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Safety/Technical

Questions pertaining to safety and technical information.

Regarding the Hyperbaric Safety Director for a hospital based hyperbaric department (monoplace chambers)
Published: 04 May 2016

Regarding the Hyperbaric Safety Director for a hospital based hyperbaric department (monoplace chambers)

Published Date:   5/2016
Review Date:       5/2019
Due Review:        5/2022


It is the responsibility of the administration, medical director and safety director to compile a policy and procedures for the type of chambers, acuity of patients and qualifications of staff.

  1. Language requiring an individual with the responsibilities of hyperbaric safety director (HSD) has been in NFPA 99 since 1970 (56D). NFPA 99, 14.3.1.3.2 requires that each facility designate an on-site hyperbaric safety director (HSD). We are not aware of any requirement in NFPA 99 that specifies that the hyperbaric safety director be on the premises when chambers are in operation.

There is further information on this topic in the annex of NFPA 99 A14.3.1.3.2. The complexity of hyperbaric medicine is such that one person should be designated as the chamber operator. That person should be knowledgeable and have the training and experience to recognize hazards.

NFPA 99, 14.3.1.4.8 requires that a chamber operator be physically present and maintain visual and audible contact with the control panel or chamber occupant(s) during hyperbaric oxygen therapy.   

The UHMS facility accreditation probe HBOHR 2.2 looks for a Certified Hyperbaric Nurse or CHT on premises when chamber operations are going on.

  1. It is acceptable for the HSD to be available by phone, and in our experience, this position is most often available 24/7 for calls regarding the hyperbaric facility.
  1. If the HSD is not available, on vacation or other, there needs to be an alternate HSD named to be responsible. It is good practice to bring staffing “up” in the department and have a succession plan in place.
    1. The individual covering for the HSD should have attended a hyperbaric safety director course, have knowledge and experience in hyperbaric medicine and with the equipment used at the facility. This could be the lead chamber operator with the most experience, for example.
    2. Unless the hospital safety director has knowledge and experience with hyperbaric medicine and has attended a hyperbaric safety director course, we would not encourage using this resource to cover the HSD absence. We would encourage working closely with the hospital safety director so that individual has some knowledge of our unique practice. 

For references see:

MEDFAQ July 07, 2015 regarding safety director training

NFPA 99, 2018 edition, chapter 14 Hyperbaric Facilities

UHMS Guidelines for Hyperbaric Facility Operations, 2nd edition

UHMS Clinical Hyperbaric Facility Accreditation Manual (Rev1)

DISCLAIMER
Neither the Undersea and Hyperbaric Medical Society (UHMS) staff nor its members are able to provide medical diagnosis or recommend equipment over the internet.  If you have medical concerns about hyperbaric medicine you need to be evaluated by a doctor licensed to practice medicine in your locale, which can provide you professional recommendations for hyperbaric medicine based upon your condition. The responsibility of approving the use of equipment resides with the physician and safety director of the facility.  Information provided on this forum is for general educational purposes only.  It is not intended to replace the advice of your own health care practitioner and you should not rely upon it as though it were specific medical advice given to you personally.

I have a medicine/safety question. A referral came to our off campus monoplace hospital owned wound care and hyperbaric center with a diagnosis of pyoderma for 20 HBO2 treatments. Aetna has already approved this treatment. They placed a VAC on her perianal deep wound and...
Published: 31 August 2017

I have a medicine/safety question. A referral came to our off campus monoplace hospital owned wound care and hyperbaric center with a diagnosis of pyoderma for 20 HBO2 treatments. Aetna has already approved this treatment. They placed a VAC on her perianal deep wound and...

I have a medicine/safety question. A referral came to our off campus monoplace hospital owned wound care and hyperbaric center with a diagnosis of pyoderma for 20 HBO2 treatments. Aetna has already approved this treatment. They placed a VAC on her perianal deep wound and they have to give her propofol to place the VAC on her. We cannot change or apply the VAC under those conditions here at the center, so the patient will go to the GI office and have the VAC changed twice a week after her HBO2 treatment on Monday and Thursday. Is there any increased danger of toxicity or seizures with this patient with this regime and the consistent use of propofol twice a week for VAC placement?


