Emergency and Critical Care Hyperbaric Medicine in the United States

  • Enoch Huang, MD
  • Volume 07 - Issue 3

The field of undersea and hyperbaric medicine has gone through an evolution since the day six U.S. Navy officers established the Undersea Medical Society in 1967. At that time, the focus of the field primarily involved the treatment of emergencies — decompression sickness, arterial gas embolisms, gas gangrene, and carbon- monoxide poisoning. Over the next 50 years, the Undersea and Hyperbaric Medical Society (UHMS) has promulgated the use of hyperbaric oxygen (HBO2) for many additional indications, and the field of hyperbaric medicine has grown to include more than the treatment of emergent indications. As the interest in using HBO2 for nonhealing wounds increased, the number of facilities available for emergency and critical-care hyperbarics has dropped in recent years.

There are numerous reasons for this:

  • lack of physician interest in taking a call

  • lack of reimbursement for taking a call

  • lack of reimbursement for emergency/inpatient treatments

  • higher risk of adverse outcomes

  • lack of training and expertise in providing the service

  • lack of equipment and facilities for providing the serviceunderseahyperbaricmedicalsociety

A recent study1 showed that only 12% of hyperbaric facilities self-identified as being able to treat a patient with decompression sickness, arterial gas embolism, or carbon- monoxide poisoning if they were ventilated and required IV medications. A patient would have to be transported an average of 95 miles to be treated for these conditions.

While many of the issues underlying the decision not to provide 24/7 hyperbaric medical services are difficult to resolve, the UHMS continues to support the education and training of providers in the use of HBO2 for the full range of hyperbaric indications. As part of this commitment, we are co-sponsoring ECCHO 2016 — an emergency and critical-care hyperbaric oxygen symposium — with Legacy Emanuel Medical Center in Portland, Oregon, on November 5, 2016. This is the first symposium of its kind — focused entirely on the use of HBO2 for the emergency and critical-care patient. The theme of this meeting is how to handle the practical concerns of treating sick patients in both monoplace and multiplace facilities. It boasts a world-class lineup of speakers from around the world, with plenty of time for panel discussion and faculty- attendee interaction.

Take advantage of this opportunity to meet world-renowned experts who have been providing this type of service for decades. Registration information can be found at: http:// www.legacyhealthevents.org/d/lvqk8t.


1. Chin W., et al. (2016). Hyperbaric programs in the United States: locations and capabilities of treating decompression sickness, arterial gas embolisms, and acute carbon monoxide poisoning: survey results. Undersea Hyperb Med 43(1): 29-43.



About the Author


An active UHM reviewer, former chair of the UHMS Clinical Practice Guidelines Oversight Committee, and current chair of the Graduate Medical Education Committee, ENOCH HUANG is the current president of the UHMS and chair of the 2017 ASM program committee.


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