Chamber only one of its kind in state
CHARLESTON, W.Va. - A Rhode Island construction worker received life-saving treatment after being exposed to carbon monoxide last week, thanks to St. Francis Hospital's hyperbaric chamber.
Bain Edmundson, 49, of Barrington, R.I., an employee of Rosciti Construction Group, was hospitalized last Tuesday after being found unresponsive in his hotel room.
Edmundson and co-workers were staying at the Holiday Inn Express along Corridor G. A ventilation pipe, meant to send fumes produced by the hotel's pool gas heater to the roof, was disconnected and pumped carbon monoxide into some guest rooms.
Edmundson's roommate, William Moran, 44, of Warwick, R.I., was pronounced dead at the scene.
Edmundson was originally transported to Charleston Area Medical Center's General Hospital before being transferred to St. Francis. That hospital has the only critical-care hyperbaric chamber unit in West Virginia. Other than it, the closest emergency hyperbaric chamber unit is in Pittsburgh.
"Every minute can make a difference when you're looking at losing brain and heart tissue," said Dr. Lester Labus, Edmundson's doctor at St. Francis.
When patients are exposed to carbon monoxide, molecules of the colorless, odorless gas bond to hemoglobin, the oxygen-carrying protein in red blood cells. The carbon monoxide bonds so tightly the hemoglobin can't carry oxygen any longer, slowly suffocating the person.
Labus said it's almost like a stroke or a heart attack except oxygen is cut off to the entire brain and heart, not just a portion of those organs.
Unfortunately, carbon monoxide is also difficult to remove from the body.
Labus said it takes about five hours for a patient to get rid of half the carbon monoxide in their body by breathing normal room air. That time drops to about 45 minutes if patients breathe pure oxygen, but even that's too long to wait.
Carbon monoxide reaches its half life in about 23 minutes when patients are in a hyperbaric chamber breathing pure oxygen. The pressure helps the oxygen to dissolve in their blood streams.
Edmundson came to St. Francis with 42 percent carbon monoxide in his blood.
"His exposure was tremendous," Labus said.
Most people have zero carbon monoxide in their blood. Smokers have 4 to 9 percent, with the percentage increasing as they smoke more.
Patients start showing mild symptoms when their carbon monoxide levels are between 10 and 20 percent, Labus said. Those can include nausea, fatigue and headaches.
At 20 percent and up, more serious symptoms begin. Patients experience seizures or die when carbon monoxide levels in their blood reach 50 or 60 percent.
After one treatment, Edmundson's levels dropped from 42 to 0.7 percent.
Patients with carbon monoxide poisoning usually receive up to five treatments, depending on the level of exposure, Labus said. Some need only one 90-minute treatment. Edmundson needed three.
Hyperbaric chambers originally were used to treat divers suffering from decompression sickness, or "the bends."
If divers resurface too fast, their bodies don't have time to adjust to the pressure change and nitrogen bubbles form in their blood. Those tiny bubbles can cause big problems, including excruciating joint pain, paralysis, breathing problems and muscle death.
The hyperbaric chamber allows divers to relive the dive and resurface correctly. The air pressure shrinks the nitrogen bubbles and they dissolve as patients slowly "submerge."
Eventually, doctors began to find other uses for the chamber.
Labus said the St. Francis chamber is used mostly to treat wounds caused by radiation treatments and diabetes. The pressurized oxygen helps create new blood vessels and allows oxygen to travel to tissue it normally cannot reach.
Once patients are fully "submerged," the pressure on his or her body is the same as if they were 66 feet under the sea.
"You're diving. Your body doesn't know the difference between air and water pressure," said Amanda Habbox, a registered respiratory therapist in St. Francis' hyperbaric unit.
It takes half an hour for the chamber to pressurize, and the same amount of time for it to decompress.
Patients remain "at depth" for 90 minutes. They pass the time by talking to nurses through the intercom system or watching television. The TV is on the outside of the chamber but nurses can patch the audio through the chamber's intercom system.
"Any movie you want, we go to the video store and get what you want," Habbox said.
Forget about bringing reading material, though.
Compressed air is extremely volatile, especially when compression levels are as great as they are in hyperbaric chambers: Over a ton of air pressure is pushing on the door when the chamber is at depth.
Habbox said one hospital saw its chamber's door blow off, go through a wall and into a parking lot below. In 2009, a grandmother and her grandson were killed at a Fort Lauderdale clinic when a spark caused the chamber to explode.
To prevent accidents, patients in the St. Francis chamber must wear 100 percent cotton clothes, cannot wear make up, hair spray or jewelry and cannot bring outside objects into the chamber.