Monoplace Delivery System

Monthly Hyperbaric Safety Notice: May 2007

More on Prohibited Items

Background

The most common cause of a chamber fire over the past several decades has been the introduction, usually by a patient, of dangerous items into the hyperbaric chamber. If sufficient vigilance is not maintained, this danger exposes both the patient and staff to the devastating consequences of fire and physical injury.

The Issue

Prohibited items extend beyond those that represent a fire hazard. Removable dentures can dislodge during a seizure and compromise a patient’s airway. Standard operating policies require that dentures are removed and stored in a denture cup prior to a patient’s entry into the chamber.

A recent incident revealed that this process may not always be as straight forward as it might seem. A patient dutifully removed and stored their dentures prior to treatment. A vigilant hyperbaric staff member noticed who had observed this process also subsequently observed that the patient was wearing dentures. She had bought in two sets, in an attempt to conceal the fact that she intended to wear dentures during her hyperbaric treatments. The patient was successfully counseled as to the dangers inherent in her behavior.

Bottom Line

One cannot be too cautious in terms of protecting the patient, staff members and the physical facility from prohibited items. Be sensitive to each patient’s mental status, ability to comprehend, any possible drug abuse, and vanity issues. A check of the patient for prohibited and concealed items should be a practice standard for every patient prior to every treatment. If deception is apparent, treatment polices should be re-emphasized. Consider holding hyperbaric treatment in unrelenting patients pending further counseling.

Contributing Author: Dick Clarke, CHT

Dick Clarke Dick is President of National Baromedical Services, which he founded in 1986. His previous background included service in the British Royal Navy, diving instructor and underwater photographer, assistant director of the seabed habitat 'HydroLab' and several years in the offshore commercial diving industry. Dick heads the Baromedical Research Foundation where he serves as Principal Investigator for several international clinical trials. He is course director for 'Primary Training in Hyperbaric Medicine' and the 'HBO 2000' series of advanced hyperbaric symposia. Dick has been a NOAA Diving Medical Officer Training Course faculty member since 1983. He pioneered the Certification in Hyperbaric Technology (CHT) program, is a past president of the National Board of Diving and Hyperbaric Medical Technology and remains active at the committee level within the Undersea and Hyperbaric Medical Society.

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