Is it possible that Dakins, with a pH of 9-10, can really be noncytotoxic?
We have a patient who is diving for Late effects of radiation. The patient is only able to come on Monday Tuesday and Friday. Would this be a beneficial treatment plan for the patient, or should pat...
Are there any special precautions taken for an HBO candidate with an ICD, which is rated for pressurization. Assuming the patient meets all other criteria. I haven't seen any specific guidelines from ...
Hello I was wondering if Radiation Pneumonitis is an indication for hyperbaric medicine, STRN? The patient continues to have right pleural effusions that require drainage. What is the heal rate like?...
My question is regarding qualification for skin substitutes. Per the CMS LCD: "For purposes of this LCD a Failed Response is defined as an ulcer or skin deficit that has failed to respond to documente...
I was diving a patient for mandible RON. Most recent PET scan shows pelvic bone metastasis. ORAL surgeon called the patient stating that HBO is spreading cancer and she has to stop it. What would be a...
Hi! Dialysis Pt with history of PAD,left BKA, bedbound and right leg contracture. Right lateral foot has arterial ulcer with exposed tendon. Pt non adherent to offloading. Referred to vascular, pt is ...
Hello, I was wondering if velcro trach collars were allowed in Monoplace chambers.
Program director says if wound is sutured closed after debridement of Osteo, it then no longer qualifies for HBO because there is no open wound. I have always thought that sutured is not healed, and m...
Everyone says you can't have a thigh wound with Wagner Grade3, but the code is listed by CMS in Group 2. Thoughts?
I have a 75 y/o M who had an extensive multiloculated soft tissue abscess in the lower lumbar and sacral subcutaneous tissue. This measured 15 x 6 cm transversely and 14 cm superior to inferior. He ...
I cannot remember where I saw the information for total contact cast and HBO. The cast has to be done after the Patient's HBO treatment. Not before? So, if the patient had a doctor visit for cast plac...
I have been working with a 60 y.o. male over the last 9 days who came into the acute care setting w/cellulitis to the LLE which escalated significantly over his stay. Blood cultures came back positive...
I have read osteoradionecrosis -Mandible should be at 2.5ATA, however DFUs and Chronic Osteo can range from 2.0 to 2.5 ATA. What makes the difference in choosing 2.0 vs 2.5 ATA? Is 2.5ATA preferred ...
Located in Indiana. Over the past year we have received a couple denials for HBOT with Anthem Medicaid.
In the denial letter Anthem references the MCG 27th Edition Ambulatory Care Guideline for HB...
Hello,
Looking for clarification on proper use of the I70 codes that are listed under "Group 2 - Wound Ulcer Codes" and include various locations of the leg and foot.
I have a patient with DM, n...
Hi,
I have a patient with scleroderma and raynaud's disease with a painful necrotic ulcer of the right 2nd fingertip, non healing > 6 months. She has seen hand surgery who suggests avoidance of debri...
Hi,
I currently have very limited information on an incoming patient. History of oral cancer 12/2022 with 8 weeks radiation, most recent treatment 4/2023. Referred by surgeon for preparation of ir...
Wondering the recommendation for EEG leads in HBO. How long the glue needs to dry in order to safely treat patient in Multi Place Chamber. Also is there any safety concerns with having a E cylinder ...
We are an outpatient hospital based wound center in southern California under Noridian. Is Epifix amniotic tissue product covered under CMS for only venous leg ulcers, or does coverage extend to ulcer...
Hello, there was a post in May of 2022 regarding the Dexcom G6. The conclusion was that there are no significant safety concerns with subjecting Dexcom G6 CGM transmitters to hyperbaric environments b...
She is a 69 yrs old and an ambulatory patient and nutrition is adequate. She is T2DM and Blood glucose is well controlled with metformin and A1c is 5.6.
Recently she had a whipple surgery in 5 mo...
We have a patient who qualifies for HBOT DFU G3, however he does have a peritoneal catheter for dialysis. Is there any reason as to why he could not dive? We do not see a reason not to, but since th...
Hello,
We have an HBO candidate who had 17 SRT treatments over a year and a half ago. Just making sure that since it was not Ionizing radiation, it is not covered under HBO guidelines?
thank you...
70 year old male with cryoglobulinemic vasculitis, multiple ulcers to the feet and fingers, in various stages of tissue necrosis. The ulcers are quite extensive and he is at risk for amputation. His p...
