Hyperbaric oxygen may play a small but critical role in our preparedness for cyanide attacks. According to the chemical terrorism update by Coleman O. Martin, MD, in the July 2002 issue of Emergency Medicine:
Hyperbaric oxygen administration is an adjunctive therapy in patients who do not respond to cyanide antidotes. This may be particularly helpful in cases where methemoglobinemia is excessive and the patient cyanotic. Hyperbaric oxygen should also be considered in patients with cyanide toxicity from smoke inhalation because their high levels of carboxyhemoglobin can hinder safe induction of methemoglobinemia.Of course O2.0 readers will know that HBOT is approved for treating carbon monoxide (CO) poisoning complicated by cyanide poisoning after smoke inhalation. Better homeland security provides all the more reason every fire rescue squad and trauma center in the US should have 24/7 access to emergency-ready hyperbaric oxygen chambers—plenty enough to handle large-scale disasters, whether tragic accidents or unspeakable acts.