AIIMS Raipur NO - 2019 (Shift-2)
Medical Surgical Nursing
Easy
Hyperbaric oxygen therapy is used to treat which of the following patients?
Appeared in: AIIMS Raipur NO - 2019 (Shift-2)
Explanation
- Hyperbaric oxygen therapy (HBOT) is a primary treatment for moderate to severe carbon monoxide (CO) poisoning.
- CO binds to hemoglobin with an affinity 200-250 times greater than oxygen, forming carboxyhemoglobin (COHb) and causing tissue hypoxia.
- HBOT works by administering 100% oxygen at pressures greater than sea level, which dramatically shortens the half-life of COHb from hours to about 20-30 minutes.
- This rapid elimination of CO helps restore oxygen-carrying capacity and reduces the risk of delayed neurological sequelae.
Why Other Options Were Wrong
- Option A: The standard treatment for organophosphate poisoning involves administering atropine to counteract muscarinic effects and pralidoxime to reactivate acetylcholinesterase. HBOT has no role in this type of poisoning.
- Option B: Mercury poisoning is treated with chelation therapy. Agents like dimercaprol or succimer bind to the heavy metal, forming a complex that can be excreted by the kidneys. HBOT is not used.
- Option D: Narcotic (opioid) poisoning or overdose is treated with the specific antagonist naloxone, which rapidly reverses respiratory depression and other effects of opioids. HBOT is not indicated.
Related Visual
Clinical Relevance
- Nursing practice connection: Knowing Indications for Hyperbaric Oxygen Therapy (HBOT) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
- A key nursing responsibility is to administer 100% high-flow oxygen via a non-rebreather mask immediately to any patient suspected of CO poisoning, even before a definitive diagnosis.
- Nurses must be aware that standard pulse oximeters are unreliable in CO poisoning; they cannot differentiate between oxyhemoglobin and carboxyhemoglobin and will show a falsely normal or high oxygen saturation. A CO-oximeter is required to measure COHb levels.
- What if? A patient with CO poisoning has a COHb level of 20% but is asymptomatic and has no other indications for HBOT? In this case, the patient would typically be treated with 100% high-flow normobaric oxygen and monitored closely. HBOT would be reserved for patients who meet specific severity criteria or who fail to improve.
How to Approach the Question
- First, identify the core concept of the question, which is the clinical application of 'Hyperbaric oxygen therapy' (HBOT).
- Recall or deduce the primary and most well-known indications for HBOT. Think about conditions involving gas bubbles (decompression sickness), poor oxygenation in tissues, or specific poisonings.
- Evaluate each option. Consider the pathophysiology of each type of poisoning.
- For 'Carbon monoxide poisoning', recognize that CO displaces oxygen from hemoglobin, and HBOT is a logical intervention to force oxygen back onto hemoglobin and into the plasma.
- For the other options (organophosphate, mercury, narcotic), recall their specific antidotes (atropine/pralidoxime, chelation, naloxone) and mechanisms, which are unrelated to hyperbaric oxygen.
- Select the option where the mechanism of HBOT directly counteracts the pathophysiology of the poisoning.
Concept Tested & Keywords
- Concept Tested: Indications for Hyperbaric Oxygen Therapy (HBOT)
- Stem keywords: Hyperbaric oxygen therapy, treat
- Lead-in keywords: which of the following
- Negative lead-in flag: false
Question ID
QbxtSUlcxxlzBD4IMsnSjO
Reference Book
E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 768-770
E6 Physiology Guyton 4SAE Part 2A p. 85-87
E6 Nursing Brunner Adult Health 3SA Vol 2 Part 3 p. 130-132
Practise the full AIIMS Raipur NO - 2019 (Shift-2)
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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