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Have you ever seen an oxygen toxicity seizure? You can see one on this You Tube, produced by the U.S. Navy many years ago.

Here are the verbatim comments of hyperbaric technicians (from the Hyperbaric Oxygen Therapy Registry) who observed oxygen seizures during routine hyperbaric treatments:

  • “He flexed his arms across his chest, eyes deviated to the right and he developed a generalized seizure for 4 minutes.”
  • “The patient had a tonic/clonic seizure that lasted 15 sec.”
  • “The patient had a seizure (sic) lasting approximately two minutes.”
  • “During the ascent developed generalized tonic/clonic convulsion.”
  • “He noted loss of clear hearing of television and then had a seizure that lasted for approx. 6 minutes.”
  • “He noted that the TV voices were breaking up, took his airbreak and had a 10 minute seizure.”

About a decade ago, I did a safety analysis from the Hyperbaric Oxygen Therapy Registry (HBOTR) for a UHMS Gulf Coast meeting. The HBOTR data (10 years ago) had details on 3,757 patients who underwent 94,349 hyperbaric treatments (an average of 25 treatments per patient). There were 30 patients reported to have had an oxygen induced seizure. To determine the validity of those data, I personally read the notes from each of the events. That’s where I got the quotes above. Every one of these events was unquestionably real. Separately, there were 137 episodes of acute onset shortness of breath, and 2 patients had sudden loss of consciousness.

I haven’t looked at HBOT safety data since I did that presentation, which was about 10 years ago. The HBOTR has grown at a logarithmic pace in the past decade. However, there’s never been any real support for what it does or the data in it. I keep it because it seems important. Today I was wondering what would happen to those patients who had seizures if no physician had been in attendance. The patients would have survived of course. We can’t say that with confidence about all the patients Helen Gelly has documented as having cardiac arrests during HBOT. Bad things during HBOT are rare. It’s much more common for patients to have ear clearing problems or a “bathroom emergency.”

It’s possible that hyperbaric oxygen therapy treatments will no longer require the “direct supervision” of an advanced practitioner trained in the field. That’s the language in the proposed rule for the Hospital Based Outpatient Payment System.

If you think that HBOT should NOT be moved to “general supervision” (which does not require a physician immediately available), you can post a comment here, but the deadline is THIS FRIDAY, SEPTEMBER 27TH.

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