HYPERBARIC OXYGEN HANDBOOK

Please discuss this section and your obligations with your referring Healthcare Professional.

 

What Is Hyperbaric Medicine?

‘Intermittent, short term, high dose Oxygen inhalation’

  • Hyperbaric Oxygen Therapy has 2 separate components - 'increased pressure' and 'increased oxygen'

  • The combination of the therapy has significant effects on the human frame

  • The human frame is Oxygen dependent

  • Hyperbaric Medicine is a method of safely delivering high doses of Oxygen to the body. It is done by breathing 100% O2 through a mask or hood while inside a pressurized air chamber.

  • The pressure (1.5-2.4 ATA) inside the chamber causes the (100%) Oxygen you breathe to be dissolved at greater levels in your blood is the same way that pressure causes carbon dioxide to be dissolved in soft drinks. The net effect is to increase Oxygen concentrations (tension) within the blood, which is then driven into the ‘targeted tissue’.​

Are There Any Side Effects To HBOT?

  • The provision of HBO is relatively safe but is not free from risk including the risk of short term myopia, barotrauma, claustrophobia, fitting in epileptics

  • A few patients have noticed an improvement in vision. Save your glasses though, because your vision will return to its pre-treatment condition. It is recommended that you wait at least 3 or 4 months after you have finished treatments before having your eyes re-examined

  • If you have cataracts, there is a remote chance that the cataracts may get slightly worse. If you have questions about this condition, your doctor can answer them for you

We Need To Know If You

  • get a cold, the flu, nasal or chest congestion

  • there is any possibility you may be pregnant

  • develop diarrhea

  • develop nausea or vomiting

  • develop an ear or sinus infection

  • change medications

  • have not eaten breakfast

  • are diabetic and didn't take your insulin

Clearing Your Ears

  • As the chamber is pressurized, your eardrum is pushed inward. This can be very painful if you do not equalize the pressure in your middle ear. We recommend all patients to clear their ears by equalizing about every 30 seconds during the ‘compressive phase’ of their initial chamber sessions. Generally any discomfort experienced by a patient when commencing treatment for the first time, is overcome with a ‘bit of technique’ after the first few sessions.

Methods Of Equalizing Pressure In Your Ear - Valsalva Maneuver

  • hold your nose closed and close your mouth

  • lift the back of your tongue toward the roof of your mouth

  • attempt to blow through your nose (short and sharp) while holding it shut

Other Methods To Clear Your Ears

  • You can try to yawn; swallow or drink sips of water. Another way is to pull and stretch the external ears whilst attempting to yawn, then repeat holding your nose and attempting to blow.

  • You will have to repeat this procedure several times during the pressurization phase of treatment.

  • If you have difficulty with your ears, please notify your attending doctor immediately. Don't wait until it hurts. Many patients who have difficulty equalizing or are experiencing pain, usually find that with a bit of daily practice you can overcome this difficulty within 4-5 sessions.

P. E. Tubes (Pressure Equalization Tubes)

  • If you cannot equalize the pressure in your ears, P. E. Tubes can be inserted through your eardrums by an ear, nose, and throat (ENT) physician. If this procedure is required we will refer you to the appropriate specialist.

  • This is a relatively painless procedure with few complications. The tubes can remain in place during the course of your treatment and normally will come out on their own. If you have P.E. tubes inserted, you must not get water in your ears. If you are not given earplugs, apply a little Vaseline to a small cotton ball and place it in your outer ear canal before washing or bathing. If you have any problems with the tubes, let us know.

Clearing Your Sinuses

  • The bones around your eye and upper jaw have air filled spaces called sinuses. The pressure in those spaces must be equalized with the Chamber pressure to avoid discomfort and pain. Sinuses normally equalize without any action on your part. Notify us at the very first sign of sinus discomfort so we can help you.

What Happens During The Treatment?

  • The first thing you do to prepare for your treatment is make sure that you wear clothing that is 100% cotton and not synthetic.

  • The attending medical staff will assist you into the chamber. You will be correctly positioned in your seat, fitted and instructed regarding the BIBS (Built-In-Breathing-System) mask. Please do not attempt to put on or take off the mask yourself. The nasal bridge of the rubber mask is easily torn and mask replacement cost is excessive.

  • When being placed in the chamber, your seat will be slid forward and correctly positioned by the attending doctor. Please hold the Oxygen hoses clear of the rolling seat, preventing them from being 'run over'. Once positioned, the rear door will be closed and fixed.

