Multiplace Delivery System
Monthly Hyperbaric Safety Notice: June 2005
Hyperbaric Chamber Pre and Post Operational Checklist
In this notice, the importance of completing a checklist before and after operating a hyperbaric chamber is discussed.
Background
A checklist of the requirements to completely set the chamber up for operation and shut it down after use is good operational practice 1, 2. The checklist should cover all systems related to the chamber and a safety check of the patients and staff. Because of the variety of chamber complexity and indications for use, the medical director, administration and the hyperbaric safety director should all be involved with the creation of this list. The checklist should be dated and singed by the operator / and or the safety director. The checklist should be filled out before and after each chamber operation. The records can be kept for a period to be determined by the quality assurance program of the facility.
Safety Issue
System failure and operator error can cause adverse consequences3. A checklist will help ensure that the chamber and its support systems are in good repair and ready for use. By completing the list and adding your signature with date and time provides accountability and helps to keep the operator focused on the job. There is a human tendency to become complacent with routine. This complacency can contribute to mishaps. A list that incorporates aspects of the daily preventative maintained program would contribute to a safer environment.
In the pre-treatment checklist it is important to include the chamber systems, the chamber interior, and a safety check. The chamber systems list will include; the control panel, manual valves, electrical circuits, alarms, communication system, medical gas, compressors, fire suppression, filters, treatment log, profiles and emergency procedures accessible. The chamber interior list will include; chamber cleanliness, attendant mask(s), Fire Suppression System accessible, doorways clear, necessary supplies available and all unnecessary equipment taken out. It is important to do a safety check that records the proper staffing, clothing, linen, patient(s) ground and that there are no prohibited items in the chamber environment. A comment section should be included to note any abnormal conditions with the equipment, staffing or patients condition.
A post-treatment list is recommended so that the chamber is clean and ready for its next use. After the chamber is depressurized it should be cleaned, restocked and all systems shut down. Any maintenance issues can be taken care of and records stored.
Key Operational Issues
- Do not assume the chamber is operational; complete the checklist and sign it.
- A checklist does not replace the daily preventative maintenance, operational / therapy logs or medical record keeping.
Bottom Line
Use pre- and post-chamber checklists to reduce operator error and system failure by ensuring that chamber systems are in good condition and ready for use. Create an environment of safety by increasing the personal responsibility of the chamber staff.
Reading Assignment
- Chapter VII, Administration, Hyperbaric Checklist, Guidelines For Clinical Multiplace Facilities, Undersea and Hyperbaric Medical Society, Inc.
- Chapter 22, pages 22-13 through 22-20, U. S. Navy Diving Manual, Revision 4, change A, 1 March 2001
- Section V, Chapter 4, Hyperbaric Incident Monitoring Study (HIMS), Christy J. Pirone, Hyperbaric Facility Safety, A Practical Guide, Best Publishing
Contributing Author: James Bell, CHT, EMT
Jim
has over 25 years experience in the operation and maintenance of multiplace hyperbaric
chambers. He serves as safety director and lead hyperbaric technologist at Hennepin
County Medical Center, in Minneapolis, Minnesota, USA. Jim is a certified hyperbaric
technologist, and an Undersea and Hyperbaric Medical Society facility accreditation
surveyor.