Hyperbaric Medicine http://membership.uhms.org/forums/topics.asp?forum=120829 Wed, 22 May 2013 08:20:16 GMT Mon, 20 May 2013 15:17:26 GMT Copyright © 2013 Undersea and Hyperbaric Medical Society Radiation-induced haemorrhagic cystitis http://membership.uhms.org/forums/posts.asp?topic=568587 http://membership.uhms.org/forums/posts.asp?topic=568587 We have a patient being treated with HBO for radiation cystitis.   He has completed 35/40 treatments.   So far, he has done great, no further episodes of bleeding for the past 2 weeks.  His urologist has asked, "What is the reoccurance rate after hyperbaric treatments?"  I have explained that HBO has been proven to help to prevent  reoccurance.  Can anyone point me in the direction to find some recent studies that have been done?  Thanks in advance. 

]]> Fri, 26 Apr 2013 15:49:57 GMT ARNP/ PA in Hyperbarics http://membership.uhms.org/forums/posts.asp?topic=572182 http://membership.uhms.org/forums/posts.asp?topic=572182 Fri, 3 May 2013 19:00:48 GMT TCOM Reimbursement http://membership.uhms.org/forums/posts.asp?topic=579867 http://membership.uhms.org/forums/posts.asp?topic=579867
I have a question regarding the performance of TCOM studies in your units.

Our Local Coverage Determination (LCD):
Noninvasive Vascular Testing (N.I.V.T.) states:


...must be performed by a physician who is competent in diagnostic vascular
studies or under the general supervision of physicians who have demonstrated minimum
entry level competency by being credentialed in vascular technology, or...

How do you interprete this requirement for reimbursement? Does the physician have to be a vascular doc or one who has minimum crediantals in vascular technology? Or, is a phsyician credentialed in any area of medicine (i.e. an internal medicine or emergency medicine doc) able to perform TCOMs and receive reimbursement?


Cuarrently we only have on CHT at my unit and am wondering if this person should be performing all TCOMS.

Thanks for responses.

]]> Mon, 20 May 2013 16:17:26 GMT TCOM Reimbursement http://membership.uhms.org/forums/posts.asp?topic=579866 http://membership.uhms.org/forums/posts.asp?topic=579866
I have a question regarding the performance of TCOM studies in your units.

Our Local Coverage Determination (LCD):
Noninvasive Vascular Testing (N.I.V.T.) states:


...must be performed by a physician who is competent in diagnostic vascular
studies or under the general supervision of physicians who have demonstrated minimum
entry level competency by being credentialed in vascular technology, or...

How do you interprete this requirement for reimbursement? Does the physician have to be a vascular doc or one who has minimum crediantals in vascular technology? Or, is a phsyician credentialed in any area of medicine (i.e. an internal medicine or emergency medicine doc) able to perform TCOMs and receive reimbursement?


Cuarrently we only have on CHT at my unit and am wondering if this person should be performing all TCOMS.

Thanks for responses.

]]> Mon, 20 May 2013 16:17:25 GMT Blood glucose monitoring http://membership.uhms.org/forums/posts.asp?topic=572062 http://membership.uhms.org/forums/posts.asp?topic=572062 The Accu-Chek Advantage blood glucose meter was approved for use under pressure and we have used it successfully in our multiplace chamber for years.  Unfortunately, this model is no longer manufactured and no other Accu-chek models are approved for use under pressure.  Does anyone know of an alternative meter that has been cleared for use under pressure?

]]> Fri, 3 May 2013 16:14:34 GMT Hyperbaric ventilators http://membership.uhms.org/forums/posts.asp?topic=485801 http://membership.uhms.org/forums/posts.asp?topic=485801 Has anyone found a pressure regulated hyperbaric multiplace ventilator more effective than the old Servo 900c? Has anyone seperated the components of the Servo-i?

Claude Wreford-Brown, Seattle

]]> Fri, 19 Oct 2012 22:48:24 GMT osteochondritis dessicans http://membership.uhms.org/forums/posts.asp?topic=568702 http://membership.uhms.org/forums/posts.asp?topic=568702 Fri, 26 Apr 2013 19:23:15 GMT marx protocol http://membership.uhms.org/forums/posts.asp?topic=567300 http://membership.uhms.org/forums/posts.asp?topic=567300 44 y/o female w history squamous cell carcinoma soft pallet. Received XRT about a year ago. Last month underwent tooth extraction of one of her molars. She received the Marx protocol...10 dives prior to the tooth extraction then 10 dives post. She has done well. She completed her last dive about 2 weeks ago. She calls now saying she may need a root canal on one of her other teeth.

My question: does she need more HBO2 treatments post root canal and is there any data on how long into the future the effects of the Marx protocol will last in patients like this?