Hello,
I am more accustomed to dealing with open wounds as opposed to dermatological issues ( fungal infections of the skin, dermatitis). Is there a good resource that can be useful for learni...
Hello there team,
We have been seeing an increase in patients with these acute and chronic inflammatory ulcers (via Pathology report) mostly with medial lower leg ulcers that are very fibrotic. ...
Hi Everyone. I just wanted to get your insight on how you restage your PI's. I have a had a recent discussion with a colleague and we differ on thoughts when to restage an unstageable. If you had p...
We have had multiple patient's lately that have a wound vac and the outside opening is small, but there is a cavity underneath that still needs a wound vac. The opening is closing faster than the cavi...
One of my providers asked about giving HBO at below 2.0 possibly 1.5ATA for a patient with CHF, for longer time period than 90minutes? Do you have any information related to this scenario?
87 yo patient seeking HBO for radiation injury after head/neck radiation. His extensive history of sarcomatoid sqamous cell carcinoma has demonstrated no recurrence since 2021 following cefemiplimab ...
I recently recieved a referral for treatment of Radiation proctitis in a patient who recieved 6000 cGy for HBOT. Radiation was done with Chemo for treatment of rectal adenocarcinoma. Problem is he c...
Are HBOT Trials for limb salvage covered by insurance if all appropriate pathways have been followed?
Hi
I’ve been caring for this malleolus injury for 6 weeks now.
On initial presentation, cellulitis present, heavily exudating. I have cleaned it well, de-sloughed and reduced in size with prontosa...
Hello! I was hoping to get an example of what needs to be included in a log for products like epifix.
I would also like to know what would need to be part of the patient record. Any links to where to...
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...
Are there any contraindications for using saline when cleansing wounds while using silver dressings?
Patient is 55 yo male with CO level of 16, Dm2, Renal failure on Dialysis presented to ER with dizziness, blurred vision, Tropinine elevated to 84.5, CT remarkable for old lacunae infarcts. EKG rate...
Hi, I have been trying to find any research related to the post-op healing duration of a compromised flap or graft regarding an appropriate window to refer to HBOT. Looking to provide education to ou...
Im hoping someone can provide some insight to some questions our podiatrist has regarding grading DFUs. We currently use the Wagner Classification system for grading diabetic foot ulcers in our clinic...
Hello. A patient was recently referred for HBOT from her radiation oncologist. Hx: In 2020, high grade urothelial carcinoma of bladder stage T2 N0. Bladder received total dose 6000 cGy at 200 Gy pe...
We are treating a patient for DFU. The patient has completed over 30 hyperbaric sessions in the Perry Sigma 40 monoplace chamber without issues. Over the past two sessions the patient has begun profus...
61 y/o male with stage 4 lung cancer with brain metastasis. His primary tumor of the RUL of the lung was removed via lobectomy. His 5.4 cm right frontal lobe brain metastatic lesion was also removed, ...
10/19/23 by
Bill Khoury,
Hello,
I am looking to see what other recommendations there are for diabetic patients and HBO in regard to hypoglycemic episodes. To clarify, I understand there are protocols for low glucose l...
Hello,
We are working up a 61 year old male for STRN, for a non-healing ulcer to the vertex of his scalp. (radiation was November 2022) He is currently on on taxol , carboplatin and Ketruda immun...
Hello,
We have a pt that will be starting HBO with the indication of Radiation cystitis secondary to ionizing radiation to his bladder. He has been taking Orgovyx (Lupron) for 8 months and will be...
Right now, I have 3 calcinosis cutis patients-one has end stage renal disease/renal osteodystrophy with secondary hyperparathyroidism; a second one has history of severe burns over 75% of his body; an...
76 y/o male morbidly obese male, approximately 270 pounds, history of gastric bypass with over 100 lb weight loss, with primary lymphedema and right lower extremity ulcers about 3% body surface area, ...
I received a referral from a local surgeon to manage an open surgical wound in a 46 yo patient on whom he had performed emergency surgery for incarcerated ventral hernia. He had put a wound vac on the...
For subsequent HBO treatments for CRAO after your initial treatment do you always titrate up starting from 2.0 ATA and stopping where there is response or do you start at the ATA that was effective wh...