 There is no safety issue here. We have used such a regimen routinely in some of our hyperbaric patients with large wounds. The effects of low dose propofol disappear after a few minutes.

What types of pillows can be used in the Monoplace chamber? Can we utilize reusable pillows?
Published: 01 March 2019

What types of pillows can be used in the Monoplace chamber? Can we utilize reusable pillows?

Thank you for your question. The UHMS HBO2 safety committee can provide information to assist you in answering your question, but the ultimate responsibility for these types of questions rests with the medical director and safety director of your facility.

Regarding pillows approved for use in Monoplace chambers: One should be careful not to allow just any pillow into the monoplace chamber. The National Fire Protection Association (NFPA) 99, “Health Care Facilities Code,” 2018 edition contains a section regarding textiles (14.3.1.6.4) that provides guidance on the decision process for textiles, garments and wound care products.

We suggest that a proper risk assessment be initiated by the Safety Director of the hyperbaric program. The risk assessment found in section A14.3.1.6.4.3 is written for hyperbaric wound dressings, but the process is useful for other items as well. The Safety Director should consider using this risk assessment when making decisions about pillows to be used in the hyperbaric environment. Furthermore, section 14.3.1.6.4.4 calls for written approval by the Safety Director and Medical Director for prohibitive items to be allowed. The Safety Committee suggests that this code applies to the acceptance or disapproval of pillows.

You may wish to review these safety factors that may impact your decision:

  • The increased oxygen atmosphere in the chamber and the need to limit combustibles
  • Silk, wool and synthetic textiles are prohibited, unless approved by the medical director and safety director and based on sound and safe reasoning
  • Static producing materials should be avoided
  • Closed cell materials, such as some synthetics may retain oxygen after decompression, presenting an additional risk once the treatment has been concluded.
  • Infection prevention: Non-synthetic cotton or down pillows are relatively safe to be used in some chambers but are challenging when it comes to disinfection. Wipe-able covers are available and may need to be considered for those types of pillows.
  • The pillows need to be able to vent with the change of pressure in the chamber to avoid the pillow expanding on decompression.

It may be beneficial to inquire of your chamber manufacturer when seeking options for pillows. The UHMS website below contains links to many chamber vendors that may offer pillows. However, the Hyperbaric Oxygen Safety Committee suggests that your own risk assessment be performed regardless of the pillow manufacturer.

https://www.uhms.org/resources/links/11-chamber-equipment-manufacturers.html

Please let us know if we can provide any additional guidance or information.

Respectfully,

The UHMS Safety Committee

 

DISCLAIMER

Neither the Undersea and Hyperbaric Medical Society (UHMS) staff nor its members are able to provide medical diagnosis or recommend equipment over the internet.  If you have medical concerns about hyperbaric medicine you need to be evaluated by a doctor licensed to practice medicine in your locale, which can provide you professional recommendations for hyperbaric medicine based upon your condition. The responsibility of approving the use of equipment resides with the physician and safety director of the facility.  Information provided on this forum is for general educational purposes only.  It is not intended to replace the advice of your own health care practitioner and you should not rely upon it as though it were specific medical advice given to you personally.

We recently stated using maggots in wound care. Have you guys used these? I looked into the product and I wondered your thoughts of the Dacron screen that holds them in place? We do not currently have any HBO patients using this therapy but trying to get prepared if it comes up.
Published: 25 March 2019

We recently stated using maggots in wound care. Have you guys used these? I looked into the product and I wondered your thoughts of the Dacron screen that holds them in place? We do not currently have any HBO patients using this therapy but trying to get prepared if it comes up.

Thank you for your question. The UHMS HBO2 safety committee can provide information to assist you in answering your question, but the ultimate responsibility for these types of questions rests with the medical director and safety director of your facility.

