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Hyperbaric Medicine
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Topics   Replies Score Author Latest Post
Crohns and HBOT 0 V. Ferrini I would like to treat a patient with Crohn's Disease with multiple recurrent perianal abscesses and anal fistulas who has failed standard care including mutiple surgeries.  I was wondering if anyone had some good literature supporting the use of HBOT since it is obviously not an indication.Thanks
by V. Ferrini
21 hours ago
Myringotomy tubes 2 J. Markowitz I realize this is a late response, but I find that number to be high also. What pressure equalization techniques are you using, and are you doing the teaching and return demonstration at the time of orientation?
by M. Casson
Wednesday, October 08, 2014
HBOT protocols 5 L. Cox I agree that your in-chamber TCOM should guide you. If tissue TCOM does not exceed 200 mm Hg, tissue healing is unlikely. With other conditions, such as ORN, well researched protocols should be followed unless cotraindicated.My understanding is that air breaks are not necessary at 2.0 ATA, but I do air breaks if at any risk, the most common being narcotic pain meds. Anything higher, I use air breaks.What I don't understand is why we use 2.4 ATA as opposed to 2.5. 2.5 ATA = 45 fsw, nice round number. 2.4 ATA = 42.6 fsw. I can't imagine a difference of 2.4 fsw making a significant physiologic difference in either treatment response or risk profile. Why don't we just use 2.5?
by J. Mackey
Tuesday, September 30, 2014
Safety in monoplace chambers 2 R. Stauble NFPA 99 clearly states what the regulations are for monoplace and multiplace chambers in a health care facility.  Commercial diving regulations are set by the Coast Guard and OSHA.  I have worked in both industries and they are totally different.  It looks like you are not located in the United States and may not have to follow the same regulation that we do.  If you want to be safe reference the https://law.resource.org/pub/us/cfr/ibr/004/nfpa.99.2005.pdf
by C. Faille
Thursday, September 25, 2014
Prior Hx of Pneumothorax 1 J. Toth Sometimes high definitiion lung CT is usefull detecting little bullae that cannot be seen on CXR. Also I ask a spirometry.Regards.Jon Uña M.D.
by J. Una Gorospe
Tuesday, September 23, 2014
Follow-up after discharge 0 A. Deal Hello.  I am researching if there are any standards set for routine follow-up calls after a patient is discharged from hyperbaric treatment?  Any information is appreciated.Thank you
by A. Deal
Tuesday, August 26, 2014
Hyperbaric ventilators 8 I had it on demo for a few weeks. Better than any other I used (Manley, penlon, siarretron), but very expensive, and no dedicated scavenging- had to rig my ownPieter Bothma, London
by P. Bothma
Wednesday, June 11, 2014
Idiopathic Pulmonary Fibrosis 0 D. Humphrey Wagner IV DFUs in a patient with IPF. Is it safe to treat in a hyperbaric chamber? Is it recommended to follow PFTs or would you completely avoid hyperbaric oxygen?
by D. Humphrey
Thursday, June 05, 2014
Blood glucose monitoring 1 V. Hall We are in the same situation at our place and we have decided to change to pre- and post-dive glucose checks. According to many papers on this topic, this should be fine with regard to avoiding developing hypoglycemia. However, you will need some sort of a protocol to follow. Check the literatur - many good articles.
by M. Ibsen
Tuesday, June 03, 2014
Peritoneal Caths 0 K. Yerkes Simonson I have had much discussion lately about if a peritoneal catheter needs to be vented during HBOT.  It seems some techs have been taught to vent and some have been taught not to vent.Do you vent a PD cath during HBOT and if so, what is your rationale?
by K. Yerkes Simonson
Monday, May 12, 2014
Wireless communications for Multiplace chamber 0 R. Alicea I am looking for a wireless headset system for our communications system.   Currently we are using a wired headset for the inside observer in our multiplace chamber.  The chamber operator is also wired.  Eartec has a system that we have tried but has some minor issues. The problem with everything I have seen is that it has Lithium batteries and when I find one that will work it is way out of budget.What is everybody out there using for wireless if any?  
by R. Alicea
Thursday, May 01, 2014
Inpatient vs. outpatient treatment 5 F. Smith I will also agree with Fowler, Pruss and Benson, but would say 30% for us. We do 3 treatments daily for inpatients and outpatients combines. We have a 12 person multiplace and two monos. We run a total of 8 mono treatments in a day and about average 18 - 20 in the multi. We are on call 24/7 for emergencies. Our unit is attached to the hospital.
by R. Alicea
Thursday, May 01, 2014
Oxygen Supply Level 6 V. Ferrini Our O2 supply is at around 72 PSI.  We have two Perry Sigma 40 monoplace chambers and a multiplace with capacity for 12.  Contact your building engineering dept and they should be able to increase it.
by R. Alicea
Thursday, May 01, 2014
infected arthroplasties 1 B. Allen Often they are comp flaps post operatively. Check a TCOM.
by P. Benson
Monday, April 14, 2014
monitoring of b/p while using IV sedation in monoplace chamber 2 K. Butler We use the bp cuff in most of our patients, but a chest tcom lead is also a good proxy if there is no art line. Cardiac monitoring is a must. I like to get a chest tcom reading at baseline before inserting the patient while I have an accurate BP. We manage our sick, sedated and intubated patients this way. P Benson MD
by P. Benson
Monday, April 14, 2014
Cisplatin 2 C. Mulleady It depends upon the indication. For elective HBOT, it's probably best to wait, but for emergency indications, I wouldn't delay treatment.
by M. Richards
Monday, March 10, 2014
PICC line flushing 0 M. Richards Does anyone routinely flush PICC lines per and post treatment?
by M. Richards
Friday, March 07, 2014
Central Retinal Artery Occlusion 1 M. Nelson This is not a covered indication. If it's private insurance, you could get the medical director to draft up a letter to the insurance company explaining the benefits that the patient can receive. Usually once they see the money that could potentially be saved they should ok the treatment. If it is CMS you would just have to eat the cost. We've treated 3 pts at our facility with Idiopathic Sudden Sensorineural Hearing Loss and one pts private insurance gave us the auth for the treatment the other 2 (one CMS, one private), denied the it, so we ate the cost.
by F. Steffich
Monday, March 03, 2014
Mafenide (Sulfamylon) 0 M. Richards According to Kindwall, mafenide or sulfamylon are contraindicated during HBO.  Everything I've seen on the topic simply echoes the sentiments of Kindwall.  Does anyone have real world experience treating HBO patients who also have mafenide on wounds?
by M. Richards
Thursday, February 27, 2014
radiation injury to spinal cord 1 R. Byrne We have had 2 cases: one was a cervical cord injury which was covered by the insurance company. He did very well with treatment. The second was a thoracic cord injury. She was not covered by her insurance company and did fairly well with treatment. Both had extensive documentation of their injuries. I hope this helps. 
by M. O'Donnell
Wednesday, February 05, 2014
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11/1/2014
UHMS: Online Wound Care Educational Series