Hyperactive hyberbarics

David Whalen
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Spate of carbon monoxide poisonings increases demand for hyperbaric treatment

The room in Memorial University's Medical School that houses the province's four hyperbaric chambers has been busier than usual this winter.

Doctors in the province have noted an upsurge of people affected by carbon monoxide poisoning. Dr. Ken LeDez, the head of the hyperbaric medicine program at the MUN faculty of medicine, blames the increase on unseasonably cold weather early in the season. LeDez said he has treated roughly a dozen people for carbon monoxide poisoning this year, compared to the usual one or two he normally sees by this point in the year.

Dr. Ken LeDez, medical director of Medicor, peers through the hyperbaric chamber at the Health Sciences Centre in St. John's. Photo by Rhonda Hayward/The Telegram

The room in Memorial University's Medical School that houses the province's four hyperbaric chambers has been busier than usual this winter.

Doctors in the province have noted an upsurge of people affected by carbon monoxide poisoning. Dr. Ken LeDez, the head of the hyperbaric medicine program at the MUN faculty of medicine, blames the increase on unseasonably cold weather early in the season. LeDez said he has treated roughly a dozen people for carbon monoxide poisoning this year, compared to the usual one or two he normally sees by this point in the year.

LeDez said most cases arise from people operating various kinds of engines in confined spaces, especially garages.

"We've seen some very serious cases of poisoning, so we're concerned about that," he said. "We want to get the message out not to operate an engine in a confined space indoors."

Carbon monoxide is heavier than air, so it can linger in space. Depending on wind and temperature, carbon monoxide poisoning can conceivably occur even when a garage door is open.

Most carbon monoxide poisoning cases this year have come from the west coast of the island. LeDez said new blood monitoring equipment in Corner Brook has helped identify more cases than usual. These patients are then being sent to St. John's for hyperbaric therapy.

"They're recognizing the cases without delay and they're calling us," LeDez said. "Part of our concern is that although we're seeing this upsurge on the west coast, that doesn't mean it's not happening everywhere else. We know it likely is."

Essentially, a hyperbaric chamber blasts the carbon monoxide in a patient's bloodstream with oxygen. Patients breathe 100 per cent oxygen at increased atmospheric pressure. The oxygen helps detach carbon monoxide from the blood and muscles, while restoring tissue damage by the gas.

"Even if patients look pretty good when they went in, they come out feeling a lot better and they start to realize how unwell or slow their thinking was beforehand," LeDez said. "Sometimes it's very striking."

LeDez said people who've been exposed to carbon monoxide should be tested afterwards, even if they feel better a day or two later.

He said ongoing after-effects can take hold up to eight weeks after exposure.

Long-term effects may include brain damage, personality and psychiatric changes, memory impairment, and tremors.

"Not everybody in the public, rescue services, or health care is fully aware that delayed damage can occur," he said.

"Even if you appear to be making a good recovery initially, that recovery may not be as complete as it might seem."

Besides treating carbon monoxide poisoning, the hyperbaric chamber can treat people with diseases like cancer and diabetes, often offsetting the need for limb amputations.

The general upsurge in activity had led the faculty to consider increasing its staffing levels. Currently, the school has only one employee permanently dedicated to hyperbaric therapy. LeDez said bringing a team including himself, one other physician, and a group of intensive care unit nurses can occasionally be chaotic.

"We're looking to recruit more personnel because our workload, not just for emergencies, but for elective cases, has increased in the last number of years partly because of the type of population we have.

"We have a lot of people with diabetes, vascular diseases, and various types of cancers."

david_whalen@hotmail.com

Organizations: MUN

Geographic location: Corner Brook, St. John's

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