New York State Police use to keep a helicopter on standby to evacuate diving officers to the nearest chamber-equipped hospital in case of a decompression emergency. Now, through an arrangement with a local dive shop and Jefferson County, the Special Tactics and Rescue (STAR) team operates its own hyperbaric chamber at the Brownville Fire Department. The 6.0-atmosphere multiplace chamber is the only one accessible to New York's 50 state and county divers, from New York City to Buffalo, for practice and emergency use. For these rescuers deep dives usually involve retrieving drowning or murder victims. Thankfully the chamber has been used exclusively for training drills since it was installed two years ago. But what a good idea to keep dedicated equipment at the ready to keep these dedicated professionals safe.
(Photo: Norm Johnston/Watertown Daily Times. State troopers on a chamber training run.)
Soon your cell phone may grow a nose that constantly sniffs the air for carbon monoxide and other dangerous airborne chemicals. Not only would this electronic innovation make your phone a personal CO detector, it could also alert civil defense authorities and emergency first responders to chemical events in real time.
Scientists at UC San Diego and Rhevision developed the tiny detectors, which use supermacro lenses to watch silicon chips that change color when exposed to airborne chemicals. Patterns of color on a single chip can signal a wide variety of toxic hazards.
UCSD's Michael Sailor and team are busy working on prototypes for cell phones and firefighter helmets. The project is funded by the Department of Homeland Security.
Thank you, Medgadget, for alerting us to another amazing new technology.
One of our chief missions is to raise awareness and help increase 24/7 access to HBOT chambers at emergency rooms for victims of thermal burns, smoke inhalation, and carbon monoxide poisoning. (Review our past coverage here.) So we were especially pleased to discover a new posting of a 2007 talk by Dr Fred Fiesseler of Morristown (NJ) Memorial Hospital. Drawn from case studies and a review of the medical literature, Fiesseler's presentation reaffirms our commitment to this mission. To listen to the audio file follow this link:
Going forward we will be identifying ER-accessible chambers in our treatment center directory and partnering with emergency medical associations and innovative companies like Healthagen to spread this lifesaving information far and wide.
Of course some political activism may be in order, too, and count on HyperbaricLink to be there.
Burnt and sunk a week ago in 5,000 feet of water 50 miles off the Mississippi Delta, the Deepwater Horizon oil platform has presented huge challenges for first responders and cleanup crews. US Coast Guard pilots and EMT divers (see video below) braved the flames to evacuate 17 injured and return 100 other workers to their families. Days of nonstop searching turned up none of the 11 missing and presumed dead.
Now robot submarines the size of pickup trucks are leading the effort to plug the well and prevent an even bigger environmental disaster, as the oil slick oozes toward the Louisiana coast. Working at depths where no diver could possibly go, the robots bring spotlights, still and video cameras (Coast Guard photo above), and diamond-edged sawblades to the deepwater scene.
Hyperbaric emergency preparedness plays a small but important role in such a tragedy. Victims reportedly suffered burns and smoke inhalation. Search-and-rescue teams, too, face serious risks of burns, smoke inhalation, and decompression illness. We've yet to learn where the injured were evacuated and how they are being treated.
Confirmation arrives late that the US Senate's year-end spending bill, a whopping $1 trillion that barely escaped a filibuster Sunday, includes a $400,000 earmark for replacement of Hennepin County Medical Center's aging hyperbaric chamber. We'd like to think our fall coverage played a small part (but know better). Here's wishing HCMC speedy project funding and completion.
One shudders to think of it, but cyanide poison has become an all-too-imaginable weapon of terror in these troubled times. Maybe we're especially troubled, writing to you from Chicago, home of the 1982 Tylenol murders and the subway scare of 2002.
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) poisoningcomplicated 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.
As the mercury falls in Minnesota, so rises the battle cry to save Hennepin County Medical Center from deep budget cuts. Without swift legislative action, before March 2010, the state's only 24/7 emergency-ready hyperbaric chamber is sure to shut down. (See our October 4 story, "Embattled MN Chamber Faces Ax.")
HCMC is fighting back. Making savvy use of online social media and good old-fashioned grassroots politics, the new Will You Lose? campaign underscores the medical center's proud history and modern role in disaster preparedness and statewide emergency healthcare access, especially for the uninsured. It also offers a great way for the hyperbaric medicine community to get involved. Please join O2.0 in signing up and spreading the word.
(Pictured: Jim Harris, CHT, at the HCMC chamber controls. Photo: Jim Gehrz, Star Tribune)
Thanksgiving arrived a little early this year in Boston. At a feast two weeks ago today, the Mass Eye & Ear community honored legendary broadcaster Norman Knight, the man who gave the infirmary and the state their first hyperbaric chamber. Even as they were toasting Knight's philanthropy, 14-year-old smoke inhalation victim Shavonne Richards lay recovering at the Norman Knight Hyperbaric Medicine Center. (See also our November 13 post and the November 15 Boston Globe story.)
Not all such young women and not all American cities are so lucky. Reliable access to 24/7 emergency-ready chambers in the US is spotty, at best, and aging equipment and economic woes only compound the problem. Part of the HyperbaricLink mission in 2010 will be to help expose and address this unmet need.
Our thanks this day to all our first responders and to people like Norman Knight, whose quiet generosity and clear vision keep us safer.
