This document outlines the development of hyperbaric oxygen therapy (HBOT) in Taiwan and the role of emergency physicians in HBOT. It discusses how three Taiwanese hospitals have integrated HBOT into emergency departments, with emergency physicians trained in both emergency medicine and HBOT. This allows for extended treatment of certain emergency patients with HBOT. The document argues that HBOT represents an opportunity for emergency medicine subspecialization and physician career advancement. It encourages attendance at the 2024 International Conference on Emergency Medicine in Taiwan to learn more about globalizing and localizing emergency care approaches.

1. The Use of Hyperbaric Oxygen
in Taiwan ED
Ching-Hsing Lee, M.D.
Department of Emergency Medicine
Hyperbaric Oxygen Therapy Center
Chang Gung Memorial Hospital, Keelung, Taiwan
December 18, 2021

2. No financial
conflict of interest
to disclose
No financial
conflict of interest
to disclose

3. Outlines
• Hyperbaric Oxygen Therapy (HBOT)
development in Taiwan
• ED x HBOT in Taiwan
• Future of Emergency Medicine x HBOT

4. Outlines
• HBOT development in Taiwan
• ED x HBOT in Taiwan
• Future of EM x HBOT

5. Clinical Practice

6. Department of Diving Medicine,
Zouying Navy Hospital, Kaohsiung
1972

7. Multiplace (10) HBO chamber
Diving simulation training chamber
Zouying Navy Hospital
1976

8. Multiplace (4) HBO chamber
Keelung Navy Hospital
1976

9. Multiplace (20) HBO chamber
Zouying Navy Hospital
1998

10. Academic Milestone

11. 1997
Undersea Medicine Institute
National Defense Medical Center, Taipei City

12. 1998
Department of Undersea and Hyperbaric Medicine
Tri-Service General Hospital , Taipei City

13. Specialty Association

14. Association of
Hyperbaric and
Undersea Medicine
April 2, 1994

15. Government Regulations

16. • 2004 The Implementation and Use of Specific
Medical Technology and Testing Medical Instruments
Regulations《特定醫療技術檢查檢驗醫療儀器施行
或使用管理辦法》
• The requirements of HBOT chambers, physicians, and
technicians
Regulations

17. Board Certification

18. Board Certification
• 2005 1st Board Certification of HBOT
physicians and technicians
•
• 2021 Ten certified HBOT training centers
600+ certified physicians

19. Outlines
• HBOT development in Taiwan
• ED x HBOT in Taiwan
• Future of EM x HBOT

20. ED x HBOT in Taiwan
• 3 HBOT centers lead by emergency
physicians
• 30+ physicians board certified both in
EM and HBOT

21. Chang Gung Memorial Hospital, Linkou

22. Practice Mode of Linkou CGMH
• 24-7-365 HBOT available
• All EM x HBOT physicians
• Independ ED and HBOT shifts
• Radiation injury, problem wound,
sudden deafness, and osteomyelitis

23. Chang Gung Memorial Hospital, Keelung

24. Practice Mode of Keelung CGMH
• Weekday HBOT available
• All EM x HBOT physicians
• Independ ED and HBOT shifts
• Radiation injury, post surgery tissue
edema, and sudden deafness

25. Tungs' Taichung MetroHarbor Hospital

26. Practice Mode of Tungs' Hospital
• Weekday HBOT available
• All EM x HBOT physicians
• ED and HBOT shifts at the same time
• Ischemic stroke, traumatic brain
injury, and sudden deafness

27. Outlines
• HBOT development in Taiwan
• ED x HBOT in Taiwan
• Future of EM x HBOT

28. EM x HBOT
WHY?

29. ED Patient Population

30. Indications for HBOT by UHMS
• Air or Gas Embolism
• Carbon Monoxide Poisoning
• Clostridial Myositis And Myonecrosis (Gas Gangrene)
• Crush Injury, Compartment Syndrome And Other Acute
Traumatic Ischemias
• Decompression Sickness
• Arterial Inefficiencies: CRAO, Problem Wounds
• Severe Anemia

31. Indications for HBOT by UHMS
• Intracranial Abscess
• Necrotizing Soft Tissue Infections
• Osteomyelitis (Refractory)
• Delayed Radiation Injury (Soft Tissue And Bony Necrosis)
• Compromised Grafts And Flaps
• Acute Thermal Burn Injury
• Idiopathic Sudden Sensorineural Hearing Loss

32. Cross Disciplines Specialty

33. EM Subspecialty

35. Emergency Physician
Career Development

36. Conclusions
EM x HBOT
• ED patients’ treatment extension
• EM subspecialty development
• EPs career advancement

37. Special Thanks
Professor Ko-Chi Niu
Chi-Mei Medical Center
Tainan, Taiwan

38. Welcome to Taiwan
ICEM 2024
19-23 June
Glocalization of Emergency Medicine
Global Wisdom, Local Solutions

39. Ching-Hsing Lee, MD
lancetlee@gmail.com
@ChingHsing_Lee
Ching-Hsing Lee

40. Q & A