 

Thank you

George Karras

]]> Wed, 24 Apr 2013 20:31:45 GMT STRN of the head and neck HBO treatment http://membership.uhms.org/forums/posts.asp?topic=565708 http://membership.uhms.org/forums/posts.asp?topic=565708 Question about returning patients for STRN prophylaxis. If the patient had undergone the Marx protocol in the past do they need to repeat the full 20 or 30 pre and 10 post or can they just do the 10 post treatments? If the 10 treatments is sufficient should they be pre or post extraction?

Thanks for responses.

]]> Mon, 22 Apr 2013 16:43:15 GMT Cardiac Function http://membership.uhms.org/forums/posts.asp?topic=546136 http://membership.uhms.org/forums/posts.asp?topic=546136 Tue, 19 Mar 2013 20:13:47 GMT HBOT protocols http://membership.uhms.org/forums/posts.asp?topic=547498 http://membership.uhms.org/forums/posts.asp?topic=547498 Hi, we are in the midst of implementing air breaks at our center which obvioulsy involves updating and revising our protocols. My question is it up to our medical director to subjectively choose protocols based on rather loose and somewhat vague suggestions based on available references? In other words their does not seem to be any reference material that is  universally accepted that states concretely what treatment protocols should be. 2.0 vs 2.4 ATA, air breaks for 2.0 vs 2.4? air breaks for co2 retainers...etc. 2.0 for osteoradio. vs 2.4.? Seems to me trial and error plays a significant part in treatment protocols- if we arent seeing any improvement at 2.0 then increase treatment to 2.4......Thank you to those that can reply..

]]> Thu, 21 Mar 2013 17:50:19 GMT Marx Protocol http://membership.uhms.org/forums/posts.asp?topic=537492 http://membership.uhms.org/forums/posts.asp?topic=537492 We have finished the 20 pre-extraction HBO treatments however the first available appointment with the oral surgeon is a month out.  My question is, will waiting a month between  HBOT and extraction pose a problem on healing and the beneficial effects of HBOT?  Any information you have to share will be greatly appreciated!

Samantha Blalock, CHT, RRT

]]> Tue, 26 Feb 2013 13:48:32 GMT Humidification levels inside the chamber http://membership.uhms.org/forums/posts.asp?topic=394122 http://membership.uhms.org/forums/posts.asp?topic=394122 I would greatly appreciate some direction here.  Safety standards suggest a humidification level of 50-70% thereabouts inside the chamber.  Are you measuring the humidification level INSIDE the chamber and if so, how?  Any information would help.

ADarlington, Canada

]]> Thu, 29 Mar 2012 12:53:26 GMT Concussions http://membership.uhms.org/forums/posts.asp?topic=537362 http://membership.uhms.org/forums/posts.asp?topic=537362 Anyone with any experience treating pts with concussions?  Two teenagers two months from concussion undergoing vestibular rehab but still not doing well.  I have seem some information on lower dose HBO.  I realize insurance may not pay, but parents are desperate.

Thoughts?

]]> Tue, 26 Feb 2013 01:02:15 GMT VP Shunt http://membership.uhms.org/forums/posts.asp?topic=537604 http://membership.uhms.org/forums/posts.asp?topic=537604 ]]> Tue, 26 Feb 2013 16:36:38 GMT Amiodarone http://membership.uhms.org/forums/posts.asp?topic=512413 http://membership.uhms.org/forums/posts.asp?topic=512413 Mon, 17 Dec 2012 16:05:12 GMT Potential HBO patients with recurrent eye cysts? http://membership.uhms.org/forums/posts.asp?topic=518714 http://membership.uhms.org/forums/posts.asp?topic=518714

I have a patient who wishes to get hyperbaric oxygen therapy with a H/O Retinal Detachment w/surgical repair, cataract removal and lens replacement on one eye with recurring cysts on the other.  

I am in particular worried about her recurring cysts and their potential expansion as she ascends from her dive.    

Thank you!! 

Scott Sherr M.D.  

 

]]> Tue, 8 Jan 2013 23:11:44 GMT idiopathic sudden sensorineural hearing loss http://membership.uhms.org/forums/posts.asp?topic=384495 http://membership.uhms.org/forums/posts.asp?topic=384495 Thu, 15 Mar 2012 15:39:51 GMT Physician agreement http://membership.uhms.org/forums/posts.asp?topic=527253 http://membership.uhms.org/forums/posts.asp?topic=527253 Do any of you have guidelines for your centers on physician agreement for diving indications?  One physician wants to dive a pt for chronic osteo in an elbow wound that has been open many month but another thinks pt should be evaluated by orthopedic surgery for nonviable bone first.

Do you require all physicians to agree to diving indications?  How do your physicians communicate, or do they, prior to starting a new pt diving?

]]> Tue, 29 Jan 2013 09:17:12 GMT Chest xrays for all hyperbaric patients? http://membership.uhms.org/forums/posts.asp?topic=507480 http://membership.uhms.org/forums/posts.asp?topic=507480 Tue, 4 Dec 2012 22:19:53 GMT