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Hyperbaric Oxygen Therapy - FAQs

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Hyperbaric Oxygen Therapy (HBOT) is a medical treatment in which the patient is enclosed in a pressure chamber breathing 100% pure oxygen (O2) at greater than one atmosphere pressure. There have been anecdotal reports showing dramatic relief of sickle cell crisis with hyperbaric oxygen. Original work done at Duke University showed that sickle cell forms of the erythrocyte were markedly reduced under hyperbaric conditions. However, there has been no large-scale study to confirm its overall usefulness clinically.

During HBO due to higher pressure the Oxygen dissolves more in the liquid part of blood (plasma) and its level increases 10-20 times of normal level. This oxygen reaches all areas of the body –those places also where it was not reaching earlier due to inadequate blood supply or less haemoglobin.

In most instances HBOT is "adjunctive therapy" that is, it is used as part of a total treatment plan to improve outcomes. HBOT is not a "cure all" but a part of your total medical or surgical care.

A doctor trained in hyperbaric medicine will examine you before your treatments begin. You may need to have a few tests to make sure it is safe to expose you to oxygen under pressure. These tests include:

  1. Check of ears for ability to equalize pressure
  2. Check of lungs i.e. chest x-ray and / or pulmonary function tests
  3. Blood tests
  4. An eye examination (if you will be receiving a long series of treatments.
  5. Any other tests depending on your general state of health eg. ECG.

Please follow these guidelines:

  • Do not drink alcohol for at least 8 hours before your treatment.
  • Do not use skin products that have alcohol or petroleum in them (hair spray, most cosmetics, oils, creams). You can apply these after the treatment session.
  • You can wear only 100% cotton (including undergarments) when inside the chamber.
  • Check with your doctor if you are to stop any of your medication.
  • Remove your:. Watch, Dentures, Hearing aid, Jewellery, Contact lens, Other prostheses
  • The hospital will provide lockers for your belongings. Do not bring any valuables.
  • Bring a book with you.

These Items are not allowed inside the treatment area:

  • Synthetic garments, nylon, rayon, etc.
  • Vaseline or oil based products like lipsticks, hair oil, hair spray, make-up, some skin lotion, or glycerin.
  • Cigarettes, lighters, or matches
  • Newspaper or loose leaf paper
  • Hearing aids and other electronic devices
  • Cellular phones or battery operated items

You May Take In:

  • One book, or a magazine.
  • If you have doubt about what can be carried in to the chamber, please ask.

There is no need to disrupt your medication routine because of HBOT treatments. Bring your medications with you when you come. If you have to have shots or IV medications our nursing staff can help you.

You Need To Know This About Smoking....

  • The purpose of HBOT is to deliver high doses of oxygen to your body through your blood. Smoking inhibits this oxygen delivery in the following ways. We strongly advise you to stop smoking during the entire period of hyperbaric therapy, continuing to smoke during your treatment period will make your therapy less effective.
  • The smoke inhibits oxygen uptake in the Lungs.
  • Most important, the nicotine in cigarettes narrows the diameter of the blood vessels. This greatly reduces the amount of blood that can reach your tissues.
  • Smoking increases lung congestion and risk of complications.
  • Smoking decreases the amount of oxygen that your blood carries.

Do not smoke while receiving hyperbaric oxygen treatment. Smoking is not permitted in the Hyperbaric Unit.

We need to know if…

  • You get a cold, the flu, nasal or chest congestion
  • There is any possibility you may be pregnant
  • You develop diarrhoea
  • You develop nausea or vomiting
  • You develop an ear or sinus infection
  • You change medications
  • You have not eaten breakfast
  • You are diabetic and didn't take your insulin
  • Anytime you have a concern
  • You develop an ear or sinus infection

Hyperbaric Oxygen Therapy is given in a cabin which is pressurized with compressed air. At a certain controlled pressure patients breathe 100% oxygen through a mask, hood or endotrachial tube. 4-6 patients can be treated at the same time. A staff nurse is present at all the times with patients inside the chamber while the treatment is monitored from a Control Panel outside the chamber.

