@article{ref1,
title="Urgent hyperbaric oxygen therapy for suicidal carbon monoxide poisoning: from a  preliminary survey to a proposal for an integrated somatic-psychiatric protocol",
journal="International journal of emergency medicine",
year="2020",
author="Costanza, Alessandra and Ambrosetti, Julia and Spagnoli, Philippe and Amerio, Andrea and Aguglia, Andrea and Serafini, Gianluca and Amore, Mario and Bondolfi, Guido and Sarasin, François and Pignel, Rodrigue",
volume="13",
number="1",
pages="e61-e61",
abstract="A considerable number of patients who made a carbon monoxide (CO) suicidal attempt  are treated with urgent hyperbaric oxygen therapy (HBOT). For these patients at  potential persistent risk of suicide, the hyperbaric chamber is a dangerous  environment and their management a complex challenge for the Emergency Department  (ED) and Hyperbaric Medicine Unit (UMH) teams. We aimed to (1) identify cases of  intentional CO poisoning treated with urgent HBOT in the UMH of the University  Hospitals of Geneva (HUG) during 2011-2018 and (2) test a proposed operational and  integrated somatic-psychiatric protocol based on acquired experience. A total of 311  patients with CO poisoning were treated using urgent HBOT, for which poisoning was  assumed suicidal in 40 patients (12.9%). This percentage appears greater than in  other European countries. Both the excess of cases of intentional CO poisonings and  difficulties encountered in their management resulted in the implementation of an  operational and integrated somatic-psychiatric protocol addressing the entire  patient's clinical trajectory, from the admission at ED-HUG to the treatment at the  UMH-HUG. The established institutional protocol includes (1) clinical evaluation,  (2) suicide risk assessment, and (3) safety measures. This is the first report-at  our best knowledge-of a protocol detailing a practical procedure algorithm and  focusing on multidisciplinary and mutual collaboration between the medical-nursing  teams at the ED, psychiatric ED, and UMH. Improvements in patient's safety and care  team's sense of security were observed. In conclusion, the opportunity to refer to a  standardized protocol was beneficial in that it offers both reduced risks for  suicidal patients and reduced stress for care teams operating in very acute and  complex situations. Further studies are needed.<p /> <p>Language: en</p>",
language="en",
issn="1865-1372",
doi="10.1186/s12245-020-00321-w",
url="http://dx.doi.org/10.1186/s12245-020-00321-w"
}