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...
We use mostly Puraply and Epifix, and log the application number, lot number, and waste in the EMR. We also separately keep a paper log of the same information, in case of a JCAHO visit. Do you know w...
I have a 90 y/o male patient who underwent thoracentesis about 3 months ago, looking for HBOT for radiation cystitis and intractable repeated urinary bleeding. Post tap cxr showed no pneumothorax, and...
The Zero G offloading device claimed to off load 100%. I do not see it listed in your product listing of off loading devices. It is hard to find information on Zero G. What happened to it? Is it still...
Regarding criteria for chronic refractory osteo: Imaging and/or bone cultures confirming diagnosis of osteomyelitis, medical management to which the patient did not respond (4-6 weeks of abx), and sur...
How should PTs bill for "non-skilled" wound care treatments, for treatments that don't require sharp debridement, compression, or wound vac? I'm thinking specifically a pt visit where a simple dressi...
6/5/23 by
Adam Copp,
Patient is here regarding worsening of the left lateral ankle ulcer no fever or chills. The patient is present with his wife. The ulcer has been present since 12/2019 per patient. The patient started ...
Has anyone ever heard of increased fluid or fluid shift in cancer patients during HBO? An oncologist told me he has seen it happen several times. I have a post radiation cysitis/proctitis patient wit...
HX: chronic wound ulcers on BLE, since September 2022 for right leg, left leg was present since July 2022. She got bit or broke down her left outer ankle and eventually healed. However, the wound has ...
I was approached last week by our infectious disease specialist who request HBO therapy for an HIV patient who has had persistent desquimation of his feet. The problem was felt to be due to antiretro...
There is controversy as to whether Benzocaine (Hurricane) should be used prior to bedside debridement. Any insight to this and what are other clinic's using.
Thank you!
82yo male patient with STRN and ORN of the mandible (diagnosis SCC of lip 2016 w/radiation from 2016-2017) - the workup on this patient indicated a small right basilar pleural effusion on 3/21/2023 (k...
Hello,
We have a 85 yr old male with radiation cystitis scheduled to start HBOT soon. He has a prosthetic R eye. First initial prosthetic eye was in 1951, with aprox 6 replacements. Any informat...
If a patient has DFU G3 or CROM along with arterial disease, would it be appropriate to dive these patients prior to bone debridement's/Amputation, given the patient has passed the TCOM challenge and ...
I have a patient who completed HBO for ORN #31 last April. His oncologist is requesting 10 additional dives due to patient having a tooth #31 extraction scheduled. There is a 10mm dept surrounding the...
Hello! New patient for HBOT. Hx metastatic renal cell carcinoma. Has not come in for a full evaluation yet and currently limited medical records. History of thoracentesis for past pleural effusions. H...