NORMAN KNIGHT HYPERBARIC MEDICINE CENTER
The heroic firefighters of Massachusetts, who receive emergency hyperbaric oxygen treatment for smoke inhalation, were among the first people to benefit from the Center and were the inspiration for Norman Knight s gifts.
THE MASSACHUSETTS EYE AND EAR INFIRMARY opened the Norman Knight Hyperbaric Medicine Center in 1995, the first hyperbaric oxygen treatment center in Massachusetts. Long established as the primary therapy for decompression sickness (the bends ), hyperbaric oxygen treatment has since been proven to be effective in a wide range of medical conditions including problem wound healing, carbon monoxide poisoning, smoke inhalation, and life threatening infections. As treatment uses have grown, the Center has expanded to keep pace with increasing demand. Using three specially outfitted, state-of-the-art hyperbaric chambers, the Center treats patients ranging from trauma victims with emergency requirements to the acutely ill and self-referred outpatients. The Center is available on a 24-hour basis and is staffed by a team of physicians and nurses specially trained in hyperbaric medicine, and who are recognized by the American Medical Association/Undersea and Hyperbaric Medical Society.
HOW DOES HYPERBARIC OXYGEN THERAPY WORK? The air we breathe contains only 21% oxygen. Hyperbaric oxygen is a medical treatment in which the patient breathes 100% oxygen at pressures greater than normal atmospheric pressure. While providing 100% oxygen through a facemask has certain benefits, providing pure oxygen in a pressurized chamber delivers unique benefits two to twenty times greater. All of the benefits provided by hyperbaric oxygen therapy are the result of this extra oxygen being carried within the blood stream not by the oxygen having direct contact with the skin or wounds. Increasing the amount of oxygen delivered to body tissues by the blood can promote the growth of new capillaries, reduce swelling and enhance the body s ability to fight infection. For a patient with a problem wound, delivering more oxygen to the damaged tissues can promote healing. For a victim of smoke inhalation, the extra oxygen being carried through the blood stream can rapidly reverse the toxic effects of poisonous carbon monoxide.
HOW MANY TREATMENTS WILL BE NEEDED? The course of treatment will vary depending on the injury. A patient suffering from carbon monoxide poisoning may require only one treatment, while a wound-healing problem may require thirty to forty treatments. If delivered on an inpatient basis, treatment may be provided twice per day. For outpatients, treatment is normally scheduled once per day for five or six days a week. The initial course of therapy will be discussed in detail with the patient and the hyperbaric medicine team before treatment begins. The exact number of treatments will be determined by the patient s response to the therapy and will be evaluated by the team and discussed with the patient on an ongoing basis. Oxygen breathed under increased atmospheric pressure is a potent therapy that can produce negative side effects if administered indiscriminately. The Center s treatment protocols follow established time-dose limits for hyperbaric oxygen exposure. THE POTENTIAL BENEFITS OF HYPERBARIC THERAPY INCLUDE: Increased oxygen delivery to injured tissue Promotion of blood vessel formation for advanced wound infection and preservation of damaged tissues Improved infection control Elimination or reduction of the effects of toxic substances Reduction or elimination of gas bubbles that obstruct tissue
Patient Story MARIA HUDSON Maria Hudson was diagnosed with cancer of the head and neck and underwent radiation treatment. While successful in treating cancer, radiation treatment can cause injury to healthy tissue surrounding the area. For Maria, that meant developing painful sores in her mouth. Maria needed some dental The staff was so empathetic and understanding of my situation and they went out of their way to make things as comfortable as possible for me, said Maria. It was a very difficult time and the staff made it manageable. I m now feeling great and very thankful to everyone at the Center. extractions but her dentists did not want to proceed as they felt the blood supply to the damaged tissue in her mouth was not sufficient and would create problems with healing. They referred her to the Norman Knight Hyperbaric Medicine Center for treatment. Hyperbaric treatment increases oxygen delivery to injured tissue, helping to heal the tissue and improve infection control. Maria required approximately thirty treatments over a six week period. With a hectic life that includes working full-time and going to school, Maria was relieved that the staff was able to work her treatments around her schedule. Today Maria s sores are healed, she has been able to have her dental work completed, and she s well on the road to recovery.
WHAT DOES HYPERBARIC OXYGEN THERAPY FEEL LIKE? Generally the therapy is painless and there are no changes to normal breathing patterns. While the eardrum will respond to changes in pressure, the patient feels no more discomfort than flying in an airplane or driving down a mountain. In rare cases patients have developed temporary changes in eyesight. Generally, altered vision related to multiple hyperbaric therapies is usually of short duration, with vision returning to pretreatment status. In unusual cases a change in eye glass prescription will be required. During therapy, patients are able to lie comfortably and watch television or listen to music. The hyperbaric chamber is clear, allowing patients to see what is occurring around them. Staff is always present and available to answer questions and provide support.