The UHMS HBO2 Safety Committee is well aware that maggot therapy is a viable and common practice in wound care. We have evaluated the Dacron screen utilized for this therapy and can find no evidence that this item poses a significant risk in the hyperbaric environment. We must reiterate that the decision to allow foreign materials into the chamber rests upon the safety director and medical director of your facility.

It was observed by members of our committee that several articles regarding maggot therapy are available for your review and may contribute to the decision-making process for your facility.

https://www.ncbi.nlm.nih.gov/m/pubmed/24224280/

http://dx.doi.org/10.1155/2014/592419

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3233395/

Respectfully,

The UHMS Safety Committee

 

DISCLAIMER

Neither the Undersea and Hyperbaric Medical Society (UHMS) staff nor its members are able to provide medical diagnosis or recommend equipment over the internet.  If you have medical concerns about hyperbaric medicine you need to be evaluated by a doctor licensed to practice medicine in your locale, which can provide you professional recommendations for hyperbaric medicine based upon your condition. The responsibility of approving the use of equipment resides with the physician and safety director of the facility.  Information provided on this forum is for general educational purposes only.  It is not intended to replace the advice of your own health care practitioner and you should not rely upon it as though it were specific medical advice given to you personally.

Is it safe to treat a patient in hyperbaric oxygen therapy when they have an indwelling peritoneal dialysis catheter that has a minicap that has a iodine impregnated sponge and titanium adapter? The minicap is not able to be substituted at all per manufacturer guidelines.
Published: 23 April 2019

Is it safe to treat a patient in hyperbaric oxygen therapy when they have an indwelling peritoneal dialysis catheter that has a minicap that has a iodine impregnated sponge and titanium adapter? The minicap is not able to be substituted at all per manufacturer guidelines.

Thank you for your question. The UHMS HBO2 safety committee can provide information to assist you in answering your question, but the ultimate responsibility for these types of questions rests with the medical director and safety director of your facility.

The iodine within the minicap of this type of catheter does not pose an increased risk of fire. Since no flammable materials are otherwise identified, the remaining concern is the titanium adapter. For more information regarding this material, please refer to previously answered questions regarding titanium and peritoneal dialysis catheters.

Respectfully,

The UHMS Safety Committee

REFERENCES:

Material Safety Data Sheet – Iodine (Ratings listed are for the 1ATA environment)

http://dept.harpercollege.edu/chemistry/msds/Iodine%20Fisher.pdf  

________________________________________

MEDFAQ Published: 03 May 2016

Can patients be safely treated with an existing peritoneal dialysis catheter? Are there any precautions that need to be taken prior to therapy?

https://www.uhms.org/resources/medfaqs-frequently-asked-questions-faq/53-safety-technical.html

________________________________________

MEDFAQ Published: 20 June 2016

Can safety committee provide and update on titanium in HBO. Dr. Weaver answered a question about this at the Winter Symposium in SLC.

https://www.uhms.org/resources/medfaqs-frequently-asked-questions-faq/53-safety-technical.html

 


DISCLAIMER

Neither the Undersea and Hyperbaric Medical Society (UHMS) staff nor its members are able to provide medical diagnosis or recommend equipment over the internet.  If you have medical concerns about hyperbaric medicine you need to be evaluated by a doctor licensed to practice medicine in your locale, which can provide you professional recommendations for hyperbaric medicine based upon your condition. The responsibility of approving the use of equipment resides with the physician and safety director of the facility.  Information provided on this forum is for general educational purposes only.  It is not intended to replace the advice of your own health care practitioner and you should not rely upon it as though it were specific medical advice given to you personally.

One of our researchers has a hyperbaric oxygen chamber. We had a question about appropriate paint to use for a HBO chamber. I am having a hard time finding information on where to find paint that is high oxygen rated. Can you help point me in the right direction?
Published: 15 July 2019

One of our researchers has a hyperbaric oxygen chamber. We had a question about appropriate paint to use for a HBO chamber. I am having a hard time finding information on where to find paint that is high oxygen rated. Can you help point me in the right direction?

