Safety Articles
Disclaimer: The ideas and opinions expressed in these documents are those of the authors. Inclusion on this list does not necessarily constitute endorsement by the Undersea and Hyperbaric Medical Society.
The articles listed below have been reproduced with the permission of the publisher. The downloadable files are in PDF format.
- A VACUUM REGULATION SYSTEM FOR CONTINUING VACUUM ASSISTED CLOSURE THERAPY (V.A.C.â) IN MULTIPLACE AND MONOPLACE HYPERBARIC OXYGEN CHAMBERS.
Raleigh GW, Niezgoda JA, Fabus SV
Center for Comprehensive Wound Care and Hyperbaric Oxygen Therapy, St. Luke’s Medical Center, Milwaukee, WI 53215 - A Functional Suction Apparatus Within the Monoplace Hyperbaric Chapter
UHM: Vol 3, No. 3, 1998 | Author: Lindell Weaver, MD - Regarding questions surrounding the availability of IV pumps and ventilators used in HBO. (PDF document)
Information supplied by UHMS Safety Committee Chair: Andrew R. Melnyczenko | Hyperbaric and Altitude Medicine | Technical and Safety Director | Phone: 507-538-5633 | Mobile: 586-612-3967 | Melnyczenko.Andrew@mayo.edu | Mayo Clinic | 200 First Street SW | Rochester, MN 55905 | - CHAMBER OPERATION FOR PATIENT EVACUATION POSTER. "Sechrist 3600H Patient Evacuation sign 8-2019, Anthony Johnston BSN, RN, ACHRN Note: This poster appeared in a January 2020 PRESSRE Safety Article, and is shared under fair use permission by UCHealth. This poster does not represent the views of the UHMS HBO Safety Committee."
- Hyperbaric centers across the country are struggling with how to provide healthcare in the setting of COVID-19. The UHMS has been given permission to publish a recent publication by the European Committee for Hyperbaric Medicine, which provides thoughtful guidelines. This rapidly evolving pandemic has prompted rapid changes in infection control measures, and alterations in established workflows. ECHM position on Hyperbaric Oxygen Therapy (HBOT) in multiplace hyperbaric chambers during coronavirus disease (COVID-19) outbreak (3/19/2020)
- Disinfecting hyperbaric chambers concerning COVID-19: The UHMS-SC directs all hyperbaric practices to follow the guidance of the Centers for Disease Control (CDC) along with guidance from the Hyperbaric Chamber Manufacturer, State and local health agencies, and your hospital infection prevention and control group. All of these sources will impact the decision for your practice. Your choice should be a decision made between the MD & HSD of your program. The UHMS-SC can provide guidance based upon existing literature available to the public, but does not endorse a particular product or procedure. CLICK HERE FOR THE FULL ARTICLE (3/18/2020)
- Undersea and Hyperbaric Medical Society, HBO2 Safety Committee: Commentary on the current status of IV pumps for monoplace chambers. 2-17-20152-17-2015 (2/18/2015)
- QUALITY ASSURANCE FOR THE HYPERBARIC TREATMENT CENTRE (2/27/14)
- COMPRESSED GAS SUPPLY SYSTEM (2/27/14)
- Emergency Workflow Building Instructions: Submitted by UHMS Safety Committee (UPDATED:10/21/13)
- CHANGES TO PVHO-2 (2012 vs 2003 Edition)
- VIDEO: Fire Behavior and Extinguishment in Hyperbaric Chambers
Useful Links:
- Hyperbaric Oxygen Therapy and Oxygen Compatibility of Skin and Wound Care Products: http://online.liebertpub.com/doi/pdfplus/10.1089/wound.2017.0742
- The MedtronicLongevity Estimator can be found at: http://www.MedtronicLongevity.com
- MRI information for Pacemakers and Reveal Cardiac Monitors including Technical Manuals and Conditions for use can be found at: http://www.mrisurescan.com
- MyCareLink Remote Monitoring information can be found at: http://www.medtronicheart.com
- CRHF educational source for Health Care Professionals, Pacing/ICD encyclopedia, EMI/EMC, and Pacemaker Longevity Estimates downloads: https://www.medtronicacademy.com
- CRHF Device Features: http://www.medtronicfeatures.com/index.htm
- CRDHF Device/Lead manuals: http://manuals.medtronic.com/manuals/main/region
- CRHF Product Performance eSource: http://wwwp.medtronic.com/productperformance
- Medtronic Corporate Website: http://www.medtronic.com
SAFE DESIGN AND OPERATION OF HYPERBARIC CHAMBERS (posted 8/30/2012)
Information:
REVIEWED BY: UHMS Hyperbaric Oxygen Safety Committee
DDC Chamber View-port Catastrophic Failure
Author(s): Association of Diving Contractors International
Information:
Publisher: ADCI
Description: This view-port was in a deck chamber where someone had placed droplight too close to the port. The resulting radiant heat from the lamp exceeded the design temperature of the view-port.
Decompression Sickness in Inside Attendants
Author(s): PJ Sheffield, C Pirone
Information:
Appeared in: Hyperbaric Facility Safety: A Practical Guide (1999)
Publisher: Best Publishing Company, Flagstaff, AZ
Description: This chapter discusses the risk of decompression sickness in hyperbaric chamber inside attendants. A review of the literature reveals that attendant oxygen breathing, more conservative decompression profiles, and attention to variables that affect attendant fitness were effective actions taken to reduce decompression sickness incidence.
