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RESEARCH, EDUCATION & MEDICINE
CHAMBER CRISIS
54
|
FALL 2016
Why Are Fewer Chambers
Available for Emergencies?
By Marty McCafferty, EMT-P, DMT
A
s many health-care institutions
face increasing pressure to control
costs, the availability of hyperbaric
chambers for dive emergencies has
been greatly limited. Although there
are approximately 1,375 hyperbaric
chambers in the United States, only 130 accept patients
on an emergency basis. In the U.S. there are only two
chambers dedicated solely to divers; all others provide
wound treatment.
With fewer hyperbaric facilities available for
emergencies each year, those that are available have
become overwhelmed by the burden of covering
larger and larger geographic areas of responsibility.
Emergency department physicians frequently contact
DAN® to help them identify available chamber facilities
to treat their most serious patients. It is not unusual
to find that the closest facility cannot accept patients
because the chamber is in use for another emergency
treatment and unavailable, necessitating an expansion
of the search range.
Compounding the problem is that some injured
divers are turned away because of a misconception that
divers need a level of care beyond what a facility can
provide. In fact, divers are generally healthier and more
stable than the average wound-care patient. Nor do
injured divers need a chamber that can be pressurized
to more than 2.8 ATA (60 feet of seawater), as is
mistakenly believed by some health-care providers. The
standard of care for the overwhelming majority of dive
injuries is a U.S. Navy Treatment Table 6 (USN TT6).
This treatment protocol does not exceed 2.8 ATA.
Monoplace (single-occupant) chambers are capable of
providing a USN TT6.
WHAT CHAMBERS TREAT
The Undersea and Hyperbaric Medical Society
(UHMS) has approved the following conditions for
treatment with hyperbaric oxygen therapy (HBOT).
Insurance companies will not typically cover the cost of
HBOT for conditions not on this list.
Acute/urgent indications:
•
crush injuries
•
compromised grafts and flaps
•
central retinal artery occlusion
•
acute peripheral artery occlusion
•
severe anemia
•
decompression sickness
•
air or gas embolism
•
burns
•
carbon-monoxide poisoning
•
idiopathic sudden sensorineural hearing loss
•
necrotizing fasciitis
•
gas gangrene
•
intracranial abscess
MATÍAS NOCHETTO