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Emercency Medical Services

Hyperbaric Oxygen Therapy in Emergency Medicine

HBOT in Emergency Medicine

K. Van Meter, L. Weiss, and P.G. Harch

 

As an entry from K. K. Jain's Textbook Of Hyperbaric Medicine all chapter references refer to the 4th Edition.
Hypoxemia and ischemia are the underlying pathologies in many of the conditions seen in an emergency department. In addition to resuscitation and other emergency treatments, hyperbaric oxygen plays a vital role in the management of these patients. This topic is discussed under the following headings:
 
Introduction
Timely resuscitation by augmentation of oxygen delivery to tissue damaged by ischemia is key to many emergency medicine interventions in sickness and injury. Further, the prompt attempt to lessen reperfusion injury and necrosis after initial resuscitative clinical success should not be forgotten. Finally, the patient, once past the initial resuscitative effort, followed by restorative oxygenation, should receive maintenance oxygenation as needed to optimize the chance of continued recovery. In other words, one of the major purposes of an emergency department is to first assure proper oxygen delivery to many of its sick and injured. The oxygen delivery must be adjusted to maximize therapeutic effect in the emergency medicine interventional phases of resuscitation and restoration, and the maintenance phase of patient management.
Oxygen delivery to tissue is dependent on cardiac output. Oxygen delivery to tissue is given by the following formula:
Oxygen delivery = cardiac output x arterial oxygen content 
(Shannon &Celli 1991)