Hyperbaric and Hypobaric Chamber Fires: A 73-year Analysis
Author(s): PJ Sheffield, DA Desautels
Information:
Appeared in: Undersea Hyper Med, 1997; 24(3): 153-164
Publisher: Undersea and Hyperbaric Medical Society, Dunkirk, MD
Abstract: Fire can be catastrophic in the confined space of a hyperbaric chamber. From 1923 to 1996, 77 human fatalities occurred in 35 hyperbaric chamber fires, three human fatalities in a pressurized Apollo Command Module, and two human fatalities in three hypobaric chamber fires reported in Asia, Europe, and North America. Two fires occurred in diving bells, eight occurred in recompression (or decompression) chambers, and 25 occurred in clinical hyperbaric chambers. No fire fatalities were reported in the clinical hyperbaric chambers of North America. Chamber fires before 1980 were principally caused by electrical ignition. Since 1980, chamber fires have been primarily caused by prohibited sources of ignition that an occupant carried inside the chamber. Each fatal chamber fire has occurred in an enriched oxygen atmosphere (>28% oxygen) and in the presence of abundant burnable material. Chambers pressurized with air (<23.5% oxygen) had the only survivors. Information in this report was obtained from the literature and from the Undersea and Hyperbaric Medical Society's Chamber Experience and Mishap Database. This epidemiologic review focuses on information learned from critical analyses of chamber fires and how it can be applied to safe operation of hypobaric and hyperbaric chambers.
UHMS Chamber Experience and Mishap Database Report (1923 - 1998)
Author(s): DA Desautels
Information:
Appeared in: Undersea Hyper Med, 1997; 24(3): 153-164
Description: This article summarizes hyperbaric mishap data collected by the UHMS Hyperbaric Oxygen Safety Committee up to 1998. This database is no longer active.
Titanium in a Hyperbaric Oxygen Environment May Pose a Fire Risk
Author(s): J Hink, E Jansen
Information:
Appeared in: Aviat Space Environ Med 2003; 74(12): 1301-1302
Publisher: Aerospace Medical Association, Alexandria, VA
Description: The use of titanium during hyperbaric oxygen therapy may pose a risk of fire. A fresh titanium surface in a high oxygen atmosphere can be a source of ignition. The clinical scenario may be a patient who accidentally breaks his titanium-framed glasses during a hyperbaric oxygen treatment in a monoplace chamber or using an oxygen hood. We recommend some safety precautions to be exercised until consensus standards have been established by the hyperbaric medicine community.
Air-Activated Chemical Warming Devices: Effects of Oxygen and Pressure
Author(s): G Raleigh, R Rivard, S Fabus
Information:
Appeared in: Undersea Hyper Med 2005; 32(6)
Publisher: Undersea and Hyperbaric Medical Society
Description: Air-activated chemical warming devices use an exothermic chemical reaction of rapidly oxidizing iron to generate heat for therapeutic purposes. Placing these products in a hyperbaric oxygen environment greatly increases the supply of oxidant and thus increases the rate of reaction and maximum temperature. Testing for auto-ignition and maximum temperatures attained by ThermaCare™ Heat Wraps, Playtex™ Heat Therapy, and Heat Factory® disposable warm packs under ambient conditions and under conditions similar to those encountered during hyperbaric oxygen treatments in monoplace and multiplace hyperbaric chambers (3 atm abs and >95% oxygen) revealed a maximum temperature of 269°F (132°C) with no spontaneous ignition. The risk of thermal burn injury to adjacent skin may be significantly increased if these devices are used under conditions of hyperbaric oxygen.
OXYGEN CONNECTION SAFETY SYSTEMS
Author(s): Bill Gearhart, CHT, DMT, EMT, CFPS
Information:
Appeared in: UHMS Pressure Membership Newsletter
Description: I wrote an article explaining the storage details of small, "E” sized oxygen cylinders in the Health Care Environment. I received one question regarding the article and it asked if there could be more cylinders if the area was larger. The determining factor in this situation is the smoke compartment size requirement in a Health Care Occupancy, which is limited to 22,500 square feet, (2,100 meters square) and the travel distance to an exit can be no longer than 200 linear feet. These requirements are stated in NFPA 101, 18.3.7 & 19.3.7, (Subdivision of Building Spaces), New and Existing Health Care Occupancies, respectively.
MONOPLACE HYPERBARIC CHAMBER GUIDELINES
Author(s): Lindell Weaver, MD & Michael Strauss, MD
Information:
Report of the Hyperbaric Chamber Safety Committee of the Undersea & Hyperbaric Medical Society
Appeared in: September 1991 (Revised 1997)
Publisher: Undersea & Hyperbaric Medical Society
Description: The guidelines are designed to provide basic information regarding safety and set-up of the monoplace hyperbaric chamber facility, and patient management. The guidelines are dynamic and subject to change as developments in the field occur. Consequently, the format is such that chapters and sections can be easily amended and revised while the basic organization of the guidelines remains intact.
GUIDELINES FOR CLINICAL MULTIPLACE HYPERBARIC FACILITIES
Author(s): UHMS Hyperbaric Safety Committee: David Desautels, Wilbur T Workman, Erick Kindwall, Keith Van Meter & James McCarthy
Information:
Report of the Hyperbaric Chamber Safety Committee of the Undersea & Hyperbaric Medical Society
Appeared in: June 1994
Publisher: Undersea & Hyperbaric Medical Society
Description: There are two basic types of clinical hyperbaric chambers: monoplace and multiplace. The monoplace chamber allows for the treatment of only one patient at a time in a 100% oxygen environment. The multiplace chamber allows more than one patient to be exposed to an air environment under increased atmospheric pressure while breathing oxygen through a mask, a hood, or endotracheal tube. The purpose of this document is to provide operations of clinical multiplace hyperbaric systems basic guidelines by which to operate such facilities.