MONOPLACE HYPERBARIC CHAMBER EMERGENCY PROCEDURES April 2006
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1 IMPLEMENTATION DATE: REVISED DATE: ADMINISTRATIVE DIRECTOR: / DATE MEDICAL DIRECTOR: / DATE DEPARTMENT DIRECTOR: / DATE 1
2 These Emergency Procedures are specific to the monoplace chamber pressurized with oxygen. In an emergency, it is vital to respond appropriately to the situation. These Emergency Procedures should be rehearsed, so as to become second nature. It is important to understand the reasons for the Primary and Subsequent Actions, and why they are taken. The Physician and Chamber Operator must work as a team to resolve the emergency quickly and efficiently. Hyperbaric Incident Report Form (S07-13.F1), located in the Standards of Care Manual, must be completed when any Emergency Procedure action is taken. 2
3 I have read and understand the Emergency Procedures, and will respond accordingly in the event of an emergency. Name Signature Date All chamber operators and supervising physicians must sign. Additionally, semi annual reviews shall be conducted in accordance with the Safety Director Handbook, Training; SD & SD
4 Patient Seizure Stop travel/maintain constant depth Notify Physician Maintain depth until directed to surface patient Determine appropriate treatment Direct patient care 4
5 Suspected Pneumothorax Stop Travel Notify Physician Maintain constant depth until directed to terminate Follow emergency dive termination procedure dive Determine appropriate treatment Direct patient care 5
6 Unresponsive Patient/Cardiac Arrest Stop Travel Initiate Code by calling Notify Physician Maintain constant depth until Follow emergency dive termination procedure directed to terminate dive Supervise patient care and emergency procedures Determine appropriate treatment Note: Patient must be clear of the chamber; this could mean the other side of the hyperbaric room or outside of the hyperbaric room depending on the Center s design. All oxygen saturated linen shall be removed prior to defibrillation. It is recommended that a minimum of :30 seconds pass prior to defibrillation. 6
7 Loss of Chamber Pressurization / Loss of Treatment Gas Notify patient of planned action Notify Physician Adjust rate of depressurization with ventilation control valve Follow emergency dive termination procedure Complete fault investigation Supervise patient care, evaluations and determine if transfer to back-up facility is required. Note: No treatments will be initiated or continued utilizing emergency gas, 2 nd gas or back-up gas supply. Contact hospital engineering department for assistance in locating gas supply deficit. 7
8 Uncontrollable Increase in Chamber Pressure Shut all chamber gas supply valves Notify Physician Notify patient of planned action Follow emergency dive termination procedure Complete fault investigation Supervise patient care, evaluations and determine if transfer to back-up facility is required 8
9 Oxygen Leak Notify Physician Determine leak source and correct if possible Secure electronic equipment. Follow emergency dive termination procedure Complete fault investigation Supervise patient care, evaluations and determine if transfer to back-up facility is required. 9
10 Fire in the Chamber Room (R) Initiate patient evacuation by decompressing the chamber, shut oxygen zone valve, remove Follow emergency dive termination procedure patient. (A) Activate Fire Alarm/Call for CODE (C) Set fire compartmentation (E) Extinguish fire if safe to do so Don smoke mask and goggles as needed De-energize electrical equipment as needed Evaluate patients after evacuation to determine if transfer to back-up facility is required. Note: Opening the chamber door will release additional oxygen into the chamber room. 10
11 Fire in the Chamber (R) Initiate patient evacuation by decompressing Follow emergency dive termination procedure the chamber, shut oxygen zone valve, remove patient. (A) Activate Fire Alarm/Call for CODE (C) Set fire compartmentation (E) Extinguish fire if safe to do so NOTE: Assess the situation prior to opening the chamber door this could cause a back draft effect. Under certain circumstances it would be better to wait for EMS arrival prior to opening the chamber door. Don smoke mask and goggles as needed De-energize electrical equipment as needed Evaluate patients after evacuation to determine if transfer to back-up facility is required. 11
12 Emergency Dive Termination / Perry Sigma 34 Notify patient of imminent rapid decompression. Warn patient NOT to hold breath during depressurization. Turn the ON/OFF switch to the OFF position Depress and hold EXHAUST BYPASS button The chamber can depressurize in approximately :2::00 from 30 psi To slow the rate of depressurization, the EXHAUST BYPASS button may be pressed intermittently, instead of being held down constantly Determine appropriate treatment Direct patient care Note: The Red indicator is activated whenever the EXHAUST BYPASS button is depressed. At the physician s discretion, the rate of depressurization may be slowed. 12
13 Emergency Dive Termination / Perry Sigma Plus Notify patient of imminent rapid decompression. Warn patient NOT to hold breath during depressurization. Turn the ON/OFF switch to the OFF position Depress and hold EXHAUST BYPASS button The chamber can depressurize in approximately :2::30 from 30 psi To slow the rate of depressurization, the EXHAUST BYPASS button may be pressed intermittently, instead of being held down constantly Determine appropriate treatment Direct patient care Note: The Red indicator is activated whenever the EXHAUST BYPASS button is depressed. At the physician s discretion, the rate of depressurization may be slowed. 13
14 Emergency Dive Termination / Sechrist Notify patient of imminent rapid decompression. Warn patient NOT to hold breath during depressurization. Turn the Master Valve to the Emergency Vent position Press and hold the red Emergency Vent Button. The chamber will depressurize at a rate of 1 psi per second. Press the Emergency Vent Button intermittently to slow the rate of decompression. Determine appropriate treatment Direct patient care Note: The Red indicator is activated whenever the EXHAUST BYPASS button is depressed. At the physician s discretion, the rate of depressurization may be slowed. 14
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