Date:  7/15/2019

Thank you for your question. The UHMS HBO2 safety committee can provide information to assist you in answering your question, but the ultimate responsibility for these types of questions rests with the medical director and safety director of your facility. If you are a safety officer responsible for this chamber and you have not attended a Hyperbaric Safety Director’s course as described by the National Board of Diving and Hyperbaric Medical Technology (NBDHMT.org), this committee would highly recommend it.

The UHMS Safety Committee cannot specify a specific brand, product, or chemical makeup for paint that would be suitable for a 100% oxygen environment. The action of painting a hyperbaric chamber is not something that should be taken lightly, as mishaps have been recorded in the literature (ref. 1), and failure to address fire safety concerns could result in unsafe conditions. This committee would strongly suggest that you reach out to your chamber manufacturer for further guidance. You should consider the design life of the particular chamber and consider all of the risks prior to an undertaking of this nature. There is guidance from the Department of Defense related to air-filled chambers that may be considered as a reference point, but these documents do not address 100% oxygen environments. (ref. 2, 3)

In general terms, chamber manufacturers will consider a number of safety factors when choosing paint for air-filled chambers, to include:

  • Is the paint low-VOC?
  • Are there residual flammable vapors that haven’t off-gassed?
  • Is it water-based (where fire is concerned)?
  • Is this product eco-friendly or non-toxic?
  • Is the product corrosion-inhibiting?
  • Is there as unpleasant or residual smell?

The safety of this process should be carefully respected and thoroughly planned, ensuring that:

  • The safety of this process should be carefully respected and thoroughly planned, ensuring that:

    • All of the manufacturer’s application instructions are followed
    • Staff applying paint are safe and the area is well ventilated
    • The location of the chamber is suitable to paint on site – If not, consider moving the chamber to a commercial site
    • The paint has had enough time to off-gas potentially harmful vapors. To validate this, it may be necessary to follow the application with high precision gas analysis and contamination scrubbing before the chamber can be used. Follow the chamber manufacturer’s guidance and study the data provided from the product’s SDS. (ref. 2, 3).

    Additionally, we encourage you to reference the following codes and standards for further guidance:

    • Section 14.2.2.5 through 14.2.2.5.3, National Fire Protection Agency (NFPA). (2018). NFPA 99 2018 Edition: Health Care Facilities Code. Quincy, Massachusetts.
    • Fire Hazard Classification, ASTM E-84 (NFPA 255), Class “A” (Class A (or 1) is the lowest flame spread rate)
    • ASTM E-84 (UL 723) provides flame spread ratings/classes: "Test for Surface Burning Characteristics of Building Materials."
    • NFPA 255 (describes the test to provide a comparative measurement of surface flame spread and smoke development of materials under specific fire exposure conditions).
    • “U.S. NAVY GENERAL SPECIFICATION FOR THE DESIGN, CONSTRUCTION, AND REPAIR OF DIVING AND HYPERBARIC EQUIPMENT,” Revision 1, August 23, 2006 https://www.navsea.navy.mil/Portals/103/Documents/SUPSALV/Diving/General%20Specifications%20Hyperbaric%20Equip.pdf?ver=2016-02-10-114010-800
    • U.S. ARMY CORPS OF ENGINEERS, NAVAL FACILITIES ENGINEERING COMMAND (Preparing Activity), AIR FORCE CIVIL ENGINEERING SUPPORT AGENCY, “UNIFIED FACILITIES CRITERIA (UFC), UFC 4-159-01N, DESIGN: HYPERBARIC FACILITIES,” 16 January 2004 https://www.wbdg.org/ffc/dod/unified-facilities-criteria-ufc/ufc-4-159-01n

    Citations:

    Respectfully,

    The UHMS Safety Committee


DISCLAIMER

Neither the Undersea and Hyperbaric Medical Society (UHMS) staff nor its members are able to provide medical diagnosis or recommend equipment over the internet.  If you have medical concerns about hyperbaric medicine you need to be evaluated by a doctor licensed to practice medicine in your locale, which can provide you professional recommendations for hyperbaric medicine based upon your condition. The responsibility of approving the use of equipment resides with the physician and safety director of the facility.  Information provided on this forum is for general educational purposes only.  It is not intended to replace the advice of your own health care practitioner and you should not rely upon it as though it were specific medical advice given to you personally.

