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Safety/Technical

Questions pertaining to safety and technical information. Open to the public.

Are the skin grip adhesive patches for Dexcom G7 soft covers ok to go in monoplane chamber?
Published: 26 Novembar 2024
0.0 of 5 (0 Votes)

Are the skin grip adhesive patches for Dexcom G7 soft covers ok to go in monoplane chamber?

Posted 1/2/2025


Q:  Are the skin grip adhesive patches for Dexcom G7 soft covers ok to go in monoplace chamber?


A:

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 Hyperbaric Medical Director (HMD) and Hyperbaric Safety Director/Coordinator (HSD/C) of your facility.

The questioner is referring to adhesive that holds the sensor in place. Dexcom, Inc. also offers an “overpatch” - an adhesive pad that covers a larger area to keep the device in place. The exact composition of this adhesive is described as a “trade secret” by manufacturers, but similar products with adhesives have been utilized in monoplace, oxygen-filled chambers with no adverse effects from an oxygen-use perspective.

The items below show published data of products evaluated in oxygen using ASTM G72/72M-15 Special Case 2 (2015) to determine their lowest autogenous ignition temperature (AIT) under hyperbaric conditions.

Product

AIT

Kendall™ 850 Foam Electrode Pads with Adhesive

230 oC (446 oF)

3M Transpore™ Tape with Adhesive

224 oC (435 oF)

Perimed© Fixation Ring with Adhesive

187 oC (368 oF)

Micropore™ Surgical Tape with Adhesive

167 oC (332 oF)

100% Cotton (shown for comparison)

241 oC (465 oF)

Vaseline™ Petrolatum Gauze (shown for comparison)

156 oC (312 oF)

(Flammability and Sensitivity of Materials in Oxygen-Enriched Atmospheres: 14th Volume (ASTM 2016))

The AIT results show us that a significant amount of effort is necessary to heat an adhesive (and Vaseline(tm)) to the point of vapor release with subsequent ignition. Given this understanding, the UHMS HBO2 Safety Committee sees no issue with the Dexcom G7 sensor adhesive. One word of caution: in general terms, if an adhesive is giving off an odor at the time of treatment, flammable vapors may be present. it would be prudent to allow enough time to pass for the adhesive to “set” or “dry”, usually no more than 24 hours.

Respectfully,

UHMS HBO2 Safety Committee

BIBLIOGRAPHY:

  1. Davis, S. E., & Steinberg, T. A. (2016). Flammability and Sensitivity of Materials in Oxygen-Enriched Atmospheres: 14th Volume. ASTM International. DOI: https://doi.org/10.1520/STP1596-EB

 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 have a patient who has a baerveldt drainage device. Is this safe to treat, are there any contraindications?
Published: 07 Novembar 2024
0.0 of 5 (0 Votes)

We have a patient who has a baerveldt drainage device. Is this safe to treat, are there any contraindications?

Posted 1/2/25


Q: We have a patient who has a Baerveldt drainage device. Is this safe to treat, are there any contraindications?


 A:

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 Hyperbaric Medical Director (HMD) and Hyperbaric Safety Director/Coordinator (HSD/C) of your facility.

This device is similar in design to the Ahmed Glaucoma valve, an item reviewed by the UHMS Safety Committee in 2020:

Undersea and Hyperbaric Medical Society, MEDFAQ Response, “Ahmed Glaucoma Valve,” Accessed 12/13/2024, UHMS MEDFAQ LINK

The safety committee understands this item to be surgically attached to the sclera of the eye and free of air. Therefore, it is reasonable to consider that pressure would have no effect on the functionality of the device if it has been properly installed and primed. The valve is designed to keep intraocular pressure balanced. However, we suggest that a risk assessment be performed by the hyperbaric physician aided by the patient’s ophthalmologist to ensure that the device is functioning normally.

The Committee did reach out to the manufacturer, Johnson & Johnson, and received the following response:      

“My R&D colleague reports that the Baerveldt Implant has not been tested under the specified condition (3 atm), so we unfortunately cannot substantiate efficacy under these conditions for this particular patient. The Baerveldt Implant functions in conjunction with the patient’s response to the encapsulation of the silicone plate, and this combined system determines the intraocular pressure (IOP). It is unknown whether HBOT will affect the relative difference between eye chamber pressure and bleb pressure (aqueous pressure at encapsulated plate) or if individual patient factors can affect this differential.

