Hyperbaric Oxygen Therapy Indications

Since its first appearance in 1977, the UHMS Hyperbaric Oxygen Therapy Indications has served as a guide for practitioners and scientists interested in hyperbaric and undersea medicine. Past UHMS president Richard E. Moon, chair of the Hyperbaric Oxygen Therapy Committee and editor for the 14th edition, along with additional Committee members and leading experts in the field, authored chapters in their respective fields. This publication continues to provide the most current and up-to-date guidance and support in hyperbaric medicine. Updates in the 14th Edition - Revised and updated references - A new chapter summarizing recently published data on trails of HBO2 for chronic traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) - Addition of flowcharts to specific chapters to aid in treatment of decision-making Table of Contents Preface Members of the Hyperbaric Oxygen Therapy Committee I. Background II. Hyperbaric Oxygen: Definition III. Utilization Review For Hyperbaric Oxygen Therapy IV. Acceptance (Addition) of New Indications for Hyperbaric Oxygen Therapy V. List of Abbreviations VI. Author Biographies PART I. Indications 1. Hyperbaric Treatment of Air or Gas Embolism: Current Recommendations 2. Arterial Insufficiencies A. Central Retinal Artery Occlusion B. Hyperbaric Oxygen Therapy for Selected Problem Wounds 3. Carbon Monoxide Poisoning 4. Clostridial Myonecrosis (Gas Gangrene) 5. The Effect of Hyperbaric Oxygen on Compromised Grafts and Flaps 6. The Role of Hyperbaric Oxygen for Acute Traumatic Ischemias 7. Decompression Sickness 8. Delayed Radiation Injuries (Soft Tissue and Bony Necrosis) and Potential for Future Research 9. Sudden Sensorineural Hearing Loss 10. Intracranial Abscess 11. Necrotizing Soft Tissue Infections 12. Refractory Osteomyelitis 13. Severe Anemia 14. Adjunctive Hyperbaric Oxygen Therapy in the Treatment of Thermal Burns PART II. Additional Considerations 15. Mechanisms of Action of Hyperbaric Oxygen Therapy 16. Side Effects of Hyperbaric Oxygen Therapy 17. Oxygen Pretreatment and Preconditioning 18. Randomized Controlled Trials in Diving and Hyperbaric Medicine 19. Hyperbaric Oxygen for Symptoms Following Mild Traumatic Brain Injury Appendix A. Approved Indications for HBO2 Therapy Index

The Undersea and Hyperbaric Medical Society (UHMS) is an international, non-profit organization serving over 2,400 members from more than 50 countries. The UHMS is the primary source of scientific information for diving and hyperbaric medicine physiology worldwide, the breadth of which is illustrated in the triennial report, Hyperbaric Oxygen Therapy Indications. With leading experts authoring chapters in their respective fields, this publication continues to provide the most current and up to date guidance and support for scientists and practitioners of hyperbaric oxygen therapy. Hyperbaric Oxygen Therapy Indications, currently in its thirteenth edition, has grown in size and depth to reflect the evolution of the literature on the approved use of hyperbarics from both a clinical practice standpoint and insurance coverage perspective. To date, the committee recognizes fourteen indications, including the new indication, idiopathic sudden sensorineural hearing loss. Additionally, this book continues to be used by the Centers for Medicare and Medicaid Services and other third party insurance carriers in determining payment for HBO2 services.

Written by internationally recognized leaders in hyperbaric oxygen therapy (HBOT) research and practice, this exciting new book provides evidence-based, practical, useful information for anyone involved in HBOT. It outlines the physiologic principles that constitute the basis for understanding the clinical implications for treatment and describes recent advances and current research, along with new approaches to therapy. This book is an essential tool for anyone who cares for patients with difficult-to-heal wounds, wounds from radiation therapy, carbon monoxide poisoning, and more. Provides comprehensive coverage of pathophysiology and clinically relevant information so you can master the specialty. Covers the relevance of HBOT in caring for diverse populations including critical care patients, infants and pediatric patients, and divers. Features a section on the technical aspects of HBOT to provide insight into the technology and physics regarding HBO chambers. Presents evidence to support the effectiveness of HBOT as well as the possible side effects. Describes situations where HBOT would be effective through indication-specific chapters on chronic wounds, radiation and crush injuries, decompression sickness, and more.

The field of hyperbaric medicine, along with hyperbaric centers throughout the United States and abroad, continues to grow. This growth has been exponential, touting an increase from 350 centers in 1993 to well over 2,500 programs today. With this progression exists a need to establish a resource guideline for developing complete and comprehensive policies and procedures for clinical hyperbaric units. Hyperbaric policy and procedures provide the guiding principles and foundation for safety, quality, transparency, and cost-effective hyperbaric medical and nursing practice. Every hyperbaric facility needs to follow its specific policies and procedures. Policy and Procedural Guidelines for Hyperbaric Facilities provides needed resource and reference guidelines for new and established hyperbaric facilties. It will serve as a reference for the development of new hyperbaric policies as well as customize and enhance current policies and procedures already in place. Policy and Procedural Guidelines for Hyperbaric Facilities addresses issues of safety and practice for both the multiplace and monoplace environments. It utilizes regulatory guidelines and standards of practice as its foundation. Topics covered in this work include, but are not limited to, governance, administration, emergency procedures, patient care, hyperbaric chamber maintenance, treatment protocols and quality improvement. The appendices include sample forms for both Class A multiplace and Class B monoplace chambers. They are intended to serve as templates for development of hyperbaric unit-specific forms. Also included are acronyms, references, and an index, all specific to hyperbaric medicine. The guidelines provided in this document will benefit the diverse group of physicians, nurses, tecnicians, and allied health-care peronnel in the hyperbaric field as they customize their unit-specific policies and procedures. The contributing authors are comprised of established experts in the field of undersea and hyperbaric medicine. They are a diverse group of physicians, nurses, and technologists who devoted an extensive amount of time and energy into producing this resource document of the highest quality. Specific acknowledgements can be found in the List of Contributors section of the book. Endorsement from Baromedical Nurses Association (BNA) The Baromedical Nurses Association (established 1985) provides a forum for hyperbaric nursing that encompasses quality, safety, teamwork, mentoring, research, education, and nursing guidelines of standards of care for the patient receiving hyperbaric oxygen therapy. The Baromedical Nurses Association endorses the Policy and Procedural Guidelines for Hyperbaric Facilities as guidelines to enable hyperbaric facilities to develop and/or endorse their unit-specific policies.