 

“Are diapers with synthetic material (infant and adult) allowed in the Monoplace hyperbaric chamber, pressurized with 100% oxygen?”
Published: 13 August 2019

“Are diapers with synthetic material (infant and adult) allowed in the Monoplace hyperbaric chamber, pressurized with 100% oxygen?”

Thank you for your question. The UHMS HBO safety committee can provide information to assist you in answering your question, but the ultimate responsibility for these types of questions rests with the Medical Director and Hyperbaric Safety Director of your facility.

The UHMS Hyperbaric Safety Committee understands the advantage that absorbent diapers offer to the patient and the caregiver. Regarding the allowance of synthetic materials in Class A or Class B chambers, one must weigh the risks carefully and consider any opportunity for risk mitigation. For guidance concerning risk assessment and mitigation, we refer you to the National Fire Protection Association® (NFPA) 99, Health Care Facilities Code, 2018 Edition, which contains a section regarding textiles (14.3.1.6.4) offering guidance on the decision process for textiles, garments and wound care products.

We suggest that you know the types of materials commonly used to manufacture these products and their potential flammability. Typically, disposable diapers contain several layers of material Consisting of::

  • The inner layer or top sheet rests against the skin of the wearer and can be made from polypropylene material. Some top sheets include a skin-care lotion, which can protect the skin from overhydration and reduce irritation.
  • The absorbent core layer is designed to hold fluids. To enhance absorbency, most disposable diapers include a matrix of fluff material and a chemical compound known as Super Absorbent Polymer (SAP) that holds up to three hundred times its weight. This material forms into a gel as it absorbs fluids, and is known by other names, including hydrogel, sodium polyacrylate, polyacrylate absorbents, or Absorbent Gel Material (AGM).
  • The fluff in the absorbent core is usually made from wood pulp and may include wheat/corn-based materials. It is designed to distribute fluid across the diaper surface, while the SAP is intended to absorb and lock liquids in its core.
  • The waterproof outer shell is most often a petroleum-based plastic or polyethylene-treated material.
  • Bands made of elastic Lycra® or spandex to keep the diaper close to the wearer.
  • Non-woven refastening tape which holds the diaper in place and allows for adjustment.

We suggest the Hyperbaric Safety Director initiate a risk assessment. The risk assessment found in section A.14.3.1.6.4.3 is written for hyperbaric wound dressings, but the process is useful for other items as well. The Hyperbaric Safety Director should consider using this risk assessment when deciding which materials may be allowed in the hyperbaric environment. Furthermore, section 14.3.1.6.4.4 calls for written approval by the (Hyperbaric) Safety Director and Medical Director for prohibitive items to be allowed. The Safety Committee suggests that this code applies to the acceptance or disapproval of diapers.

You may wish to review these safety factors that  impact your decision:

Material Considerations

  • The increased oxygen atmosphere in the chamber and the need to limit combustibles
  • Silk, wool and synthetic textiles are prohibited unless approved by the Medical Director and (Hyperbaric) Safety Director based on sound and safe reasoning
  • Avoid static producing materials
  • Closed-cell materials, such as some synthetics may retain oxygen after decompression, presenting an additional risk once the treatment has been concluded. Patients must avoid contact with any naked flames for approximately 30 minutes after therapy.
  • Although most codes regarding textiles are not written for 100% oxygen environments, garments are required to comply with UL requirements and A Guide to the Undited States Apparel and Household Textiles Compliance Requirements; NISTIR 8115, https://nvipubs.nist.gov
  • The Safety Committee is aware of practices that have utilized cotton towels to fashion a cloth diaper as well.

Static Considerations

  • Confirmation of the continuity of ground between the patient and the chamber before each therapy.
  • Consider placing a damp cotton towel over the garment to lessen static capacity.

