Authors (including presenting author) :
SUEN HK(1), TANG KB(1), YAN WW(1)
Affiliation :
(1)Hyperbaric Oxygen Therapy Centre, Pamela Youde Nethersole Eastern Hospital
Keyword 1: :
carbon monoxide poisoning
Keyword 2: :
hyperbaric oxygen therapy
Keyword 3: :
mass casualty incident
Keyword 4: :
pediatric hyperbaric medicine
Keyword 5: :
disaster preparedness
Introduction :
The Tai Po fire incident on 26th November 2025 resulted in a sudden surge of patients with carbon monoxide (CO) poisoning, posing an unprecedented challenge to health care services in Hong Kong. Hyperbaric oxygen therapy (HBOT) is a recognized treatment for moderate to severe CO poisoning, as it rapidly dissociates carboxyhemoglobin, restores tissue oxygenation, and reduces the risk of ischemic and neurological injury. Pamela Youde Nethersole Eastern Hospital (PYNEH) HBOT Centre was activated as a regional referral hub and rapidly mobilized to receive and treat multiple critically ill victims in the immediate aftermath of the incident.
Objectives :
This study reports the clinical and operational management of multiple CO-poisoned patients following a large-scale fire incident in Tai Po District, emphasizing challenges in resource mobilization and coordinated response at the PYNEH HBOT Centre.
Methodology :
Within 24 hours of the incident, 15 patients aged 3 months to 76 years were referred for HBOT. Clinical characteristics, treatment logistics, and resource utilization, manpower allocation were retrospectively reviewed to evaluate the Centre’s surge response and operational readiness.
Result & Outcome :
Of the 15 patients, most were critically ill; eight required endotracheal intubation and mechanical ventilation. The mean interval from consultation to HBOT initiation was 5.5 hours. A total of 10 chamber sessions were delivered in the first 24 hours, with 3 more sessions conducted subsequently, for a total of 24 patient treatment episodes. Operational challenges included manpower limitations, restricted chamber capacity, limited hyperbaric-compatible ventilators and physiological monitors, and insufficient pediatric HBOT expertise. Effective multidisciplinary coordination among HBOT teams, intensive care, and pediatricians facilitated uninterrupted treatment delivery.
This experience demonstrates the feasibility of PYNEH HBOT Centre’s role in acute disaster response, even under resource-constrained conditions. Effective management relied on multidisciplinary collaboration and rapid resource mobilization. Strengthening surge capacity, expanding pool of attendant for critically-ill, pediatric readiness, enhancing hyperbaric-compatible equipment inventory and disaster preparedness remains essential for optimizing outcomes in future events involving CO poisoning.
