Wound dressings are commonly used inside hyperbaric chambers. They play an important role in infection control and patient outcome. Important safety concerns include production of heat, production of static electricity, production of flammable vapor, ignition temperature, and total fuel load. The NFPA 99, chapter 14 Hyperbaric Facilities – provides our guidance for safety and operational issues. Specifically, the process for effectively managing patients wound care dressing(s) and/ or product(s) during hyperbaric oxygen therapy.  NFPA 99 - 14.3.1.6.4.4 states “Physician and safety director approval to use prohibited items shall be stated in writing for all prohibited materials employed”.[1]

When establishing policies, operational procedures or “GO-NO GO” lists, use language that provides clarity. There are three categories for items that require specific authorization when introduced or restricted for use into the hyperbaric chamber, our “GO – NO GO lists.  For the sole purpose of clarity we use the following:

• GO – Items approved for use in a Monoplace Hyperbaric Chamber
• RESTRICTED – Items that may be used with CAUTION in a Monoplace Hyperbaric Chamber.
• STOP – DO NOT USE in a Monoplace hyperbaric chamber

As clinicians it is our responsibility to understand and educate our patients about prohibited items in the hyperbaric environment. The use of a Prohibited Items reminder can be helpful. See patient education topic and handout in English "Patient Education - Prohibited Item Reminder" and in Spanish "Educación al Paciente - Recordatorio Sobre Articulos Prohibidos".

In addition, hyperbaric facilities are required by NFPA 99 to post signage of prohibited items. The poster "Fire Safety Time Out" can be used to remind patients of items that are specifically prohibited by NFPA 99.