Go-No-Go Lists / Prohibited Items

Last updated on 3/21/22 | First published on 10/18/17 | Literature review current through Mar. 2024 [cite]

Authors: Tiffany Hamm BSN, RN, CWS, ACHRN, UHMSADS, Jeff Mize RRT, CHT, UHMSADS, more...

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INTRODUCTION

This topic is a resource with tables/ lists of items that are prohibited, restricted and allowed during hyperbaric oxygen therapy (HBOT). It includes links to a risk assessment algorithm, downloadable lists and HBOT authorization form.

DISCLAIMER

The following Go-No-Go lists are provided as a resource for reference only. It is the responsibility of each hyperbaric facility to complete the risk assessment as stated in the NFPA 99 Chapter 14 appendix (see “Risk Assessment Algorithm”). To facilitate assessment, the Go-No-Go risk assessment tool was created, as an interactive process that enables the user to document the product information necessary to complete the risk assessment process. For an overview of the Go-No-Go risk assessment tool, watch the webinar "Performing risk assessments with the Go/No-Go Tool and the Burman Scoring System", and refer to topic "How to Assess HBOT Prohibited Items: The Go/No-Go Risk Assessment Tool And The Burman Scoring System". For challenges and solutions related to prohibited items risk assessment, see topic "Prohibited Item Risk Assessment".

GO-NO-GO LISTS

Approved for use in Monoplace chamber materials list

Concern categories: Energy Source, Fire / Flashpoint, Pressure, Pharmacologic, Patient Comfort, Acrylic Damage, Infection Control, and Choking Hazard

Table 1. Approved for use

MATERIAL	DESCRIPTION	CONCERN	REFERENCE
Breathing system equipment (built-in)	Supply hose with door connection, demand valve mask, face tent, trach collar, non-rebreather masks	Comfort, Pharmacologic	Midwest Hyperbaric Operations Manual
Catheter, (indwelling urinary cath or wound drainage system)	Flexible tubing with collapsible reservoir Empty excess drainage, purge air	Comfort, Pressure	Midwest Hyperbaric Policy & Procedure Manual Midwest Hyperbaric Operations Manual
Cloth restraints	No velcro or metal components, use kerlix roll for restraint	Energy, Fire, Acrylic Damage	Midwest Hyperbaric Policy & Procedure Manual Midwest Hyperbaric Operations Manual
Contact lenses (soft and gas permeable)	Comfort
Cotton gauze dressings	Pads, packing, wraps, island-type with non-stick surface	Comfort, Pharmacologic
Diaper (adult/infant) / Kotex	Should remain against patient skin, moist, no velcro closures	Comfort, Infection	Midwest Hyperbaric Policy & Procedure Manual
Dressings (aqueous) or topical medication	Hydrocel	Pharmacologic, Fire, Comfort	Midwest Hyperbaric Policy & Procedure Manual
ECG and pressure line monitoring cables	Biomed approved/maintained Use of pass-through to connect to monitor outside chamber.	Energy	NFPA 99 14.2.7.6 [1]
Eyeglasses	Plastic or metal composition, lenses	Comfort	Midwest Hyperbaric Safety Discussion
Feeding tube (Dobhoff)	Flushed and clamped	Comfort, Pressure, Pharmacologic	Midwest Hyperbaric Policy & Procedure Manual
Gowns, hospital issue	100% cotton, unit supplied, pocket less, no metal snaps or Velcro, uncontaminated. Must check for concealed items	Comfort, Fire	NFPA 99 14.3.1.5.4 [1]
Heimlich Valve	Attached to indwelling chest tube and sterile glove or urinary drainage bag	Pharmacologic, Comfort, Pressure	Midwest Hyperbaric Operations Manual
IV extension tubing for Monoplace Hyperbaric chamber	Use of pass-through to connect to hyperbaric IV pump outside chamber	Pressure	Midwest Hyperbaric Operations Manual Midwest Hyperbaric Policy & Procedure Manual
Mattress, wedges, pillows	Only those recommended by chamber manufacturer	Comfort, Fire, Pressure	Midwest Hyperbaric Policy & Procedure Manual
Nail polish, acrylic nails	Allowable if applied no less than 12 hours prior to treatment	Fire	Midwest Hyperbaric Policy & Procedure Manual
Nasogastric tube	Un-clamped with end loosely covered	Comfort, Pressure	Midwest Hyperbaric Policy & Procedure Manual
Nebulizer equipment (in-chamber)	Disposable nebulizer, 5-in-1 adapter, liquid medication	Pharmacologic, Comfort	Midwest Hyperbaric Policy & Procedure Manual
Plastic drink cup	No-spill style, vented, unit supplied, only approved unit-supplied fluid	Comfort, Pressure, Fire, Pharmacologic	Midwest Hyperbaric Safety Discussion
Plastic tape	No paper or silk tape	Fire, Energy	NFPA 99 14.3.1.5.4.1 [1]
Pressure infuser with spacer	Ethox Surgi-Press, oxygen-safe lubricant (silicon base)	Pressure, Pharmacologic	NFPA 99 14.3.6.2.1.4 [1]
Sheets, pillow cases, towels, wash cloths, blankets	100% cotton, unit supplied	Comfort, Fire	NFPA 99 14.3.1.5.4.2 [1]
TCOM electrode with cord	Radiometer – Max 28v and 4w in class B chamber Use of pass-through to connect to monitor outside chamber	Energy	NFPA 99 14.2.7.6.1, 14.2.7.6.1.1 [1]
Urinal, bedpan	Disposable, plastic	Comfort
Ventilator breathing circuit (hyperbaric)	Sechrist Model 500A Use of gas port to connect to control module outside chamber	Pressure, Pharmacologic	Midwest Hyperbaric Operations Manual Midwest Hyperbaric Policy & Procedure Manual