  • Now we are ready to pressurize the chamber. This is when you need to clear your ears, and you must repeat this procedure when you feel pressure building in your ears and or sinuses. Compression usually takes about 5-7 minutes and you will have to clear your ears several times during this phase. You will notice a rushing sound above your right ear. This is the inlet valve where normal air is forced into the Chamber via the external compressor.

  • The chamber must be filled under pressure (usually between 1.5 to 2.0 ATA) to attain the correct atmospheric condition to maximize and facilitate the benefits of 100% Oxygenation.

  • You will notice that the chamber air gets warm during the compression phase of treatment. When the correct pressure level is attained, the doctor will vent out the warm air and ventilate the chamber with fresh air for the entire length of your treatment. The chamber has a cooling facility.

  • Please maintain the mask; obviously the purpose of treatment is to administer 100% Oxygen, which is being delivered through the mask. Once correctly fitted, the air seal between the mask and your face should remain intact. The seal can easily be disrupted, causing Oxygen to leak from the mask into the chamber. This does not present a problem except that you are wasting valuable Oxygen minimising the benefit to yourself. The attending practitioner can monitor the chamber Oxygen levels on the external console panel.

  • After your treatment is finished the doctor slowly decompresses the chamber. This takes about 7-8 minutes. You will not be required to clear your ears during the decompression phase. Your ears will usually clear automatically.

 

A Word About Safety

YOU CANNOT SMOKE OR TAKE IN A MOBILE PHONE OR ANY OTHER BATTERY OPERATED DEVICE INSIDE A HBO CHAMBER

  • To decrease the risks of fire inside the chamber, a number of precautions are routine :

  • Oxygen concentration inside the chamber is constantly monitored and kept at a safe level

  • You are required to wear appropriate clothing, made out of 100% cotton or fire retardant material - you will be given a disposable hat, shoe covers and gown to be worn on each occasion.

 

These Items Are Not Allowed Inside The Chamber

 

  • synthetic garments including nylon, rayon, etc

  • Vaseline or oil based products like lipsticks, hair oil; hair spray, heavy make-up, skin lotion, or glycerin

  • Cigarettes, lighters, or matches

  • Newspaper or loose leaf paper

  • Hearing aids and other electronic games and devices

You May Take In

 

  • One book, or a magazine

  • If you have any doubt about what can be carried in to the chamber, please ask the attending doctor/technician

What About My Medications?

 

  • Your medical doctor will continue to monitor your medications. 

What You Need To Know About Smoking

  • The purpose of Hyperbaric Oxygenation is to deliver high doses of concentrated Oxygen to your body through your blood. 

  • Smoke inhibits Oxygen uptake in the lungs

  • Nicotine in cigarettes narrows the diameter of the blood vessels (vasoconstriction), greatly reducing the amount of available blood that can reach your tissues

  • Smoking increases lung congestion and the risk of complications

  • Smoking directly impacts on spinal cord function

 

Patient Consent

  • You will be asked to sign a form consenting to treatments

Adv Skin Wound Care. 2017 Mar;30(3):125-129. doi: 10.1097/01.ASW.0000508712.86959.c9.

A Retrospective Analysis of Adverse Events in Hyperbaric Oxygen Therapy (2012-2015): Lessons Learned From 1.5 Million Treatments.

Jokinen-Gordon H1, Barry RCWatson BCovington DS.

Author information

Abstract

OBJECTIVE:

To describe the distribution and occurrence of adverse events recorded during hyperbaric oxygen (HBO) therapy from 2012 to 2015. In this analysis, events are defined as otic/sinus barotrauma, confinement anxiety, hypoglycemia, oxygen toxicity, pneumothorax, seizure, and shortness of breath.

DATA AND ANALYSIS:

The data for the analysis were drawn from a proprietary electronic health data system that contained information on 1,529,859 hyperbaric treatments administered during 53,371 treatment courses from 2012 to 2015 in outpatient wound care centers across the United States managed by Healogics, Inc, Jacksonville, Florida.

RESULTS:

Of the 1.5 million treatments included in the analysis, 0.68% were associated with an adverse event. Barotrauma and confinement anxiety were the most frequently reported events. Medically severe events were extremely uncommon, with fewer than 0.05 instances of oxygen toxicity per 1000 treatments and only 1 confirmed case of pneumothorax.

CONCLUSIONS:

Results indicate that the occurrence of adverse events associated with HBO therapy is infrequent and typically not serious. The findings of this study suggest that when administered according to the appropriate therapeutic protocols HBO therapy is a safe and low-risk intervention.

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