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Hyperbaric Medicine
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Topics   Replies Score Author Latest Post
Cardiac Function 1 W. Palko-Schraa I agree with your cardiologist.  I have treated multiple patients with low ejection fractions.  As long as the patient does not show up with signs of heart failure i.e. SOB, chest pain, etc., I have not had a problem with these patients.  This is my personal experience.  I have not caused a patient to go into acute failure secondary to HBOT. Vince 
by V. Ferrini
Monday, March 25, 2013
Marx Protocol 1 J. Whitlark I can't say what the recommended time frame is for patients having extractions post last HBO treatment. If the oral surgeon and the hyperbaric physician are concerned about the down time and the patient has established ORN then the 30/10 protocol may be an option for you? Honestly, I can not offer much more info about this but I have sent your question to my medical director to see what she thinks.  http://www.ncbi.nlm.nih.gov/pubmed/10023268
by J. Cormier
Thursday, March 07, 2013
Concussions 1 D. Denham The clinical trials that are on-going right now are looking at post-concussion treatment with 60 mins of 100% O2 at 1.5 ATA.  I believe they are doing 5 sessions/week for 40 sessions.  Here's a link to the clinical trial: http://clinicaltrials.gov/show/NCT01105962. The preliminary data is impressive.We have treated a few patients with post concussion symptoms and have had some good results. Unfortunately, insurance does not cover this indication.
by R. Byrne
Tuesday, March 05, 2013
VP Shunt 0 Anyone with experience with treating TBI patient with programmable shunt?
by
Tuesday, February 26, 2013
Amiodarone 1 E. Slisher Yes we treat, but we follow the Healogics recommendations of 400 mg daily, due to the risk of pulmonary issues. We have had no problems doing this mutiple times. P Benson MD
by P. Benson
Monday, February 25, 2013
Potential HBO patients with recurrent eye cysts? 1 S. Sherr Unless they are air filled cysts, then they should not be affected.  Keep in mind all of our patients are diving with two fluid filled cysts, namely their eyeballs. P Benson MD
by P. Benson
Monday, February 25, 2013
idiopathic sudden sensorineural hearing loss 12 R. Byrne We treat 6 days a week for 15 treatments total.  If you are only open 5 days a week, that is fine.  Try to start them as soon as possible after the onset of symptoms.P Benson MD
by P. Benson
Monday, February 25, 2013
Physician agreement 3 D. Denham Do you have a medical director?  This is the medical director's role.  If you do not have a medical director, then you need to make sure all of your doctor's are at least educated on the requirements of your payors and especially the CMS LCD or NCD that you are covered by.  If you don't have a medical director, perhaps you have a contracted group that staffs your unit (healogics, paragon, etc?)  In any case, your doctors having varying definitions of what is an indication for treatment is putting themselves as well as your clinic at risk for audits, denials, and demand for return of reimbursement. P Benson MD 
by P. Benson
Monday, February 25, 2013
Chest xrays for all hyperbaric patients? 3 S. Sherr I have read that this may not be necessary unless the patient has risk factors.We require a chest x-ray on every patient before treatment.  It would be interesting to see a study on this - how often do we catch a contraindication for hyperbaric therapy via the mandatory pre-treatment chest x-ray.
by J. Cormier
Friday, February 15, 2013
treatment protocol for ORN when additional extractions are needed 1 R. Byrne We are currently diving a patient under the Marx protocol 20/10. This particular patient was with us about a year ago (or slightly more) for the same diagnosis and completed the entire 20/10 Marx protocol then as well. This is the plan of care both her physicians felt would be most beneficial. I am not sure how other clinics may handle this scenario. Just sharing our recent experience.
by J. Cormier
Friday, February 15, 2013
AICD in monoplace 5 L. Hezel We have had no problems treated patients with AICD. I always get a copy of the patients card, call the manufacturer and have them fax me the relevant approval paperwork. Most I have come across have been approved to 2.5 ATA or 3 ATA.
by J. Cormier
Friday, February 15, 2013
CO poisoning study 0 J. Cormier Recently (Jan 2013) I was attending a two day medical management of CBRNE (chemical, biological weapons, etc) course in Arlington TX. It is tied to emergency preparedness and FEMA. One of the instructors briefly brought up a study he stated had been completed at Hopkins. He said the study was about the effectiveness of using oscillating ventilators for treating carbon monoxide poisoning. He implied the results showed this therapy to be just as effective or more effective than hyperbaric therapy. I have looking for this study to read it myself but have had no luck. Is anyone out there familiar with this? I contacted the course instructors to see if they could send me in the right direction but I have not heard anything back as of yet.
by J. Cormier
Friday, February 15, 2013
Diabetic Foot Ulcers; criteria for "diabetic" 2 P. Benson We treated a patient using the diabetic foot wound diagnosis who was no longer diabetic post pancreatic transplant. This patient did not take any diabetes medications and had a normal a1c. The patient had been diabetic for many years and our physician argued the vessel damage from the diabetes still existed and, therefore, hyperbaric therapy was warranted. We had documentation of his diabetic history.
by J. Cormier
Friday, February 15, 2013
Insurance company requiring negative pressure wound therapy before HBOT 3 V. Ferrini I know I am posting this late and you have probably already dealt with this particular patient. If it helps for future patients - whenever we have had, what we have felt, are unjustified denials from insurance companies we usually request a physician to physician review and resubmit with a letter of medical necessity. This has worked well for us so far.
by J. Cormier
Friday, February 15, 2013
athrosclerosis 0 L. Cox Was wondering what the protocal for  athrosclerosis (peripheral ischemia) would be.
by L. Cox
Friday, February 08, 2013
Duragesic Patch 0 J. Twigg A colleague at another center told me she read a safety update on Mededonline (no longer available) regarding Duragesic patches in hyperbaric chambers. I've searched in other engines but have not found any reference to the subject. Do other centers remove the patches? Thank you, 
by J. Twigg
Tuesday, February 05, 2013
Fibromyalgia 0 J. Whitlark I work at a free standing wound clinic and we have been contacted by a patient's mother about treating her 17 year old daughter with fibromyalgia... does anyone have any input on this as far as it being beneficial or possibly a treatment protocol?? I have tried to look for supporting articles and have found limited information and none of it is current.  Thanks for any help you have to offer! Samantha B. CHT
by J. Whitlark
Friday, January 04, 2013
Corneal laceration ?caused by HBOT? 1 R. Byrne To update on this: the patient was found to have a corneal infection that was misdiagnosed as a corneal abrasion. She was admitted to ICU and has currently no vision in the affected eye. It is likely that HBOT had no impact on this unfortunate situation.
by R. Byrne
Wednesday, January 02, 2013
2 people in monoplace chamber 3 Thank you for your answers, While I  remain uncomfortable with this situation, I feel somewhat more comfortable with your input.
by M. O'Donnell
Thursday, December 27, 2012
monoplace fire safety protocol 2 L. Hezel Steve Fabus called today and may yet jump in with his comments.  It is important to note that what I meant by "stop the supply to the chamber" meant...switch to emergency vent and decompress the chamber ( as in the attached policy).  Many monoplace assemblies require a minimum supply pressure to work.  If you shut off the zone valve to the chamber then the chamber will not have enough supply pressure to operate the emergency vent.   Tnanks Steve for the catch...  
by J. Bell
Tuesday, December 04, 2012
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11/1/2014
UHMS: Online Wound Care Educational Series