Recently in Hyperbaric Oxygen Therapy (HBOT) Category

October 20, 2011

New Information on True Causes of Death from Smoke Inhalation: Hydrogen Cyanide Poisoning

On October 6, 2011, the Fire Smoke Coalition launched the first Smoke Inhalation Treatment Database for use by EMTs, first responders and medical professionals throughout the world.

In the United States, residential fires are the third leading cause of fatal injury and the fifth most common cause of unintentional injury death, yet the majority of fire-related fatalities are NOT caused by severe burns--they are cause by smoke inhalation.

Despite the amount of fires in the U.S. decreasing each year, the amount of civilians dying in fires is actually increasing. For example, in 2009, 1,348,500 fires were attended by public fire departments, a decrease of 7.1 percent from the year before; however, 3,010 civilian fire deaths occurred, which is an increase of 9.3 percent.

In fire smoke, hydrogen cyanide can be up to 35 times more toxic than carbon monoxide, an underappreciated risk that can cause severe injury or death within minutes. In a review of major fires over a 19-year period, cyanide was found at toxic or lethal levels in the blood of approximately 33 percent to 87 percent of fatalities.

While many fire department medical directors and physicians have altered treatment protocols to consider cyanide as a deadly poison in smoke inhalation patients, thousands still have not. Until cyanide is presumed to be responsible along with carbon monoxide, especially in victims removed from closed-space structure fires, people will continue to die of what is actually a complicated illness. It cannot be assumed that carbon monoxide is the only poison requiring treatment, or that it is the sole cause of death.

The Coalition is requesting all medical providers and physicians to enter data following treatment to smoke inhalation victims. Information collected will be available to all medical professionals, day or night, and will hopefully provide insight into "new" treatment practices that include consideration of an antidote for cyanide poisoning associated with smoke inhalation--more than just hyperbaric chamber therapy that forces high amounts of oxygen into a patient to cleanse the lungs of carbon monoxide. There are only two FDA approved cyanide antidotes in the United States--the Cyanokit®, also known as Hydroxocobalamin, is one of them.

In April, the Congressional Fire Services Institute (CFSI) passed a resolution noting that there is mounting proof, obtained through atmospheric monitoring on fire grounds throughout the U.S., that hydrogen cyanide (HCN) is a predominant toxicant found in fire smoke. The resolution calls for educating the fire service about the dangers of smoke inhalation--including those of HCN--through support of a national education program, the development of HCN poisoning treatment protocols for all local and state emergency medical services (EMS), and efforts by the Centers for Disease Control and Prevention (CDC) to establish a national database of smoke inhalation injuries, medical complications and deaths linked to HCN.

If you or someone you know suffers a burn injury or a smoke inhalation injury, you should call Kramer & Pollack LLP in Mineola, NY so that the personal injury attorneys in that firm can determine whether another party has legal liability for injuries suffered, and if the injured party has a solid legal case.

October 4, 2011

Smoke Detectors Save Lives, but Too Many Homes Don't Have Them

In late September in the small town of Greenville, NC, a popular local restaurant owner died during a fire inside his house in the middle of the night. The man's two dogs also died in the fire. Unfortunately, it does not seem that this incident had to end up this way--smoke detectors just might have saved the man's life.

Derek Oliviero was just 27 years old--young enough to be able to run from the house and avoid severe burns if he had become aware of the fire. But he died of smoke inhalation when his home stared burning because a faulty electrical outlet in the kitchen malfunctioned while he was asleep. Firefighter found the man in the house around 3 a.m. but he was unresponsive. They tried to revive him, but their efforts failed.

Neighbors witnessed the incident. "It took a long time to get him out of the house. It was really scary," said one of them.

Here is another recent story that shows just how important smoke detectors are for saving lives when fire breaks out while people are asleep. In Fort Edward, NY, a family of four was able to escape without serious harm after their home caught fire early on a Sunday morning in early October.