We note with enthusiasm the prompt application of hyperbaric oxygen therapy in this recent news story out of Boston. Unconscious in a burning building, the victim was rescued by brave, capable Boston firefighters, Massachusetts General Hospital's excellent ER staff, and the Norman Knight Hyperbaric Medicine Center at the Massachusetts Eye and Ear Infirmary. In cases like this, HBOT can provide lifesaving treatment for thermal burns, smoke inhalation, and carbon monoxide poisoning within the golden hour after the traumatic event.
While the trip from Dorchester to the Mass Eye and Ear Infirmary is a short one by ambulance, there are undoubtedly communities without such ready access to an emergency hyperbaric facility. An update to our treatment center directory will provide an index of chambers with 24-hour access and emergency response capabilities.
You've got to love a website that touts itself as "the finest public digital expert site available." It's Carbon Monoxide Headquarters and it's a little bit wacky but undeniably chock-full of information. Favorite click-through: The canary button that loads data from a 1912 study comparing birds to mice as an early warning system for coal miners. Another light reminder to purchase and plug in yours.
We still hear America heating. Recent close calls involving 30 middle-schoolers in North Dakota and a family of four in Michigan should remind us all to get our furnaces tuned up for the season and plug in those carbon monoxide (CO) detectors. You might also want to check if your local emergency room enjoys 24/7 on-call access to a hyperbaric oxygen chamber. And don't forget Canada, where emergency HBOT was already scarce before one major center in St John's, Newfoundland, went offline earlier this year. We worry the sluggish economy is choking off our best chances for the prevention and treatment of CO poisoning.
We hear America heating. Everywhere the old furnaces are kicking on this weekend, and so the carbon monoxide season begins. Firefighters rushed eight Utahns to the local hyperbaric chamber. They're hanging on by their chattering teeth in the Twin Cities (see below). How's your town set for the right lifesaving equipment?
Land of 10,000 Lakes and just one trauma-grade hyperbaric chamber? Things were looking bad enough for Hennepin County Medical Center's 45-year-old chamber, kept in service with great care by the only emergency HBOT facility in Minnesota. Well, forget a replacement anytime soon. Now, after the defeat of state healthcare legislation, the program's very survival hangs in the balance. This is a vital public health issue, and O2.0 urges national leadership from the hyperbaric medical community. Shouldn't every Level 1 trauma center in America have a reliable chamber? Surely we can count on firefighters, EMTs, hospitals, and ERs to join the cause.
Carbon monoxide, "the silent killer," is responsible for more poisonings than any other source in the industrialized world. As reported in the New York Times last year, recent research suggests as many as 11,000 undetected cases of CO poisoning occur annually. At particular risk are firefighters, who work takes them into close proximity with CO and other harmful products of combustion.
Detecting carbon monoxide poisoning in the field or in the emergency room can be difficult, since the symptoms are often flu-like and may be misdiagnosed as being caused by another condition. Early detection is critical. CO leaves the bloodstream quickly, but its effects on heart tissue and the brain can be lasting.
Last year a leading manufacturer of medical devices, Masimo, introduced a pulse oximetry device, the finger clip familiar to hospital patients, that can detect both oxygen and carbon monoxide levels in the blood. With the device, emergency room personnel and first responders have a better chance of identifying high levels of CO in the blood.
Now the company is working with the International Association of Firefighters (IAFF) on a campaign to increase CO poisoning awareness and encourage firefighters to have their CO levels checked at the scene. Because the risks are significant and early detection critical, it's essential firefighters and other first responders understand the symptoms of CO poisoning and have the tools to identify it promptly.
We applaud their efforts. At HyperbaricLink we have a special interest in the issue of carbon monoxide poisoning and its neurologic effects. We also see the potential for increasing use of HBOT in first responder work and willcover both topics with dedication.
Although a multi-center, randomized controlled trial has not been conducted, hyperbaric oxygen therapy is used to treat both acute and chronic CO poisoning and the neurologic effects that result. The HyperbaricLink Evidence Index identifies four clinical trials being conducted to learn more about the treatment of CO poisoning with HBOT. The Undersea and Hyperbaric Medical Society, which approves the use of HBOT for CO poisoning, provides additional information here.
Stay turned for the latest news about HBOT treatment protocols for carbon monoxide poisoning and hyperbaric oxygen in emergency medicine.
Firefighters and fire victims face really tough odds—a mortality rate of 29%—when they suffer both burns and smoke inhalation. Hyperbaric oxygen therapy has become a well-accepted and approved treatment for fire-related burns, thermal lung damage, and carbon monoxide and cyanide poisoning.
One major study had to be stopped early because investigators and statisticians decided patients should not be denied the benefits of HBOT.
O2.0 did a quick review of the clinical evidence on hyperbaric oxygen for treating smoke inhalation injury and preventing neurologic complications. There's a disturbingly common theme. Access to HBOT for fire emergency victims has been slowed not by the clinical evidence, not by the health economics, but by the poor availability of facilities.
New York State Police use to keep a helicopter on standby to evacuate diving officers to the nearest chamber-equipped hospital in case of a decompression emergency. Now, through an arrangement with a local dive shop and Jefferson County, the Special Tactics and Rescue (STAR) team operates its own hyperbaric chamber at the Brownville Fire Department. The 6.0-atmosphere multiplace chamber is the only one accessible to New York's 50 state and county divers, from New York City to Buffalo, for practice and emergency use. For these rescuers deep dives usually involve retrieving drowning or murder victims. Thankfully the chamber has been used exclusively for training drills since it was installed two years ago. But what a good idea to keep dedicated equipment at the ready to keep these dedicated professionals safe.
