Hyperbaric Oxygen Therapy as an Adjunct to Pre-hospital Advanced Trauma Life Support.

Most commercial diving operations and naval operations have 24/7, on-site availability of hyperbaric oxygen therapy to perform routine surface decompression or immediate treatment of arterial gas embolism or decompression sickness. Availability and prompt use of hyperbaric oxygen therapy in the field for treatment of divers with dysbaric conditions has demonstrated its efficacy in acute, co-morbid conditions such as acute exsanguination, blast injury, crush injury, and cardiopulmonary arrest affecting those same divers. Hyperbaric oxygen therapy applied in these cases has demonstrated its utility to augment the efficacy of conventional, pre-hospital advanced cardiac life support and advanced trauma life support. Case studies gleaned from actual experience with the diving industry illustrate the use of hyperbaric oxygen therapy in these conditions. The unexpectedly favorable results have been replicated by controlled laboratory animal studies. The deck decompression or saturation multiplace chambers used by offshore diving operations can easily and quickly be converted for use as medical field resuscitative units. Lightweight and mobile hyperbaric chambers can be outfitted for use in ambulances or helicopters to address civilian street injury or military "far-forward" injury. These transport chambers are compact in design to be efficient transport stretchers designed to hold both the patient and the medical support clinician. It is hoped that hyperbaric oxygen therapy will gain an increasing role as an adjunct to pre-hospital advanced cardiac life support and advanced trauma life support resuscitative efforts as a low-cost, high-yield intervention. In this regard HBO as applied to ATLS/ACLS in civilian and military medical systems may be a productive, disruptive new application of technology.