HBOT-Faq

HBOT has been proven effective for many medical conditions, and as a result the Undersea and Hyperbaric Medicine Society, one of the premier research institutes, has approved following indications:

  • Air or Gas Embolism
  • Carbon Monoxide Poisoning & Carbon Monoxide Poisoning Complicated by Cyanide Poisoning
  • Clostriidal Myositis and Myonecrosis (Gas Gangrene)
  • Crush Injury, Compartment Syndrome, and other Acute Traumatic Ischemia
  • Decompression Sickness
  • Enhacement of healing in selected problem wounds
  • Exceptional Blood Loss (Anemia)
  • Intracranial Abscess
  • Necrotizining Soft Tissue Infections
  • Refractory Osteomyletis
  • Delayed Radiation Injury (Soft Tissue and Bony Necrosis)
  • Compromised Skin Grafts & Flaps
  • Thermal Burns

Similar to all treatment modalities, HBOT is not used for diseases where there is no clinical evidence that it works. There have been claims that HBOT might help with problems like aging skin, or to prolong normal healthy life. Those have not been documented nor accepted in the wider medical community.

Except for decompression sickness and arterial gas embolism, the typical treatments are approximately two hours long. Patients are generally treated once a day, but sometimes may require therapy twice a day. Each single treatment session lasts about 2 hours. This includes 90 minutes in the chamber plus another ½ hour for preparation before, and observation after. The number of treatments required would depend on the type of problem that you have. The hyperbaric doctor will determine your treatment schedule. Normal treatment days are Monday through Saturday, excluding holidays. You must be on time for your session since any delays affect the treatment of all patients. A late arrival may result in the cancellation of your treatment. If you are unable to attend your session because of an urgent problem, please call.

A patient's clinical response and other factors often dictate the number of treatments required. Emergency cases, such as carbon monoxide poisoning, arterial gas embolism or decompression sickness, may only require one or two treatments. Non-healing wounds may call for as many as 20 to 30 treatments.

The treatment is painless. At the beginning and end of your treatment, you may notice a feeling of fullness in your ears. This is much like the feeling when flying in an airplane or diving underwater. As your eardrums respond to the changing pressure, you may hear popping or crackling noises. The Paramedic / Nurse will teach you how to relieve this sensation by clearing your ears.

  • The first thing you do to prepare for your treatment is to change into a suit made of a fire retardant fabric or 100% cotton.
  • The staff will assist you in entering the treatment chamber. You will be positioned at your seat.
  • Now we are ready to pressurize the chamber, this is when you need to clear your ears. Compression takes about 10-15 minutes and you will have to clear your ears several times during this phase. If you have P.E. tubes you do not need to clear your ears. Notify the inside attendant at the first sign of discomfort in your ears or sinuses so we can stop compression and help you. The Technician / Doctor will adjust the rate of compression to reduce the fullness in your ears.
  • You will notice the air gets warm during compression. When our treatment pressure is attained, we will vent out the warm air and ventilate with fresh air for the whole time of the treatment. The chamber has an air conditioning system. Treatment normally ends after about 90 minutes
  • The inside observer will place your Oxygen mask / hood on and set the oxygen flow and exhaust dump hose to the proper settings. Hoods, neck rings and console panel are the responsibility of the inside observer and should not be operated by the patient. Neck rings must remain on until the end of the treatment. The staff will assist you in removing the neck rings.
  • After your treatment is finished we slowly decompress the chamber. This takes another 10 - 15 minutes. Don't try to clear your ears during the decompression phase. Your ears will clear automatically.

Safety is important...

To decrease the risks of fire inside the chamber, we take several precautions. The oxygen concentration inside the chamber is constantly monitored and kept at a safe level. Everyone inside should wear clothes of 100% cotton or fire retardant material.

  • In the unlikely event that a fire occurs, the inside observer will provide you with guidelines to follow. Try to stay in your seat. A fire deluge system will be activated.

Consent

We cannot legally treat you without your written consent. You will be asked to sign a form consenting to treatments and photographs (of wounds).

When used in standard protocols hyperbaric oxygen therapy is safe. Commonest side effect may be slight discomfort or pain in the ears (aural barotrauma) if the ears are not able to equalize pressure. Pneumothorax and air embolism and transient reversible myopia after prolonged HBO therapy are rare complications. An occasional patient may be claustrophobic. Rarely, patients feel light-headed for a few moments after treatment. This ends quickly and does not interfere with normal activity.

The Valsalva Manoeuvre

  • 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

  • You can try to yawn; swallow or drink sips of water.
  • You will have to repeat this procedure several times during the pressurization phase of treatment
  • If you have difficulty with your ears, notify an inside attendant immediately. Don't wait until it hurts.