Hyperbaric oxygen therapy (HBOT), as administered at the Mosaic Life Care at St. Joseph - Wound Care, is a medical treatment during which the entire body is placed in a transparent, airtight chamber at increased atmospheric pressure. The patient is surrounded by and breathes 100 percent pure oxygen. This treatment is proven effective for a number of different medical and surgical conditions either as a primary or adjunctive treatment. It is also used to treat many other medical conditions that are still considered experimental by the mainstream medical establishment — despite decades of reported benefit.
At Mosaic Life Care at St. Joseph - Wound Care we utilize monoplace hyperbaric chambers. They are large enough to hold a seven-foot patient. The pressure can be increased to as much as three times normal atmospheric pressure (although the usual treatment pressure is twice atmospheric or less). Pure, 100 percent oxygen is continuously maintained and circulated throughout the treatment. There is no need to wear a mask or hood at our clinics because the entire chamber is pressurized with oxygen instead of room air. This method requires much more oxygen per treatment, but provides additional benefit at lower pressures — especially to areas of the body with poor blood flow.
While breathing pure O2, the patient's blood plasma becomes saturated, carrying 15 to 20 times the normal amount of oxygen to the body's tissues. The ultimate result is that the body's natural wound-healing mechanisms, which are oxygen dependent, are able to function more efficiently. Around 16% of wound care patients treated may require HBOT.
Frequently Asked Questions
1) Does the increased pressure cause discomfort?
2) Does the increased pressure cause discomfort?
4) Are there any negative after effects?
5) What are some preparations before hbo therapy?
6) What are the approved indications for hyperbaric oxygen therapy?
Do you still have questions?
If you have further questions or would like to receive additional information on hyperbaric oxygen therapy, please call Wound Care at (816) 271-7546.
Responses:
1) Hyperbaric treatments are painless, but the patient may experience a sensation of “fullness” in the ears, similar to driving down a mountain, flying, or scuba diving. The “full” feeling occurs as the eardrums respond to the change in pressure. The hbot technician demonstrates how to relieve this fullness before treatment.
2) Hyperbaric treatments are painless, but the patient may experience a sensation of “fullness” in the ears, similar to driving down a mountain, flying, or scuba diving. The “full” feeling occurs as the eardrums respond to the change in pressure. The hbot technician demonstrates how to relieve this fullness before treatment.
3) Once a patient is in the chamber and the door is closed, the oxygen begins to circulate. This starts a gradual increase in pressure—called compression. There may be some slight warmth, but that is temporary. The hbot technician remains by the chamber throughout the treatment to adjust the rate of compression according to patient tolerance and to coach the patient on relieving the “full” sensation in the ears. Compression generally lasts 10-15 minutes depending on how effective one is at clearing their ears.
When the interior of the chamber reaches the prescribed pressure, the sensation of “fullness” in the ears will cease and the patient is free to rest or sleep. The temperature in the chamber remains at room temperature. The patient may also watch tv, listen to music, or chat with family over the intercom during the treatment, which usually lasts one hour.
Near to the end of the treatment, the hbo technician will gradually decrease pressure that was added at the beginning. This is decompression, which generally lasts 10 to 15 minutes. During decompression, there may be a slight “popping” sensation in the ears as a result of the changing (decreasing) pressure. This “popping” is a normal adjustment, similar to what happens when driving up a mountain or ascending in an airplane. It is usually much easier to equalize ear pressure during decompression than during the compression phase.
4) Generally patients experience no negative after effects from hbot. However, some patients report a “cracking” sensation in their ears between treatments as oxygen behind the eardrums is absorbed into the blood stream. This can be relieved in the same manner as clearing the ears during compression and decompression. Also, some patients report feeling light headed for a few minutes immediately following a treatment, but this is brief, and they are quickly able to continue with their normal daily activities such as working or driving.
As with all medical procedures and treatments, some potential after effects may result from exposure to hyperbaric oxygen. These are rare, but will be discussed in detail by the doctor and hbo technician before treatment.
5) Medications: some medications are not compatible with hyperbaric oxygen therapy. The hbo technician will obtain a complete drug history before treatment. Each drug taken will be considered individually in relation to hbot, and should changes be indicated, the prescribing doctor will be advised.
Some commonly used medications may potentiate side effects from hbot. They must be limited or substituted with another drug. These include: high doses of aspirin and prednisone (or similar cortisone type drugs), and morphine, or alcohol within 8 hours of treatment.
Special precautions also are required for hbot patients who are taking insulin, pain medication, tranquilizers, high doses of prednisone and other corticosteroids, and anticoagulants. The doctor or nurse will explain any needed precautions.
Colds and other symptoms: it is important to notify the hbo technician should symptoms occur of a cold or the flu, fever, cough, sore throat, runny nose, cold sore, nausea, vomiting, diarrhea, or a generalized ache-all-over feeling. Those types of illnesses are not helped by oxygen, so the hbo treatments may need to be postponed until symptoms have subsided and the doctor allows resumption of hbot.
Smoking: nicotine is another substance that is not compatible with hbot. Once hbot has been prescribed, patients should stop the use of tobacco in any form until therapy is complete. This “no smoking” rule applies to cigarettes, pipe tobacco, and cigars, as well as chewing tobacco and snuff. If a person just cannot stop the use of tobacco, hbot will not be as effective.
Cosmetics: cosmetics, hair spray, nail polish, perfume, or shaving lotion containing a petroleum, alcohol or oil base are not allowed while in the hbo chamber. However, those products may be reapplied after each treatment. It is important to discuss all skin care products with the hbo technician so they may assure safety.
Clothing: patients are provided with 100-percent cotton gowns to wear during treatment. No articles containing nylon or polyester can be worn in the chamber. Watches and other jewelry, dentures, contact lenses and other prosthetic devices will also need to be removed before treatment. It is also important that cleanliness be maintained during the course of treatment.
Scheduling: the hbo technician will usually schedule treatments on a daily basis. Every effort will be made to consider personal schedules and other activities of daily living. There may be times when an hbot appointment must be cancelled or postponed due to emergency situations. If, on the other hand, it is not possible to keep an appointment, the clinic should be notified as soon a possible.
6) The following is a list of approved indications for the use of hbot in wound care which are currently reimbursed by medicare, Medicaid, HMOs and other insurance carriers:
- Soft tissue radionecrosis
- Actinomycosis
- Preservation of compromised skin grafts and flaps
- Chronic refractory osteomyelitis
- Diabetic ulcer of the lower extremities
- Crush injury/acute traumatic peripheral ischemia
- Progressive necrotizing infections (necrotizing fasciitis)
- Acute peripheral arterial insufficiency
- Osteoradionecrosis
