# Rapid Initiation of Hyperbaric Oxygen Therapy for Multiple Simultaneous Cases of Acute Carbon Monoxide Poisoning at a Single Center

## TL;DR

This paper describes the successful treatment of 11 patients with acute carbon monoxide poisoning using hyperbaric oxygen therapy at a single hospital in Japan.

## Contribution

The study demonstrates the feasibility of managing multiple simultaneous carbon monoxide poisoning cases using HBOT in a single facility.

## Key findings

- All patients received normobaric oxygen and those with severe conditions underwent HBOT within 3 hours of hospital arrival.
- Symptoms resolved completely within 2 to 4 weeks with no physical or cognitive sequelae.
- The study emphasizes the importance of disaster medicine training and coordination in managing mass casualty incidents.

## Abstract

Hyperbaric oxygen therapy (HBOT) is used to treat acute carbon monoxide poisoning. However, few reports have detailed its use in large patient cohorts, and optimal management guidelines have yet to be established. Herein, we report the clinical presentation and simultaneous treatment of multiple patients experiencing acute carbon monoxide poisoning on an offshore ship within the territorial waters of Japan.

Eleven patients were promptly transported to our hospital from a Japanese Maritime Self-Defense Force destroyer owing to accidental acute carbon monoxide poisoning. We opted to treat this incident as a mass casualty and immediately appointed a medical control officer and established medical teams. The medical control officer guided the general treatment plan and coordinated with the various sections, and the medical teams treated the patients. The patients were immediately administered normobaric oxygen via a facial mask. Those with the most severe conditions underwent simultaneous HBOT within 3 hours of hospital arrival. Two and 4 weeks after the second therapy session, all symptoms had resolved, with no physical or cognitive sequelae.

We report the successful treatment of patients with concurrent acute carbon monoxide poisoning via HBOT at a single facility. This report highlights the feasibility of efficacious treatment at a single facility in scenarios in which multiple individuals experience carbon monoxide poisoning. It is important that all staff members, including those in administration, understand the concept of disaster medicine. Additionally, in HBOT facilities, regular training is needed for events involving a large number of HBOT-indicated patients.