skin bends in monoplace chamber

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Is it possible for a patient to present with the Skin Bends during treatment in a monoplace chamber? Knowing the patient is at pressure and that no inert gas is present we are stumped on what could be happening here. Pt has completed 43 treatments in a monoplace chamber. The patient is diving for chronic refractory osteo and has a HBOT order of 2.0ATA for 90minutes with no air breaks. There has been no change in patient medications or other possible allergens. See pictures below.

Nov 28, 2023 by Sean Finley, EMT-B, CHT

3 replies

Eugene Worth
MD, M.Ed., FABA, ABPM/UHM

Sean:

Another interesting and unique patient.

I want to be sure of one thing ... before we hazard into unknown and unsupported 'guessing.'

Are you absolutely positive that you pressurized on oxygen? If the patient was at 2.0ATA for 90 minutes of air, I could come up with a 'rare' incidence of truncal skin changes looking like skin bends .... BUT given the patient's history of already having 43 treatments without this event, I'd look somewhere else.

If you did think this skin bends, did you have the patient breathe surface O2 after the treatment, and did the rash disappear?

Other items to check ... like changes in antibiotics, laundry changing the soap brand, etc. etc.

Others feel free to assist.

My bottom line opinion is that I've never seen a case of true skin bends in someone who didn't breathe air during pressurization. On 100% oxygen, it shouldn't be possible.

gene

Nov 28, 2023

Sean Finley
EMT-B, CHT

Thanks Dr Worth,

We are absolutely positive that we are pressurizing with oxygen. The medical air we use for air breaks comes from cylinders and is on a demand regulator in the chamber. We are wondering if its a reaction to the linen, possible change in detergent used due to this rash not appearing on his face or neck.

Nov 29, 2023

Eugene Worth
MD, M.Ed., FABA, ABPM/UHM

I'm thinking along the same lines.

Not HBOT related.

gene

Nov 29, 2023

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