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A Sad State of Affairs October 25, 2009

Posted by Chris Sullivan in Technical Diving.
Tags: , , , , , , ,

Yesterday (October 24th, 2009) I attended the 30th annual meeting of  the  Great Lakes Chapter of the Undersea and  Hyperbaric Medical Society. For reasons I’ll explain at another time, this is probably the last meeting of the chapter, due to reorganization of the parent society.

There were many interesting talks, but one thing really stuck in my mind about the state of hyperbaric medicine in Canada – and that is that it isn’t taken seriously enough. Hyperbaric medicine is used in the treatment of several ailments, including

  1. Air  or gas embolism
  2. Carbon monoxide poisoining
  3. Clostridial  myositis and myonecrosis (gas gangrene)
  4. Crush injury, compartment syndome and other acute ischemia
  5. Decompression sickness
  6. Enhancement of healing in selected problem wounds
  7. Exceptional anemia
  8. Intracranial abscess
  9. Necrotizing soft tissue infections (like necrotizing fasciitis a.k.a. flesh-eating disease)
  10. Ostemyelitis
  11. Delayed radiation injury
  12. Grafts and skin flaps
  13. Thermal burns

One particular aspect of the above was in  the treatment of diabetic foot ulcers, which often would otherwise result in amputation. With the population (like me) aging, diabetes is becoming more common and the incidence of this problem will grow proportionately.

However, when we visited the Hyperbaric Facility at Toronto General Hospital and asked why it wasn’t in use at that time, the reply was that there was no funding to pay for technicians. Meanwhile it seems that private hyperbaric facilities are popping up all over the place for treatments that have no proven benefit, putting, as we heard, the situation as on where a clinic “can charge patients for hyperbaric oxygen therapy for conditions that is doesn’t work for, but cannot charge for condition for which it can”.

Per capita Canada has about 10% of the number of chambers as the US available for physician-prescribed HBOT. Part of this I’m sure is the stringent controls on private facilities  that  can avail themselves of  government funding,  and of public facilities  that can access private funds (i.e extra-billing  which was outlawed decades ago  by the government of Pierre Trudeau).  But it also seems there is a general ignorance and/or  scepticism with regard the to usefulness of HBOT, and the leaders of the  chapter are campaigning for greater awareness and education amongst the medical community.

Let’s hope they succeed. Access to recompression chambers for emergency use  is essential to divers, but actually provide greater benefits to the general public. That’s a double win.



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