References

https://www.babygearlab.com/expert-advice/what-is-inside-those-disposable-diapers

https://tapes.averydennison.com/en/home/solutions/personal-care/baby-diaper.html

https://nvlpubs.nist.gov/nistpubs/ir/2016/NIST.IR.8115.pdf

Please let us know if we can provide any additional guidance or information.

Respectfully,

The UHMS Safety Committee


 

DISCLAIMER

Neither the Undersea and Hyperbaric Medical Society (UHMS) staff nor its members are able to provide medical diagnosis or recommend equipment over the internet.  If you have medical concerns about hyperbaric medicine you need to be evaluated by a doctor licensed to practice medicine in your locale, which can provide you professional recommendations for hyperbaric medicine based upon your condition. The responsibility of approving the use of equipment resides with the physician and safety director of the facility.  Information provided on this forum is for general educational purposes only.  It is not intended to replace the advice of your own health care practitioner and you should not rely upon it as though it were specific medical advice given to you personally.

What is the proper management of gastric tubes in the Monoplace HBO chamber?
Published: 21 September 2019

What is the proper management of gastric tubes in the Monoplace HBO chamber?

Date posted:  9/21/2019


Thank you for your question. The UHMS HBO2 safety committee can provide information to assist you in answering your question, but the ultimate responsibility for these types of questions rests with the medical director and safety director of your facility.

For the Monoplace environment, it is reasoned that Gastrostomy tubes (commonly known as G-Tubes) may remain either closed or open during therapy and throughout pressure changes. Your facility’s Hyperbaric Medical Director should make the determination based upon the needs of your program. Here are several considerations that may aid you in determining the best approach for your facility:

  • It is recommended that the disposition of the tube remain static (open or closed) throughout therapy to reduce the potential for air trapping and rapid release of air and fluid (Boyle’s Law).
  • Open G-tube ends may be wrapped with sterile gauze to contain any potential drainage.
  • Closed G-tube ends may also be wrapped, in the event of accidental opening.
  • Closed G-tube ends may reduce the amount of drainage, but require an additional step to complete before and after therapy. You may wish to adjust your pre/post therapy checklists accordingly.
  • After therapy, you may wish to check the tube for patency and proper function prior to departure.

Respectfully,

The UHMS Safety Committee


 DISCLAIMER

Neither the Undersea and Hyperbaric Medical Society (UHMS) staff nor its members are able to provide medical diagnosis or recommend equipment over the internet.  If you have medical concerns about hyperbaric medicine you need to be evaluated by a doctor licensed to practice medicine in your locale, which can provide you professional recommendations for hyperbaric medicine based upon your condition. The responsibility of approving the use of equipment resides with the physician and safety director of the facility.  Information provided on this forum is for general educational purposes only.  It is not intended to replace the advice of your own health care practitioner and you should not rely upon it as though it were specific medical advice given to you personally.

Is there any literature or consensus about treating patients less than 5 days a week on a regular basis? We have a patient who can only come 3 days a week due to his work. Is it only the total number of treatments received that matters or does the time frame in which it is received also important? (not referring to Marx protocol patients).
Published: 21 September 2019

Is there any literature or consensus about treating patients less than 5 days a week on a regular basis? We have a patient who can only come 3 days a week due to his work. Is it only the total number of treatments received that matters or does the time frame in which it is received also important? (not referring to Marx protocol patients).

Date posted: 9/21/2019


Thank you for your question. The UHMS HBO2 safety committee can provide information to assist you in answering your question, but the ultimate responsibility for these types of questions rests with the medical director and safety director of your facility.

There is significant interest in this question throughout the hyperbaric community as there are a number of occasions where circumstances often prohibit consecutive hyperbaric therapy. The committee refers you to resources such as Pubmed and the Rubicon Foundation. A literature search has revealed the following result:

Rate of delivery of hyperbaric oxygen treatments does not affect response in soft tissue radionecrosis.

