Hyperbaric Medicine Department

What is a hyperbaric oxygen therapy?

Hyperbaric oxygen therapy is the administration of 100% oxygen at pressure greater than that at sea level. This is accomplished via a monoplace (one patient) chamber. This chamber is pressurized with 100% oxygen to reach treatment depth.

During the late 1930's, oxygen at pressure was proposed as a treatment of decompression sickness. In the early 1960's, Dutch investigators showed the efficacy of hyperbaric oxygen in the treatment of gas gangrene and anemic states. Later in that decade, hyperbaric oxygen therapy became the standard for naval diving accidents. Subsequent studies have shown the efficacy of oxygen in the treatment of wounds, enhancement of white cell killing ability, preservation of hypoxic tissue, and angiogenesis. The clinical indications for the use of adjunctive hyperbaric oxygen therapy continue to be defined.

Hyperbaric oxygen therapy is the primary treatment for decompression sickness (the bends), arterial gas embolism and severe carbon monoxide (CO) poisoning. It has been shown to be an important and useful adjunct in the treatment of gas gangrene, chronic refractory osteomyelitis, radiation tissue damage, anaerobic infections, crush injury, compartment syndromes, and other acute traumatic ischemias. It is also utilized as an adjunct in necrotizing soft tissue infections of subcutaneous tissue, muscle and/or fascia.

The average "depth" of each treatment is 2.0 to 2.5 atmospheres absolute or 33 to 50 feet of sea water. Each treatment lasts 90 to 120 minutes, and depending on treatment protocol, the patient may complete between 20 and 60 treatments. Since June 2001, the Hyperbaric Medicine Department at St. Joseph Medical Center has been proud to provide this state-of-the-art treatment technology to the Berks County area.

Precautions

The therapy is essentially painless. It is common for patients to experience changes within their middle ear during compression. The attending staff will assist the patient in adjusting to these changes. Patients with colds or upper respiratory infections may be predisposed to middle ear or sinus barotrauma and should not undergo therapy until the condition abates, unless emergency or urgent hyperbaric oxygen therapy is indicated. Patients with severe claustrophobia may not tolerate the daily treatments.

Smoking and hyperbaric oxygen therapy is clinically incompatible. All patients are urged to stop smoking. If this is not possible, therapy may have to be discontinued. Treatment protocols have been carefully designed to minimize pulmonary and central nervous system oxygen toxicity. Certain drugs and other medications may produce unwanted side effects and should be avoided.

Rigorous safeguards are followed to minimize complications. Some patients undergoing prolonged periods of daily hyperbaric oxygen treatment may experience visual acuity changes that are usually reversible. Other contraindications to hyperbaric oxygen therapy are severe asthma or advanced COPD, and pregnancy.

Medicare approved uses for hyperbaric oxygen therapy include:

• Air gas embolism
• CO Poisoning
• Decompression sickness
• Clostridial Myonecrosis (gas gangrene)
• Radiation Tissue Damage (soft tissue, osteoradionecrosis)
• Selected problem wounds
• Traumatic Ischemias (crush injuries, compartment syndromes)
• Refractory osteomyelitis
• Compromised skin flaps/grafts
• Intercranial abcesses
• Non-healing diabetic ulcers
• Acute blood loss - anemia

Physical Evaluation

A Hyperbaric Physician evaluates patients referred for hyperbaric services, and depending on disease indication, a Trancutaneous Oxygen Study (TCOM) may be performed upon initial consult.

Hyperbaric Medicine Staff

Michael Bradley, DO, serves as Medical Director for the Hyperbaric Medicine Department. Specialty-trained Registered Nurses and licensed Physical Therapists perform hyperbaric treatments under the guidance of qualified physicians.

Equipment

Since June 2001, the Hyperbaric Medicine Department utilizes state-of-the-art monoplace chambers. This large, acrylic-walled chamber lessens confinement anxiety and has a TV/DVD and radio/CD player available during treatments to facilitate patient relaxation.

Location & Hours

The Hyperbaric Medicine Department is located on the second floor of the Walnut Medical Pavilion at our Downtown Campus, 640 Walnut Street, Reading, PA, adjacent to The Wound Center. Patients are scheduled Monday through Friday, from 7:30 am until 5:00 pm.

To schedule a consult, please call The Hyperbaric Medicine Department at 610-378-2174.