Table modified from National Baromedical Services, 2012 [2]

Use with caution in a Monoplace chamber material list

Concern categories: Energy Source, Fire / Flashpoint, Pressure, Pharmacologic, Patient Comfort, Acrylic Damage, Infection Control, and Choking Hazard

Physician with Safety Lead may approve individual material on specific patient
An authorization form is required

Table 2. Use with caution

MATERIAL	Risk Assessment – Action to be taken	CONCERN	REFERENCE
The physician in charge, with the concurrence of the safety director, shall be permitted to use ONE of the following prohibited items in the chamber: Suture material Surgical dressings Alloplastic devices Synthetic textiles Bacterial barriers Biological interfaces	Is there a more suitable alternative to this dressing? Does this dressing produce heat in the chamber? Does this dressing produce too much static electricity? Does this dressing have a low ignition temperature/flashpoint? Is the total fuel load too high? Is there an adverse effect when this product is used inside the hyperbaric chamber? Physician with Safety Lead may approve individual material on specific patient;	Pressure, Fire, Pharmacologic	NFPA 99 14.3.1.5.4.3 [1]
Cast or splint (freshly applied - fiberglass material)	Wait until exothermic reaction in material has subsided; at least 8 hours	Fire, Energy
Compression bandages: ACE wrap, Shur-band wrap, Profore, Surepress, Coban wrap	If not removed cover with moist towel	Energy, Fire, Pharmacologic	NFPA 99 14.3.1.5.4.3 [1]
Epidural infusion catheter.	Catheter may remain in place, clamped Pump is not allowed	Pharmacologic	Midwest Hyperbaric Policy & Procedure Manual
Hair color or perm (newly applied)	Not allowed if < 24 hours since application due to off gassing of fumes	Fire
Hair extensions (synthetic)	If unable to remove COVER WITH MOIST TOWEL	Fire, Energy
Implanted pacer, defibrillator, or intrathecal pump, transducer	Consider each device individually by manufacturer and model Must obtain specific details in writing before approval can be given	Pressure, Pharmacologic,	Midwest Hyperbaric Safety Discussion
Insulin infusion	Plasma glucagon levels decrease during HBO, Hypoglycemia risk; treat with caution	Pharmacologic	Midwest Hyperbaric Policy & Procedure Manual
Petroleum or oil based topical or impregnated dressings: Adaptic, Xeroform, Bacitracin	The risk assessment process for hyperbaric wound dressings are as follows: Is there a more suitable alternative to this dressing? Does this dressing produce heat in the chamber? Does this dressing produce too much static electricity? Does this dressing have a low ignition temperature/flashpoint? Is the total fuel load too high? Is there an adverse effect when this product is used inside the hyperbaric chamber? Physician with Safety Lead may approve individual material on specific patient. If not removed material must be covered with a moist towel	Fire, Pharmacologic	Midwest Hyperbaric Safety Discussion Midwest Hyperbaric Policy & Procedure Manual
Transdermal medication patches	Consider each medication individually, efficacy with vasoconstriction, flammability of base product; consider alternative route If not removed material must be covered with a moist towel	Fire, Comfort, Pharmacologic	Midwest Hyperbaric Safety Discussion
BP (NIBP) cuff with tubing	Use of pass-through to connect to Oscillomate 1630 monitor outside chamber.	Energy	NFPA 99 14.2.7.6 [1]

