Hyperbaric oxygen therapy (HBOT) is indicated for the emergency treatment of carbon monoxide poisoning complicated by cyanide poisoning after smoke inhalation. HBOT dissolves additional oxygen in the blood plasma and has been shown to work effectively alone and in combination with hydroxocobalamin (Cyanokit) and other cyanide antidote kits.

The emergency treatment of smoke inhalation offers perhaps the single best reason for the healthcare community to demand 24/7 access to hyperbaric chambers across the US. Cyanide, carbon monoxide, inhaled particulates, and thermal injuries together require speedy action to save the lives of firefighters and other fire victims. The clinical evidence for HBOT may not be as strong for nonfire cyanide poisoning as for nonfire carbon monoxide poisoning, but the benefits of oxygen are well established. “Oxygen and sodium thiosulfate are the most widely accepted cyanide antidotes…. The mechanism of action of oxygen as a cyanide antidote is unclear, but it potentiates the effect of other antidotes. When used in the setting of smoke inhalation, it is also therapeutic for CO poisoning. Thus, high concentrations of oxygen should be promptly delivered.” Ongoing surveillance projects and prospective trials may bolster the clinical case for HBOT in the routine treatment of smoke inhalation.

Supplemental oxygen, at normal or hyperbaric pressures, is the primary treatment for carbon monoxide poisoning. Hyperbaric oxygen therapy (HBOT) dissolves additional oxygen in the blood plasma and has been shown to block all known cellular mechanisms of CO toxicity. HBOT is also used to treat smoke inhalation in firefighters and other fire victims who suffer carbon monoxide poisoning complicated bycyanide poisoning.

Hyperbaric therapy rapidly removes carbon monoxide from the blood and body tissues. It saves lives and also prevents delayed neurological sequelae in survivors.

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