Batangas Hyperbaric Medicine and Wound Healing Center

The Batangas Hyperbaric Medicine and Wound Healing Center, situated in the ground floor of the newly built 3-storey building at St. Patrick’s Hospital Medical Center, is a part of the institution’s ever growing commitment to provide quality health service to the localities of Batangas province and its nearby areas.

It began its operation on April 18, 2001, with a local fisherman from Mabini, Batangas as its first patient. From then on, different patients from Batangas province, as well as divers from different parts of the world come to the center to seek medical consultation and treatment, both in diving accidents and wound healing.

INTRODUCTION: THE HYPERBARIC CHAMBER

The history of modern hyperbarics goes back to the invention of the air compressor, about 300 years ago. But the history of using chambers for the treatment of diving illnesses begins just a little more than 100 years ago. The advent of air compressors, coupled with the development of boiler technology, has brought us to where we are today.

Hyperbaric chambers are used to support a variety of tasks in scientific and research diving. Principally, chambers outfitted for diving are used for surface decompression, omitted decompression, recompression of an injured divers, training, research, pressure testing of an equipment, and healing for chronic wounds. This type of chamber is often referred to, interchangeably, as a decompression chamber, recompression chamber, or hyperbaric chamber.

Hyperbaric chambers are pressure vessels. They contain a volume of gas that can be held at a pressure different from the ambient pressure. Chambers are usually cylindric in shape, with hemispheric ends. They are described using diameter denotations and their rated working pressure, which is usually expressed in pounds per square inch (p.s.i.) or ata. Most chambers for treating divers are rated to a working pressure of 6 ata or 165 fsw. Many chambers used for medical treatment are rated for 3 ata, or 66 fsw. These can be very useful for treating the more common type of DCS.

The chamber that is being used in Batangas Hyperbaric Medicine and Wound Healing Center was originally built in Australia to AS 1210 design code and has the maximum working design pressure of 710 kPa (equivalent to 7.1 bar, 243 feet, 71 meters). The chamber is equipped to provide 100% oxygen therapy or recompression therapy using the US Navy shallow oxygen tables (60 feet or 18 meters) up to deeper tables to 165 feet or 50 meters.

GENERAL OBJECTIVES

To promote St. Patrick’s Hospital Medical Center and Batangas Hyperbaric Medicine and Wound Healing Center as the only facility in the country equipped with Chamber that uses 100% oxygen therapy in treating diving related injuries/accidents and chronic wounds.

SPECIFIC OBJECTIVES

The Batangas Hyperbaric Medicine and Wound Healing Center aims to promote:

1. dive safety in the diving communities

2. enhance chronic wound healing

HYPERBARIC CHAMBER AND SUPPORT EQUIPMENTS

• Pressurization and exhaust systems

• Viewports

• Depth control gauges and control manifolds

• A two-way communication system

• Built-in-breathing system (BIBS) for the delivery of oxygen, including connections

for demand-type oxygen inhalators or a ventilation hood system for constant flow

delivery

• Gas monitoring ports

• Stop watches

• Illumination system, generally consists of an external lighting source illuminating

the interior via light pipes or by shining light through an observation port, but may

include specially designed internal lighting

• Fire suppression system—water based, including a deluge system and a hand line

Compressors
Air Drier/Cooler
Air Filters

HYPERBARIC TREATMENT TEAM

· Two technicians, outside. One at the controls, one supervising the log book, equipment, and assisting the inside attendant.

· One inside attendant

· One DMO or at least MO immediately available

COMMAND STRUCTURE

· The medical doctor is in charge, and therefore is responsible. But a “Team” approach is best.

· All others are not medically trained, therefore they cannot make treatment decisions (extensions, etc.)

· Next is the dive supervisor, who oversees the operation, keeps the log book, assists the operator at the panel, and the inside attendant.

The supervisor, inside attendant, chamber operator should work more as a “team” in making decisions, but the Supervisor coordinates the operational team with the DMO.

OTHER PERSONNEL REQUIREMENTS

· Should pass the written examination given by DMO and Mr. Bob Ramsay

· Should pass the hands-on training and skills assessment test

· Should be a certified oxygen provider

· Should be a certified/professional CPR provider

· Should have a knowledge in nursing care and procedures

CHAMBER MAINTENANCE

Preventive maintenance is the number one tool. It protects the staff and all involved in the system. A little fault ignored today may cause catastrophic failure in the future. All personnel should not try and guess what is happening, simply report it.

Proper care of a hyperbaric chamber requires both routine and periodic maintenance. After every use, or no less than once a month, whichever comes first, the chamber should be maintained routinely. During these checks, minor repairs should be made and supplies restocked. At least twice a year, the chamber should be inspected inside and out. Any deposits of grease, dust, or other dirt should be removed and the affected areas repainted as appropriate.