As colder temperatures approach our area, the risk for acute domestic carbon monoxide poisoning increases. Faulty heating systems, such as space heaters, fireplaces, furnaces and water heaters, along with power blackouts and the use of cheaper, but dangerous, heating methods during difficult economic times make fall and winter the prime time for deaths caused by carbon monoxide (CO), often called the “invisible killer.” An estimated 15,000 emergency department visits and 500 unintentional deaths in the United States occur each year as a result of accidental CO exposure.
One way to help patients exposed to CO leaks is with hyperbaric
oxygen therapy (HBOT). HBOT increases the amount of oxygen dissolved in the
blood by exposing the patient to increased barometric pressure within a sealed chamber.
Without HBOT, it takes about seven hours for toxic levels of carbon monoxide in
a patient’s bloodstream to decrease by half; however, HBOT reduces the
half-time of carbon monoxide to just 23 minutes.
Greater Baltimore Medical Center’s (GBMC) HBOT, located in the hospital’s Wound Care and Hyperbaric Medicine Center, treats patients in accordance with Medicare and the Undersea and Hyperbaric Medical Society (UHMS) guidelines. It is one of six medical facilities in the Baltimore region to offer HBOT. The GBMC Wound Care and Hyperbaric Medicine Center has one of the largest monoplace HBOT units in the nation, with six solo chambers and the capacity to treat 24 patients a day.
“In alignment with UHMS standards, all treatment protocols are evidence-based and are supported by substantial, documented research on the beneficial effects of this therapy for each medical condition treated at our hospital,” says Ziad Mirza, MD medical director of the Wound Care and Hyperbaric Medicine Center at GBMC “Hyperbaric oxygen therapy is a safe and effective treatment for patients who have suffered from acute CO poisoning. HBOT delivers oxygen straight to the organs and allows the body to resume normal function.”
CO is a colorless, odorless toxic gas
produced by incomplete combustion of fuel. At low levels, symptoms are very
deceptive, because they can resemble the flu, food poisoning or other
illnesses. Even healthcare
professionals might not immediately suspect CO poisoning. Minor to
moderate levels of exposure can trigger headaches, fatigue, shortness of
breath, nausea and dizziness. Victims can become mentally confused or even
“It is easy to overlook the symptoms of CO poisoning, and prolonged exposure can be fatal. Know the symptoms of CO poisoning and never ignore them, especially if others are experiencing them too. The consequence for not acting can be severe neurological damage or death,” adds Mirza. “Get to the hospital for emergency care immediately and say that you suspect CO poisoning. If you call an ambulance, make sure the ambulance crew knows you have symptoms of CO poisoning.”
HBOT is administered in a solo chamber of clear acrylic allowing a GBMC-trained technician and physician to closely monitor the patient and permits the patient to readily see outside the chamber. Patients are in constant view and communication with the attending technician via an intercom. During treatment, which can last 90 minutes or more, a patient lays on a stretcher inside the chamber. When the doors are sealed, technicians slowly raise the chamber’s barometric pressure to the desired levels to treat the patients inside. Technicians can raise the barometric pressure up to three atmospheres, or the equivalent of about 66 feet below sea level. During the treatments, the patient breathes 100 percent oxygen inside a pressurized chamber, quickly increasing the concentration of oxygen in the bloodstream. These changes can improve blood circulation and the blood’s ability to deliver oxygen to the body. When the session ends, they slowly depressurize the cabin. The length of time that a patient must remain in the chamber varies according to the CO saturation level of the blood.
Mirza says that clinical studies have shown that HBOT is an effective treatment for other health conditions besides CO poisoning, such as chronic bone infection, diabetic wounds of the lower extremities, delayed radiation injury, compromised flaps and grafts and necrotizing infections.
“Approximately 5 million people in our country suffer from chronic, non-healing wounds. Since the inception of our Wound Care and Hyperbaric Medicine Center in 1991, we have healed nearly 16,000 wounds. This tremendous achievement is due to the availability of advanced therapies such as hyperbaric oxygen therapy as well as the specialized training and hard work of our wound care team,” says John R. Saunders, Jr., MD, chief medical officer of GBMC Healthcare.
A patient with acute CO poisoning may require only one treatment. Medicare and most healthcare plans reimburse for HBOT for the treatment of CO poisoning. The patient’s response to hyperbaric treatment ultimately affects the exact number of treatments and health insurance companies may require pre-authorization for those treatments.
Hyperbaric Medicine at GBMC
GBMC HealthCare includes Greater Baltimore Medical Center, a 255-inpatient bed acute care not-for-profit hospital which opened in 1965; Greater Baltimore Medical Associates, a group of more than 40 multi-specialty physician practices on the hospital’s Towson campus and in off-campus locations across the region; Greater Baltimore Health Alliance, a network of employed and community-based clinician partners working collaboratively to provide better health and better care at a lower cost, Gilchrist Hospice Care, Maryland’s largest hospice organization offering in-home care, a 34-bed inpatient center on the GBMC Towson campus and a 10-bed inpatient center in Howard County; and the GBMC Foundation, which raises funds to support the organization’s mission. For more information, visit www.gbmc.org