PREPARING FOR TREATMENT Because tobacco products constrict blood vessels and limit the amount of blood and oxygen that can be delivered to tissues, patients should not smoke during the entire course of treatment. In addition, as some medications change the body s response to oxygen, it is important to provide the hyperbaric medicine team with a complete list of medications that you are taking - including non-prescription drugs and alcohol. Hairspray, make up, perfume, deodorant or any hair or skin products containing oils and grease cannot be worn while in the chamber. To reduce the potential for static electricity, you will be provided with cotton garments to wear during therapy. Dentures and partial plates will be removed, and it may be necessary to remove contact lenses and glasses. Please keep in mind that personal items, including all jewelry, are not permitted within the hyperbaric chamber. Lockers are provided during treatment, but please leave valuable items at home. If you are experiencing cold or flu symptoms, such as a fever, cough, sore throat, nausea, vomiting, headache, diarrhea, or generalized body-aches, please notify a hyperbaric staff member as soon as possible. These symptoms may require a temporary delay in your treatment schedule that can normally resume when symptoms are relieved.
Patient Story FRANCIS NEGROTTI One of the complications of diabetes can be poor circulation, particularly to the feet and lower legs. A diabetic for more than twenty years, Francis Negrotti had undergone amputation of his leg below the right knee. A month after his surgery, Francis wound was turning black. Poor circulation was preventing the wound from healing and his doctors feared they might have to remove more of the limb. His physicians referred him to the Norman Knight Hyperbaric Center for treatment of his wound. For patients with problem wounds, the hyperbaric chamber promotes faster healing by delivering a large amount of oxygen to the affected area, which in turn encourages damaged blood vessels to regenerate. With increased blood flow to the affected area, healing can take place. After receiving forty treatments, Francis wound had healed, saving the rest of his leg. The staff at the Hyperbaric Center couldn t have been more helpful, said Francis. The quality of care I received was terrific and I had a marvelous outcome.
Patient Story ROBERT LEWIS With his wife out to dinner with friends, Robert Lewis was looking forward to spending a relaxing evening at home. He returned from his evening run and sat down to enjoy a sandwich when his heart started pounding uncontrollably and he began to feel disoriented. He then discovered that his cat had fallen over and was breathing shallowly. Sensing something was seriously wrong, Robert quickly called 911. Unbeknownst to Robert, the heating system that The whole experience had been installed in his was very frightening, home eighteen years earlier was improperly vented, but the staff at the Center quickly put me causing dangerous carbon at ease, said Robert. monoxide (CO) to flood They explained his home. He was initially everything in depth transported to a local and were very attentive, making sure that heart attack. But when hospital and treated for a I was comfortable Robert relayed the story of throughout the entire his cat, the emergency process. Having the department physicians Center so close saved tested him and found high me from a possible levels of CO in his blood. tragedy and I feel With carbon monoxide very fortunate. poisoning, the faster the toxic CO is removed from the blood stream, the better the patient prognosis. Robert was quickly transported to the Norman Knight Hyperbaric Medicine Center for treatment. After just a few hours of treatment in the hyperbaric chamber, Robert was feeling much better and was able to go home. He has experienced no residual symptoms and is feeling good as new. His cat is also doing great.
APPROPRIATE INDICATIONS FOR HYPERBARIC REFERRAL The Undersea and Hyperbaric Medical Society suggests the following indications are appropriate for Hyperbaric Oxygen Therapy: STANDARD OF CARE Acute Carbon Monoxide Poisoning - smoke inhalation; cyanide poisoning Enhancement of Healing - problem wounds - diabetic vascular disease Decompression sickness Radiation Tissue Injury - late bone or soft tissue complications Osteoradionecrosis - mandible Cerebral Arterial Gas Embolism - decompression and iatrogenically induced ADJUNCTIVE THERAPY Crush Injury; Compartment Syndrome - other acute ischemias Exceptional Blood Loss Anemia - patient refusal of blood; cross matching difficulties Clostridial Myonecrosis - gas gangrene Necrotizing Soft Tissue infections - subcutaneous tissue, muscle, fascia Chronic Osteomyelitis - refractory to antibiotics and debridement Thermal Burns - acute management; wound healing support
NORMAN KNIGHT HYPERBARIC MEDICINE CENTER 243 Charles Street, Boston, Massachusetts 02114 (617) 573-4411 (617) 523-5498 (T.D.D.) www.meei.harvard.edu DANIEL G. DESCHLER, MD Associate Professor, Department of Otology and Laryngology, Harvard Medical School Director, Head & Neck Surgical Oncology Service and Director, Norman Knight Hyperbaric Medicine Center, Massachusetts Eye and Ear Infirmary NORMAN KNIGHT Broadcast pioneer with 60 years of leadership and ownership of TV, radio and cable facilities. The companies he created were sold years ago; his dedication to saving lives continues. DIRECTIONS The Norman Knight Hyperbaric Medicine Center is located on the 11th floor of the Massachusetts Eye and Ear Infirmary. For directions to the Center and a listing of area hotels, please visit us on the web at www.meei.harvard.edu. The Massachusetts Eye and Ear Infirmary General Information line is (617) 523-7900. For consultation, 24 hour emergency service or for more information, please call the Center at (617) 573-4411.