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The Respiratory Care Practitioner and HBO
To become a CERTIFIED HYPERBARIC TECHNOLOGIST (CHT)
- At least 18 years of age
- High school diploma or equivalent
- Qualifying Vocations - Respiratory Therapy is listed as one of the 15 qualifying vocations.
- Completion of a hyperbaric technology certification training program
- Completion of a minimum of 480 hours of undersea, hyperbaric or aviation technology/medicine.
- Letter of recommendation from present employer, administrator, or medical director.
Responsibilities
The Dive
Preparing the Patient for a Dive
- Explain procedure
- 100% cotton or linen clothing (Patient should have recently washed hair- no hair spray or hair oils)
- Wet body hair to reduce static electricity
- Be sure patient has voided before entering chamber
- Place on chamber cart and take vital signs
- Be sure that absolutely nothing else except medically approved items are taken into the chamber
- Give patient Afrin nasal spray to help equalize air spaces.
- Instruct patient in valsalva maneuver
- Instruct in the use of Air-break mask (Place next to patient so can blow air to patient)
- Place water bottle and urinal in with patient.
- Attach ground spike
- Roll patient into chamber and lock chamber door
- Turn Master Selector Valve "ON", this allows gas into chamber
- Inform patient that they are about to go to pressure
- Stay with patient entire time
- Make sure patient is awake for decompression
- For intubated or trached patients see Ventilator section
Dive Protocol
Set Pressure Rate Set Control- usually 2 psi/min
Adjust Pressure Set control to desired pressure (usually 2 atm) Chamber will automatically go to selected pressure at the set rate. Takes about 10 min Chamber will maintain pressure After treatment time has elapsed, adjust the Pressure Set Control to zero. The chamber will depressurize at the rate previously set. When the chamber pressure gauge reaches 2 psi, turn the Master Selector Valve to "OFF" Allow time for the Chamber Pressure gauge to show ALL BLACK. SLOWLY disengage the pneumatic door lock and open the chamber door Emergency Depressurization
- Emergency vent - 1 psi/sec.
- Takes 15 seconds
- Will rupture ear drums
- 30 seconds without damage to ears. Purge 5 sec, wait 5 sec, purge 5 sec, etc
- Patient skin still super-saturated with oxygen. Can't defibrillate immediately until oxygen dissipates
- Have a maximum of 39 minutes to get patient out of chamber. CO2 builds up and will cause unconsciousness.
Special thanks to our consultant, colleague, and leading man in the movies, without whom this presentation would not have been possible - Chad Jackson, RRT, DMT.
