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Hyperbaric Medicine
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Topics   Replies Score Author Latest Post
infected arthroplasties 1 B. Allen Often they are comp flaps post operatively. Check a TCOM.
by P. Benson
Monday, April 14, 2014
Inpatient vs. outpatient treatment 4 F. Smith Agree with Fowler and Pruss similar excperience in our shop.
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
HBOT protocols 4 L. Cox Do you have a referrence to any studies comparing outcomes of 2.0 vs 2.4? It's true that some TCOMs values will go up at 2.4 vs 2.0, but the outcome we're measuring is wound healing (at least when TCOMs are involved).Until I see real evidence that 2.4 is better, I'm sticking with 2.0 since it's both safer for inside attendants and the patients.
by M. Richards
Thursday, March 06, 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
Oxygen Supply Level 5 V. Ferrini MMP= (Depth x .445) + OBPMMP- Minimum Manifold PressureDepth- treatment depth in FSW (or use psig at treatment depth)OPB – Over bottom pressure (manufacturers recommended psig for breathing regulator at 1ATA)
by C. Faille
Monday, February 17, 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
bisphosphonate associated osteonecrosis 2 R. Byrne Thank you for your reply.  Sorry I am responding so late!Rosemary
by R. Byrne
Thursday, January 23, 2014
Carbon monoxide poisioning in pregnancy 1 P. Tibbles In a situation like this it best to give the treatment.  A concern is that a pregnant woman exposed to CO usually has a 10 to 15% lower level of COHb than does her fetus.  If your faciltiy doesn't have it already buy "HYPERBARIC MEDICINE PRACTICE" 3rd Edition by Eric Kinwall, MD & Harry Whelan, MD. This book is an abundance of information.    Frank Steffich, CHT/Safety Director Central Jersey Wound & Hyperbaric Treatment Center 901 West Main St Freehold, NJ, 07728
by F. Steffich
Thursday, January 23, 2014
fire safety/breathable gas 1 K. Lazaridis We use a Draeger Paat C Smoke Hood.  A while back there was an article on MedEd Online that discussed this issue.  One of their recommendations at that time was the Draeger hood.  These hoods should fulfill the NFPA requirement.  A couple of years ago the hoods were about $200 per hood plus a wall mount bracket ($40).  We've got 2 in our unit - one on each end by our fire extinguishers.  After purchasing these hoods, another dept in our hospital came over & loooked at them as they also needed a hood to meet safety requirements. Whatever hood you go with, make sure you do fire drills that require your staff don the hoods.  Feel free to contact me with any questions. Brian Pruss RRT/CHT 605-322-8610 brian.pruss@avera.org
by B. Pruss
Friday, January 17, 2014
Omni Pressure Relief Mattress 1 D. McElrath Morning Don, We purchased a standard Omni Pressure mattress for our wide gurney a couple of years ago.  Pt report for those that we were able to compare pre/post new mattress found it a lot more comfortable.  We do have fewer complaints about the mattress now than we did years ago.  We still have some with back problems that have issues, but I'm not sure any mattress would for them.  As far as reducing risk for pressure ulcers, the mattress should help, but I don't have any data to give you on that question. Downside - they're expensive. Our plan when we update our chamber in a couple of years will be to upgrade to the bariatric mattress.  I can't afford a $1300 mattress individually, but rolling it into a big purchase won't hurt as bad. Personal experience side note:  I've spent a nite on that mattress & seemed pretty comfortable (snowed in during a blizzard). Good luck. Brian Pruss RRT/CHT Avera McKennan Hyperbaric Medicine 605-322-8610
by B. Pruss
Friday, January 17, 2014
Tarlov cyst 0 J. Welko A patient came to the unit requesting to try HBO2 treatment for a Tarlov cyst (CSF cyst of the subarachnoid space of the spine) which has become symptomatic.  Has anyone treated or know of any patients who have been treated for this?
by J. Welko
Monday, November 25, 2013
HBOT post revascularization 0 M. Craig So Im having a hard time with the "rules" for using diagnosis code 440.23. If my patient goes for revascularization to help an arterial wound, how soon after the proceedure should he start HBO? AND, does his wound still need to be ischemic after the proceedure in order to qualify for HBO? Im getting mixed responses. Some say start HBO as soon as possible after revscularization and some say the wound must still be getting worse and ischemic after the revascularization in order for HBO to be an option.
by M. Craig
Wednesday, November 20, 2013
Encouraging patients to make their appts 1 E. Pinson I have found that if the patients do not have to wait very long to get into the chamber and the process is efficient when there are being treated, they are more likely to keep their appointments.  Continually reminding them that the benefits of HBOT are a cumulative effect and that they will not see as much improvement/benefit if they are not receiving regular treatment, can also help.Good luck
by R. Byrne
Friday, November 08, 2013
Osteo in pt with MS 0 D. Denham Has anyone had experience diving a pt with MS and osteo?  My concern would be "toxic effects" of the 2-2.4 ATA, based on work from others that this is too much oxygen.  (Not to be confused with seizure oxygen toxicity.)  Would the 1.5 ATA do anything for the osteo?  Would any insurer cover that?  Any comments would be greatly appreciated! 
by D. Denham
Wednesday, October 30, 2013
URGENT: Myeloma with Wegener's Granulmatosis 0 M. Rolph Hello! I was wondering if anyone has any experience of treating Myeloma with Wegener's Granulomatosis - or at least something akin to the latter - with HBOT? I am looking for supportive evidence of some sort, that may convince the Haematology consultant dealing with my father's case, to consider HBOT as a possible solution for the lesions he has across his hands, abdomen and his lower extremities.He can barely walk, as the lesions cause him considerable pain.Just to make you aware, none of the people at the hospital in the UK where he is being treated, have ever seen anything like it, apparently (just had his 3rd round of photographs take today, 6 weeks after diagnosis).I have done a fair bit of research, which seems to suggest that it could be beneficial. The consultant who is dealing with the case, has been very dismissive of the evidence I have presented (didn't even look at it - he is very busy though...!). His main concern is that elevated partial pressures of O2 may lead to an increase in the growth/spread of the Myeloma.Is he correct?I am not trying to cure the Myeloma, by the way! I am trying to find something that may accelerate the healing of the lesions, to improve my father's quality of life.  If anyone has any experience with this kind of thing, I would really appreciate your feedback. Many thanks in advance.
by M. Rolph
Monday, September 30, 2013
Sclerotic chronic Graft versus Host Disease 1 N. Norsworthy I have no literature to offer, but would suggest a TCOM with O2 challenge, and then a physician to physician contact with the insurance company.
by M. Casson
Wednesday, October 16, 2013
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