With that being said, I did a quick literature search on the effects of hyperbaric oxygen on intraocular pressure or glaucoma. There is not much data given that this is not a standard treatment used in our field, but it seems that hyperbaric oxygen will, at least, likely not induce elevated IOP. If anything, there have been reports of decreased IOP (Gallin-Cohen PF, Podos SM, Yablonski ME. Oxygen lowers intraocular pressure. Invest Ophthalmol Vis Sci. 1980;19(1):43-48) or improved visual function in glaucoma patients without a lowering of IOP (Bojić L, Kovacević H, Andrić D, Romanović D, Petri NM. Hyperbaric oxygen dose of choice in the treatment of glaucoma. Arh Hig Rada Toksikol. 1993;44(3):239-247). Ultimately, IOP control and optic nerve health is what we want to monitor for these patients, and I highly recommend close monitoring with the patient’s eye care provider around time of treatment.”

These additional references may assist you in completing the risk assessment and determining the proper course of action for your particular case. Again, The Safety Committee suggests consulting the patient’s ophthalmologist prior to the decision to proceed with hyperbaric oxygen therapy:

Ersanli D, Akin T, “The effect of hyperbaric oxygen on intraocular pressure,”  Vol 33, No.1 : Journal of the Undersea and Hyperbaric Medical Society, 2006

McMonnies CW, “Hyperbaric oxygen therapy and the possibility of ocular complications or contraindications” Journal of clinical and experimental optometry, 2015, Volume 98, Issue 2, Pages 122-125

Respectfully,

UHMS HBO2 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.

Policy on Active Shooters
Published: 11 Oktobar 2024
0.0 of 5 (0 Votes)

Policy on Active Shooters

Posted: 10/11/24


Q: Policy on Active Shooters


A: 

I would defer to the institution’s local policy. It is not our place for the Safety Committee to weigh in on individual procedural documents. We could give references that may be useful in guiding document creation. 

Good examples of these are the San Diego ASM presentations and posters that were so well done. These talks may still be available for CME.  Visit www.courses-uhms.org

A quick search of UHM showed the below older abstracts.

A couple of related MEDFAQs as well:

https://www.uhms.org/resources/featured-resources/medfaqs-frequently-asked-questions-faq/safety-technical/search.html?yrfaqsearch=shooter

 

I have a patient with an implanted loop recorder and Watchman device. Is it safe to treat with HBOT at 2.0 ATA.
Published: 09 Maj 2024
3 of 5 (1 Vote)

I have a patient with an implanted loop recorder and Watchman device. Is it safe to treat with HBOT at 2.0 ATA.

Posted: 7/3/24


Q: I have a patient with an implanted loop recorder and Watchman device. Is it safe to treat with HBOT at 2.0 ATA.


A: 

The committee would be glad to assist you in answering your question, but please realize that the ultimate responsibility for these types of questions rests with the medical director and safety director of your facility.

Loop recorder:
In cases of undocumented medical devices where little is known of the device, we cannot unequivocally recommend it’s allowance in the chamber. Without knowing the manufacturer, make or model of the device, testing the device does not seem feasible. A proper risk assessment of the device would also be difficult to accomplish. You may wish to discuss removal of the device with the patient if there is an urgent/emergent need for Hyperbaric Oxygen Therapy or the benefit of therapy is deemed to be prodigious.

Watchman device:
This device is similar in design and purpose to other types of cardiac stents. The particular difference is that this implant helps to reduce clotting in a specific region of the heart known as the left atrial appendage. Patients with atrial fibrillation may benefit from the use of this implant by reducing the risk of stroke due to clots that tend to form in this area of the heart.

Several members of the Safety Committee have indicated that there are no overt concerns raised that would prohibit a patient with a cardiac Watchman Implant from receiving Hyperbaric Oxygen Therapy.  One of the committee members consulted Boston Scientific and spoke with their representatives. They confirmed that “There are no issues with the Watchman and HBO therapy”. Additionally, the committee consulted a cardiovascular specialist who is familiar with this implant, who agreed with this conclusion. Therefore the UHMS Safety Committee sees no reason to withhold hyperbaric oxygen therapy from a patient due to the presence of a cardiac Watchman implant.

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.