Wednesday, June 29, 2016

FAQ's on Hyperbaric Oxygen Therapy, Indraprastha Apollo Hospitals Delhi, India

Q- Who will benefit from Hyperbaric Oxygen Therapy?

Ans- HBOT has been proven effective for many medical conditions, and as a result the Undersea and Hyperbaric Medicine Society, one of the premier research institutes, has approved following indications:
·         Air or Gas Embolism
·         Carbon Monoxide Poisoning & Carbon Monoxide Poisoning Complicated by Cyanide Poisoning
·         Clostridia Myositis and Myonecrosis (Gas Gangrene)
·         Crush Injury, Compartment Syndrome, and other Acute Traumatic Ischemia
·         Decompression Sickness
·         Enhancement of healing in selected problem wounds
·         Exceptional Blood Loss (Anaemia)
·         Intracranial Abscess
·         Necrotizing Soft Tissue Infections
·         Refractory Osteomyelitis
·         Delayed Radiation Injury (Soft Tissue and Bony Necrosis)
·         Compromised Skin Grafts & Flaps
·         Thermal Burns

Q- What is it NOT used for?

Ans- Similar to all treatment modalities, HBOT is not used for diseases where there is no clinical evidence that it works. There have been claims that HBOT might help with problems like aging skin, or to prolong normal healthy life. Those have not been documented nor accepted in the wider medical community.

Q- How long is a hyperbaric treatment?

Ans- Except for decompression sickness and arterial gas embolism, the typical treatments are approximately two hours long. Patients are generally treated once a day, but sometimes may require therapy twice a day. Each single treatment session lasts about 2 hours. This includes 90 minutes in the chamber plus another ½ hour for preparation before, and observation after. The number of treatments required would depend on the type of problem that you have. The hyperbaric doctor will determine your treatment schedule. Normal treatment days are Monday through Saturday, excluding holidays. You must be on time for your session since any delays affect the treatment of all patients. A late arrival may result in the cancellation of your treatment. If you are unable to attend your session because of an urgent problem, please call.

Q- How many treatments are needed?

Ans- A patient's clinical response and other factors often dictate the number of treatments required. Emergency cases, such as carbon monoxide poisoning, arterial gas embolism or decompression sickness, may only require one or two treatments. Non-healing wounds may call for as many as 20 to 30 treatments.


Q- How does a hyperbaric treatment feel like?

Ans- The treatment is painless. At the beginning and end of your treatment, you may notice a feeling of fullness in your ears. This is much like the feeling when flying in an airplane or diving underwater. As your eardrums respond to the changing pressure, you may hear popping or crackling noises. The Paramedic / Nurse will teach you how to relieve this sensation by clearing your ears.
·         The first thing you do to prepare for your treatment is to change into a suit made of a fire retardant fabric or 100% cotton.
·         The staff will assist you in entering the treatment chamber. You will be positioned at your seat.
·         Now we are ready to pressurize the chamber, this is when you need to clear your ears. Compression takes about 10-15 minutes and you will have to clear your ears several times during this phase. If you have P.E. tubes you do not need to clear your ears. Notify the inside attendant at the first sign of discomfort in your ears or sinuses so we can stop compression and help you. The Technician / Doctor will adjust the rate of compression to reduce the fullness in your ears.
·         You will notice the air gets warm during compression. When our treatment pressure is attained, we will vent out the warm air and ventilate with fresh air for the whole time of the treatment. The chamber has an air conditioning system. Treatment normally ends after about 90 minutes
·         The inside observer will place your Oxygen mask / hood on and set the oxygen flow and exhaust dump hose to the proper settings. Hoods, neck rings and console panel are the responsibility of the inside observer and should not be operated by the patient. Neck rings must remain on until the end of the treatment. The staff will assist you in removing the neck rings.
·         After your treatment is finished we slowly decompress the chamber. This takes another 10 - 15 minutes. Don't try to clear your ears during the decompression phase. Your ears will clear automatically.

Safety is important...
To decrease the risks of fire inside the chamber, we take several precautions. The oxygen concentration inside the chamber is constantly monitored and kept at a safe level. Everyone inside should wear clothes of 100% cotton or fire retardant material.
·         In the unlikely event that a fire occurs, the inside observer will provide you with guidelines to follow. Try to stay in your seat. A fire deluge system will be activated.

Consent
We cannot legally treat you without your written consent. You will be asked to sign a form consenting to treatments and photographs (of wounds).

Q- Are there side effects to HBO?

Ans- When used in standard protocols hyperbaric oxygen therapy is safe. Commonest side effect may be slight discomfort or pain in the ears (aural barotrauma) if the ears are not able to equalize pressure. Pneumothorax and air embolism and transient reversible myopia after prolonged HBO therapy are rare complications. An occasional patient may be claustrophobic. Rarely, patients feel light-headed for a few moments after treatment. This ends quickly and does not interfere with normal activity.

Q- What are the methods of equalizing pressure in our Middle Ear?

Ans- The Valsalva Manoeuvre
·         Hold your nose closed and close your mouth.
·         Lift the back of your tongue toward the roof of your mouth.
·         Attempt to blow through your nose (short and sharp) while holding it shut.

Other Methods
·         You can try to yawn; swallow or drink sips of water.
·         You will have to repeat this procedure several times during the pressurization phase of treatment
If you have difficulty with your ears, notify an inside attendant immediately. Don't wait until it hurts.

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