The decade since the first Handbook on Hyperbaric Medicine has seen major advances: studies have clarified the actions of hyperbaric oxygenation; clinical practice is becoming more scientific; various organisational and operational guidelines are now widely accepted. This new Handbook arises from the EU Co-operation in Science and Technology (COST) programme for hyperbaric medicine, COST B14, in combination with the results of a number of recent experimental and clinical studies.

A textbook may sometimes gain the unusual trait of longevity beyond all other books - it can be revised and remain a primary source of information for generations of students. Hyperbaric Medicine Practice seems destined to become such a book. This 4th edition, edited by Harry T. Whelan, pays tribute to its original author, Dr. Kindwall, who died in 2012. It also adds new information of interest to all in the field of diving and clinical hyperbaric medicine. Most chapters have been written or revised by new authors, but many have returned to update their chapters. New chapters include indications for hyperbaric oxygen treatment subjects recently approved for treatment such as idiopathic sudden sensorineural hearing loss and central retinal vein occlusion. There are also chapters on submarine rescue and problems that pertain to technical and rebreather diving. This book will be an important addition to the library of physicians in clinical hyperbaric medicine and those involved with divers—recreational, commercial, and military—as well as other professionals who care for them. - comments by Henry J.C. Schwartz, MD, FACP New Information and Updates in the Fourth Edition Indications for the Use of HBO2 - Completely re-written chapters on basis for HBO2 therapy of Radiation Necrosis and Burns - New clinical trial data for traumatic brain injuries - Tabulation of almost all published cases of hyperbaric oxygen used for refractory osteomyelitis and the new CPT codes needed for reimbursements - Updates on the multiplace hyperbaric chamber with monitoring and provisions for critical care and carbon monoxide emergency - A new complete description of the multiplace hyperbaric chamber as a medical device - Improved illustrations and better clarification for the use of hyperbaric oxygen for crush injuries - Totally new chapter on the role of hyperbaric oxygen for fracture management - Complications and Contraindications for the Use of HBO2 - Completely re-written chapter on the contraindications and relative risks, and the management recommendations - Completely re-written chapter on complications and the management recommendations - Updated details on use of medications and indications for myringotomy The Science of HBO2 - Additional basic science and clinical data regarding HBO2 management of infectious diseases - Completely re-written chapter on basis for HBO2 therapy of Infectious Diseases - Updates on mechanism of action of HBO2 and preconditioning - Added human and animal literature section utilizing hyperbaric oxygen for brown recluse spider bite - Re-written evidence-based recommendations for use of hyperbaric oxygen for brown recluse spider bite - New innovative research developed in Brazil when the first lines of hyperbaric medicine therapy history in South America were written. - Introduces challenging questions to readers including: Should we try HBO2 for Hansen’s disease in present day? Is there any better way to increase oxygen toxicity against Mycobacterium leprae than methylene blue? - All new hyperbaric oxygen mechanism chapter complimented by exceptionally well-illustrated figures - New approach to appreciating the mechanisms of hyperbaric oxygen with primary effects that occur immediately and secondary effects that are long standing and generally require repetitive treatments - In-depth discussion about the physiological, cellular and molecular response to exogenous ketone supplementation and ketogenic diet - New section on pharmacokinetic disposition of drugs in HBO2 New section on antibiotic interactions Updated literature on pharmacodynamics interactions Fully updated discussion on the use of hyperbaric oxygen therapy in pediatrics including risks and benefits, practical considerations, indications and controversies and oxygen administration schedules Discussion of latest information on pediatric disease indications for hyperbaric oxygen therapy and current controversies Updated recommendations for pediatric psychological preparation and sedation

Written by internationally recognized leaders in hyperbaric oxygen therapy (HBOT) research and practice, this exciting new book provides evidence-based, practical, useful information for anyone involved in HBOT. It outlines the physiologic principles that constitute the basis for understanding the clinical implications for treatment and describes recent advances and current research, along with new approaches to therapy. This book is an essential tool for anyone who cares for patients with difficult-to-heal wounds, wounds from radiation therapy, carbon monoxide poisoning, and more. Provides comprehensive coverage of pathophysiology and clinically relevant information so you can master the specialty. Covers the relevance of HBOT in caring for diverse populations including critical care patients, infants and pediatric patients, and divers. Features a section on the technical aspects of HBOT to provide insight into the technology and physics regarding HBO chambers. Presents evidence to support the effectiveness of HBOT as well as the possible side effects. Describes situations where HBOT would be effective through indication-specific chapters on chronic wounds, radiation and crush injuries, decompression sickness, and more.