperbaric oxygen therapy showed markedly fewer cognitive deficits at six weeks and one year after they were first exposed to carbon monoxide.

An estimated 40,000 Americans are treated annually for excess exposure to carbon monoxide. Mental impairments caused by exposure can range from inability to focus or concentrate to substantial memory problems.

“Just like the symptoms of carbon monoxide poisoning, the long-term effects are often attributed to other factors,” Dr. King said. “It is critical that any person who has been exposed to carbon monoxide be informed about hyperbaric oxygen therapy as a treatment option.”

Hyperbaric oxygen therapy’s use for carbon monoxide poisoning is covered by most insurance plans.

A Disservice to the Field

Dr. King also noted that the depiction of the experience of patients and medical personnel in a hyperbaric chamber was misrepresented. On the show, the facility was represented as a scary, uncomfortable environment only used in extreme circumstances.

“The patient and staff experiences in a hyperbaric chamber shown on ‘ER’ were not typical,” Dr. King said. “Most multi-patient hyperbaric chambers are very comfortable, allowing patients and attendants to relax in comfortable seats, snack and watch movies. Only certified medical personnel with experience in hyperbaric oxygen therapy are allowed to aid patients.

Pressure levels are carefully monitored and gradual changes in atmosphere are introduced to maximize comfort and safety.”

Today, hyperbaric oxygen therapy is used to treat numerous medical conditions, including wounds and tissue damage caused by radiation.

“Hyperbaric oxygen is a proven medical therapy that yields positive results when applied appropriately. The field of hyperbaric medicine has been undermined by inaccurate portrayals on television and inappropriate applications of it for personal or experimental uses,” King said.

“Hyperbaric oxygen therapy must be administered in a professional facility and for conditions that are proven to be beneficial, such as carbon monoxide poisoning.”

About HyOx Medical Treatment Center

HyOx Medical Treatment Center in Atlanta, Georgia, is one of the nation’s most comprehensive outpatient rehabilitation facility focused on hyperbaric medicine and wound care. Each year, the HyOx team provides more than 2,500 hyperbaric oxygen treatments for various conditions, ranging from diabetes-related non-healing wounds and crush injuries to carbon monoxide poisoning and soft tissue damage from radiation. Board-certified physicians are available on site to supervise patient care and treatment schedules. Treatments are prescribed based upon the directives of the referring physician and the results of a comprehensive hyperbaric medicine consultation and evaluation. For more information on HyOx, visit www.hyox.com, or contact Meridith Kelly at 678-303-3200.