Two members of the family suffered only minor smoke inhalation as they fled from the house at 12:30 a.m. The local fire chief said that two parents and two young children lived in the home, and that the father was awakened by a smoke detector. He then alerted the rest of the family after discovering a fire on the first floor.

The family climbed out a second-story window onto a porch roof, and then jumped from the roof to the ground as the fire quickly spread. "The smoke alarms saved their lives," the chief said. "When we got there, fire was coming out all of the windows."

The chief said the incident served as a good reminder for people to check their smoke detectors as the heating season begins. "They're alive because of the smoke alarms," he said.

Lastly, keep in mind that smoke detectors should be in more places than just the home. Here's an example why: In late September, eleven elementary-school-aged children suffered smoke inhalation on a school bus outside Boston.

Boston police said that a possible engine malfunction caused smoke to build inside the school bus. All were reported to have minor injury from the smoke inhalation, and they were transported to local hospitals as a precaution.

In such a case, there might be legal liability on the part of the owners of the bus because of the injuries suffered by the children. Smoke inhalation can happen very quickly, and is dangerous because of the poison gases contained in the smoke. Even 5 or 10 seconds of inhaling smoke might require hyperbaric oxygen therapy to force fresh oxygen into the lungs and save the patient from death.

If you or someone you know suffers a burn injury or smoke inhalation injury, you should call Kramer & Pollack LLP in Mineola, NY so that the personal injury attorneys in the firm can determine whether another party has legal liability for injuries suffered, and if you have a solid legal case.

April 12, 2010

Hyperbaric Oxygen Therapy (HBOT)

Hyperbaric oxygen therapy is a non invasive mode of medical treatment in which the patient is entirely enclosed in a pressure chamber filled with oxygen at a pressure greater than one atmosphere.

It is a painless procedure that can be carried out in either in a monoplace chamber where only one patient is in the chamber, or a multiplace chamber where the patient along with someone else are inside the chamber. The chamber is pressurized with 100% pure oxygen.

Topical hyperbaric oxygen therapy technique includes delivering 100% oxygen directly to an open, moist wound at a pressure slightly higher than atmospheric pressure through special devices. The patients may be trained and can use these devices at home.

There are many conditions that may benefit from hyperbaric oxygen therapy such as sores and gangrene that will not heal or that are related to diabetes, decompression sickness, osteomyelitis, severe anemia and others. Healing wounds and burn victims can benefit from this treatment with its effect on body tissues and wound healing.

In severe thermal burns tissue damage will happen leading to hypoxia (insufficient supply of oxygen) and tissue death. Tissue damage may progress due to the failure of the surrounding tissue to supply borderline cells with oxygen and nutrients necessary to sustain viability. Hypoxia will prevent normal wound healing. HBOT will accelerate wound healing by providing the oxygen needed to stimulate and support wound healing.

Burned patients have increased susceptibility to infection due to the loss of skin which acts as a barrier to bacterial invasion. HBOT can be useful in treating some of these infections. It can act by enhancing leukocyte and macrophage activity, potentiating the effects of antibiotics and act directly on anaerobic bacteria.

Hyperbaric oxygen therapy is also used in the treatment of smoke inhalation. Carbon monoxide has a high affinity to hemoglobin and when it is inhaled it will bind to hemoglobin forming a compound called carboxyhemoglobin (COHb), this will lead to hypoxia and decrease oxygen delivery to tissues. Hyperbaric oxygen decreases the half life of carboxyhemoglobin and fasten the disassociation of carbon monoxide from hemoglobin making hemoglobin available for oxygen.

Side effects may include:

  • Ear and sinus barotraumas.
  • Myopia.
  • Aggravation of congestive heart failure.
  • Oxygen seizures.
  • Pulmonary barotraumas
.

The Hyperbaric oxygen therapy course will vary depending on the condition, severity and the response of the patient to therapy.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.