Given that this study represented a response rate in soft tissue radionecrosis only, the committee does not propose that this logic be applied universally to all other indications for hyperbaric oxygen therapy.

Respectfully,

The UHMS Safety Committee


 DISCLAIMER

Neither the Undersea and Hyperbaric Medical Society (UHMS) staff nor its members are able to provide medical diagnosis or recommend equipment over the internet.  If you have medical concerns about hyperbaric medicine you need to be evaluated by a doctor licensed to practice medicine in your locale, which can provide you professional recommendations for hyperbaric medicine based upon your condition. The responsibility of approving the use of equipment resides with the physician and safety director of the facility.  Information provided on this forum is for general educational purposes only.  It is not intended to replace the advice of your own health care practitioner and you should not rely upon it as though it were specific medical advice given to you personally.

In the Monoplace chamber, is it always proper to turn off oxygen supply if there is a fire in the chamber? It is very logical to cut off O2 which is fueling fire, however at another class we were told never to turn off O2 because you then lose control of chamber. Which is correct?
Published: 21 September 2019

In the Monoplace chamber, is it always proper to turn off oxygen supply if there is a fire in the chamber? It is very logical to cut off O2 which is fueling fire, however at another class we were told never to turn off O2 because you then lose control of chamber. Which is correct?

Posted: 9/21/2019


 

Thank you for your question. The UHMS HBO2 safety committee can provide information to assist you in answering your question, but the ultimate responsibility for these types of questions rests with the medical director and safety director of your facility.

It is well known that the reduction of pressure is proven to decrease the rate and intensity of an oxygen-enriched fire. It is this committee’s opinion that in the event of a fire in the Monoplace chamber, maximum decompression should not be delayed as the heat of combustion will significantly contribute to increasing pressure in the chamber. As such, rapid evacuation of the patients and staff in the immediate and surrounding areas is critical.

Additionally, it is imperative that each hyperbaric facility contact their chamber manufacturer to understand the behavior of their emergency ventilation controls associated with their particular chamber model and system design. When describing the system to the manufacturer, consider any potential system modifications that may have occurred since installation.

You may also consider:

  • A test of your system with and without gas supply during decompression to understand how the system behaves. Consider the time required to decompress and the impact on facility evacuation and perform fire drills with each of these scenarios in mind.
  • Develop your emergency procedures to reflect the behavior of your particular system. NFPA 99, Annex B.14.3.2 contains guidance in drafting the emergency procedures for fire in a Class B chamber.
  • It is also important to perform a timed test of the emergency ventilation function periodically per the manufacturer’s maintenance recommendations.
  • Once all chambers have been decompressed, it is common for emergency procedures to include the shutdown of oxygen supply at the zone valves prior to evacuation or relocation.

Lastly, the Safety Committee has reached out to two Monoplace chamber manufacturers to address this question. Each of them confirmed that the emergency ventilation function installed on their chambers require a gas supply in order to operate normally. These manufacturers also stated that when the emergency ventilation function is activated, the inflow of oxygen to the chamber ceases.  The gas supplying the actuating valves that keep the exhaust valve open will remain, so that the chamber can fully decompress. Again, it is important to confirm and test the function of your particular chamber, as there are many variations of this design. Your understanding of this design will lead to a procedure that will dictate a series of life saving events. Therefore, this question is one that should be asked and answered by every Hyperbaric Safety Director and Medical Director.

Respectfully,

The UHMS Safety Committee


 DISCLAIMER

Neither the Undersea and Hyperbaric Medical Society (UHMS) staff nor its members are able to provide medical diagnosis or recommend equipment over the internet.  If you have medical concerns about hyperbaric medicine you need to be evaluated by a doctor licensed to practice medicine in your locale, which can provide you professional recommendations for hyperbaric medicine based upon your condition. The responsibility of approving the use of equipment resides with the physician and safety director of the facility.  Information provided on this forum is for general educational purposes only.  It is not intended to replace the advice of your own health care practitioner and you should not rely upon it as though it were specific medical advice given to you personally.