Multiplace Delivery System
Monthly Hyperbaric Safety Notice: July 2005
Patient Oxygen Delivery System Monitoring
In this notice, the importance of monitoring and analyzing the patient oxygen delivery system is discussed.
Background
Analysis of patient breathing gas is an important requirement during multiplace chamber operations. Patients may receive oxygen through a head tent-hood system, a mask, t-tube, ventilator or other delivery device. It is our responsibility to know that the oxygen concentration is acceptable and the carbon dioxide concentration is kept to a minimum. Patients (insurers, we hope!) are paying to be treated with pure oxygen, a gas that can come from a high pressure source or a liquid oxygen (LOX) system.
The Safety Issue
What is the patient breathing? USP oxygen is a drug, prescribed by a physician and it comes with a minimum purity. Our responsibility is to check the oxygen source daily before patients begin therapy. Once the concentration has been verified; by analysis, patients can begin treatment. Once the treatment begins, the delivery system should be monitored on a regular basis to demonstrate adequate oxygenation and acceptable carbon dioxide levels. The guidelines here at Duke University Medical Center call for 98% oxygen or better and less than 1% carbon dioxide from surface to 68 fsw. These readings are taken from the expired side of the breathing system. Most head tents average 99% O2 and 0.1-0.5% CO2. Readings are recorded in the chamber log every 30 minutes.
Key Operational Issues
- Do not assume the oxygen is pure until you have analyzed it.
- Problems with the various delivery systems are easily detectable with proper gas analysis.
Bottom Line
Analyze treatment gas before and during treatments. Set standards for acceptable oxygen and carbon dioxide concentrations for treatments and stick to them.
Contributing Author: P. Owen Doar III, B.S.
Owen
graduated from Baptist College at Charleston, in South Carolina, in 1969. He
then moved slightly north to North Carolina, and Duke University Medical Center.
Initially employed as a hyperbaric research technician, Owen moved up the administrative
and technical framework to his present position as a manager of F.C. Hall Laboratory,
one of the premier international hypobaric and hyperbaric facilities. Owens’s
modest printed resume belies an experture and knowledge base second to none.
He certified as a hyperbaric technologist soon after the inception of the CHT
program, is an associate member of the Undersea and Hyperbaric Medical Society
and appears as a co-author in publication that address phycologic responses to
hyperbaric environments.