The role of hyperbaric oxygen in current emergency medical care.

HBO is the definitive treatment for carbon monoxide poisoning, air or gas embolism, and decompression sickness. It is an important adjunct to other treatment modalities in the management of patients with cyanide poisoning, exceptional blood loss (anemia), crush injury, and gas gangrene. In addition, HBO has many investigational uses such as reduction of edema in acute bowel obstruction before surgical intervention. It should be remembered that the best hope for tissue recovery occurs when HBO is initiated within 4 to 6 hours of injury. After this time irreversible muscle and peripheral nerve damage usually will have occurred in ischemic tissue.