Table modified from National Baromedical Services, 2012 [2]

Do not use in a Monoplace chamber material list

Concern categories: Energy Source, Fire / Flashpoint, Pressure, Pharmacologic, Patient Comfort, Acrylic Damage, Infection Control, and Choking Hazard

Table 3. Do not use

MATERIAL	DESCRIPTION	CONCERN	REFERENCE
Battery powered devices	Holter monitor, external pacer, TENS unit, watch, hearing aid, VAC device, voice box, house arrest band,	Energy	NFPA 99 14.7.6.1 [1] Midwest Hyperbaric Policy & Procedure Manual
Cell phones, pagers, iPad, shuffle	All electronic devices never allowed in monoplace	Energy	NFPA 99 14.3.1.5.1.2 [1]
Cerium, magnesium, or magnesium alloys	Metals found in equipment	Fire	NFPA 99 14.3.2.5 [1]
Clothing, personal (including socks)	Use clean hospital issue, HBO approved, only	Fire, Energy	NFPA 99 14.3.1.5.7 [1]
Contact lens (hard, non-gas permeable)	In compressed air environment only	Pressure
Cosmetics, lotions, creams, oils, deodorant, perfume, body splash	Make-up, skin care products, after shave, perfume	Fire	NFPA 99 14.3.1.5.5.2 [1]
Dental appliance (removable)	Dentures, partial, retainer	Choking hazard
Electronic devices	Photoflash, flood lamps, laser equipment	Fire	NFPA 99 14.3.2.1.3,4 [1]
Entertainment devices	Headset, games, radio, CD player, TV remote	Energy	NFPA 99 14.3.1.5.1.2 [1]
Flammable hair sprays or hair oils	Mousse, gel, wax, pomade, spray	Fire	NFPA 99 14.3.1.5.5 [1]
Flammable liquids, gases, or vapors	Alcohol skin preps/pads, perfume, nail polish remover, alcohol based deodorant/antiperspirant	Fire	NFPA 99 14.3.1.5.2.3 [1]
Food, gum, candy, chewable pills	Choking Hazard
Hair (synthetic) Wigs	Must be Removed	Fire, Energy
Linens (heated)	Blanket from warmer or microwave	Fire	NFPA 99 14. 3.1.5.1.1,2 [1]
Linens (non-HBO approved linen)	Silk, wool, or synthetics (only 100% cotton)	Fire, Energy	NFPA 99 14.3.1.5.4.1 [1]
Matches, cigarette lighter	Tobacco products, flammable	Fire, Energy	NFPA 99 14.3.1.5.1.1 [1]
Metal	Jewelry, snaps, knives, keys, coins, body piercing, external skeletal fixation devices	Acrylic Damage, Energy	Midwest Hyperbaric Policy & Procedure Manual
Paper products	Newspaper, books, magazines	Fire
Personal warming devices	Chemical heating pads, hand or pocket warmers	Fire, Energy	NFPA 99 14.3.1.5.1.2 [1]
Silk and paper tape	Use plastic tape instead	Energy, Comfort	NFPA 99 14.3.1.5.4.3 [1]
Sulfamylon topical	Mafenide Acetate, use Silvadene instead	Fire,	Midwest Hyperbaric Policy & Procedure Manual
Toys	Sparking, choking hazard	Energy	NFPA 99 14.3.1.5.1.2 [1]

Table modified from National Baromedical Services, 2012 [2]

RISK ASSESSMENT ALGORITHM

Figure 1 -Risk Assessment Process [1]

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NOTE: This is a controlled document. This document is not a substitute for proper training, experience, and exercising of professional judgment. While every effort has been made to ensure the accuracy of the contents, neither the authors nor the Wound Reference, Inc. give any guarantee as to the accuracy of the information contained in them nor accept any liability, with respect to loss, damage, injury or expense arising from any such errors or omissions in the contents of the work.

REFERENCES

Topic 46 Version 1.0

Go-No-Go Lists / Prohibited Items

Go-No-Go Lists / Prohibited Items

INTRODUCTION

DISCLAIMER

GO-NO-GO LISTS

Approved for use in Monoplace chamber materials list

Use with caution in a Monoplace chamber material list

Do not use in a Monoplace chamber material list

RISK ASSESSMENT ALGORITHM

REFERENCES

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