title: Requests for emergency hyperbaric oxygen treatment for carbon monoxide poisoning in Ankara, Turkey.
abstract: BACKGROUND
  Carbon monoxide (CO) poisoning is common in Turkey. Our department is the main provider of emergency hyperbaric oxygen therapy (HBOT) in Ankara and neighboring cities. In this study, we analyzed the characteristics of CO-poisoned patients who were referred by phone to our department for emergency HBOT.
  
  
  METHODS
  We retrospectively reviewed the records of phone consultations with emergency departments regarding the need for treatment of CO-poisoned patients with HBOT between 14 January 2014 and 14 January 2015. The following information was extracted from medical records: age, gender, CO source, exposure duration, carboxyhemoglobin (COHb) level, symptoms, electrocardiography (ECG) findings, cardiac enzymes, pregnancy, the distance of referring hospital to our centre, time between admission and consultation and HBOT decision.
  
  
  RESULTS
  Over the one-year period, 562 patients with CO poisoning were referred for HBOT. We recommended HBOT for 289 (51%) patients. HBOT was recommended for 58% (n = 194) of the patients with COHb ≥ 25%, 72% (n = 163) of the patients with a history of syncope, 67% (n = 35) of the patients with ECG abnormality, and 67% (n = 14) of pregnant patients. Patients for whom HBOT was not recommended despite having positive signs of severe poisoning were referred significantly later compared to patients for whom HBOT was recommended.
  
  
  CONCLUSIONS
  We found that the duration from admission to an emergency department to HBOT consultation affected our decision-making.
authors.affiliation: Department of Underwater and Hyperbaric Medicine, Gülhane Askeri Tıp Akademisi, Sualtı Hekimliği ve Hiperbarik Tıp A.D. Etlik, Ankara, Turkey. kubra_ozgk@hotmail.com.
authors.forename: Münïre Kübra
authors.initials: MK
authors.lastname: Özgök-Kangal
authors.affiliation: Department of Underwater and Hyperbaric Medicine, Gülhane Military Medicine Academy, Ankara, Turkey.
authors.forename: Iclal
authors.initials: I
authors.lastname: Karatop-Cesur
authors.affiliation: Department of Underwater and Hyperbaric Medicine, Gülhane Military Medicine Academy, Ankara, Turkey.
authors.forename: Gökhan
authors.initials: G
authors.lastname: Akcali
authors.affiliation: Department of Underwater and Hyperbaric Medicine, Gülhane Military Medicine Academy, Ankara, Turkey.
authors.forename: Senol
authors.initials: S
authors.lastname: Yildiz
authors.affiliation: Department of Underwater and Hyperbaric Medicine, Gülhane Military Medicine Academy, Ankara, Turkey.
authors.forename: Günalp
authors.initials: G
authors.lastname: Uzun
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002249:Carbon Monoxide Poisoning / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D002263:Carboxyhemoglobin / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D003657:Decision Making; D004630:Emergencies; D004638:Emergency Treatment / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D006931:Hyperbaric Oxygenation / Q000706:statistics & numerical data*; D007223:Infant; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013575:Syncope / Q000628:therapy; D013689:Telephone; D061665:Time-to-Treatment; D014187:Transportation of Patients; D014421:Turkey / Q000453:epidemiology
chemical_list: D002263:Carboxyhemoglobin
keywords: Toxicity; clinical audit; hyperbaric medicine; transport