A Study on Heuristic Transportation Routes of Patients with Acute Dysbarism for the Best Prognosis

PURPOSE: Acute dysbarism is a potentially lethal injury associated with environmental medicine. Therefore, prompt treatment, including transportation of victims, is important for the best prognosis. The aim of this study was to examine transportation routes of patients with acute dysbarism for the best prognosis in Korea. METHODS: Geography of South Korea was analyzed using the geographic information system (GIS). The study examined two scenarios using transportation analysis, which relies on a GIS base and pressure variation during air and ground transportation. Given the practical assumptions, we propose some heuristic transportation routes based on the simulation of altitude, transportation time, and availability of related factors. RESULTS: Currently, transportation by ground to the treatment facilities always passes high altitude areas above 152 feet. Also, available helicopters for air transportation could not approach the treatment facilities due to the limitation of flying distance and insufficiency of medical staff and treatment equipment. Altitude variation and delayed time were identified during the period of transportation by ground from Ganneung or Incheon to Tongyoung. Heuristic algorism through the above facts recommends air transport along coasts as the best method for transportation from Ganneung or Incheon to Tongyoung. CONCLUSION: In Korea, transportation by ground was not expected to result in the best prognosis for patients with acute dysbarism. Transportation by air should be considered first as the method of transportation. Also, for the best treatment of patients with acute dysbarism, additional treatment facilities need to be established in the west coast region.

A Study on Hyperbaric Chambers for Treating Decompression Sickness in the Republic of Korea

PURPOSE: With the recent increase in underwater activity, the number of people at risk for decompression sickness has greatly increased. However, an organized medical system for emergency treatment, evacuation, and hyperbaric oxygen therapy of decompression sickness has not been established yet. We collected information about domestic hyperbaric chambers available for treating decompression sickness. METHODS: We identified 95 hyperbaric chambers in hospitals, hydrospace construction corporations, military, maritime police, 119 rescue services, and other organizations through a telephone survey. We visited the 95 chambers and collected information about location, operating institutes, chamber specifications, and operational status. Twenty-four oxygen capsules were excluded from the study because of inadequate working pressure. RESULTS: Seventy-one hyperbaric chambers available for hyperbaric oxygen therapy were identified among 59 organizations. The hyperbaric chambers were distributed evenly along coastal lines; that is, 21 on the east coast, 26 on the west coast, 21 on the southern coast, and three on Jeju Island. Thirty-eight chambers with maximal working pressure of > or =5 atm could be used for severe decompression sickness and arterial gas embolism treatment. Twenty-nine chambers had a seating capacity equal to-or more than three patients. Twenty-eight chambers had two or more compartments; thus, they could handle complex medical situations. Thirty-eight chambers with medical locks were useful for severe decompression sickness treatment. CONCLUSION: A sufficient number of domestic hyperbaric chambers available for treating decompression sickness were distributed evenly along the coastal lines. However, potential barriers need to be overcome to establish an efficient decompression sickness treatment system.