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Routine Inspection

DAILY INSPECTION

Each day, prior to beginning treatments, the following inspections should be performed:

  1. Visually inspect each acrylic chamber for scratches and crazing (fine hairline cracks). If deep scratches (those not easily polished out) or signs of crazing are present, report this to the Program Director immediately.
  2. Visually inspect interior and exterior for cleanliness.
  3. Visually inspect door gasket for damage and cleanliness. Remove and clean/replace as required.
  4. Visually check that each chamber ground wire connection is secure.
  5. Confirm bulk liquid oxygen supply pressure between 50-70 psi.
  6. Perform a general visual inspection of the complete chamber for other damage, loose knobs or IV ports, etc.
  7. Check adequate supply of IV disposable tubing.
  8. Confirm adequacy of all ancillary equipment (EKG, Ventilator, air break, supplies, etc.).
  9. Confirm that exhaust hose secure (chamber and wall) and not kinked.
  10. Check radio battery charger plugged in and indicator light on. Verify communications.
  11. Confirm air BIB’s cylinder has adequate volume (500 psi minimum).
  12. Confirm adequate oxygen volume. Record above checks in Daily Inspection lists.
  13. Conduct chamber ground continuity testing.

MONTHLY INSPECTION

At the beginning of each month complete the following checks:

Chamber

  1. Remove the door seal.
  2. Clean out the seal groove and clean the seal with a damp cloth. Be careful not to stretch the seal by pulling it; push it away from you as you go.
  3. Lubricate brass door lugs with Krytox.
  4. Closely inspect both acrylic cylinders for scratches and crazing.
  5. Polish internal/external acrylic with Novus Product.
  6. Clean deposits from stretcher rails and stretcher wheels.
  7. Wash stretcher assembly with soapy water.
  8. Clean external acrylic cylinder of IV deposits and dust.
  9. Check operation of emergency vent system.
  10. Conduct chamber ground continuity testing.
  11. Record cycle count for the chamber.

PRE-TREATMENT CHECKLIST: EQUIPMENT

  1. Confirm clean 100% cotton bedding is fitted. Limit to 2 sheets and one pillow case
  2. Check controls as follows
    1. Main valve OFF
    2. Rate valve 1 to 3 as applicable
    3. Set valve 1 turn to the left
    4. Chamber pressure zero
    5. Set pressure zero or below
  3. Open oxygen wall supply valve slowly. Note pressure is 50-70 psi.
  4. Align chamber gurney with chamber and lock wheels.

PRE-TREATMENT CHECKLIST: PATIENT

  1. Equipment pre-treatment checks complete and documented.
  2. Patient pre-treatment safety checks complete and documented.
  3. Place patient into chamber, perform patient ground test, secure patient ground. Secure ancillary equipment (IV, ECG) as indicated.
  4. Confirm door seal area free of obstructions, such as sheets, pillow corners, or IV lines.
  5. Confirm IV pump (s) is running normally (when in use). Confirm that all monitoring devices/ancillary equipment turned on and functional. Check for IV blanks, secure if IV fluids are not to be administered. Prepare IV administration sets as necessary.
  6. Determine other ancillary equipment necessary for this treatment, set up as required.
  7. Remove gurney, taking care not to strike chamber door.
  8. Provide oral fluids as necessary/requested.
  9. Provide urinal as necessary/requested.
  10. Slowly close door and secure cam assembly.
  11. Immediately turn control valve to the ON position. Confirm radio communications with patient and adjust volumes as necessary.
  12. Inform patient that you are about to begin compression. Check rate set appropriate for patient.  All first time patients are to be compressed a 1-1.5 psi/min. (as tolerated for further treatments).
  13. Pressure safety lock as set (after 2 psi).
  14. Watch patient closely, confirm ear equalization is taking place. If difficulties arise, halt compression.
  15. Observe the infusion tubing closely (when in use) to confirm it remains free of air bubbles. If air is observed, regardless of its volume, stop the pump and remove air. If the air is in the tubing within the chamber, return the patient to 1 ATA. Flush the line and then return to the compression phase.
  16. Note and record time that patient arrives at treatment pressure.
  17. Note treatment protocol (time and pressure) and compression rate.

POST-TREATMENT CHECKLIST: PATIENT AND EQUIPMENT

  1. Visualize tympanic membranes on all first time patients and in any case of patient difficulty. If barotrauma noted, notify hyperbaric physician/Clinical Director
  2. Complete paper work.
  3. Remove sheets, blanket and pillowcase.
  4. Wash mattress, mattress support and pillow with Tor-HB cleanser or manufacturer approved cleaner.
  5. Wash internal chamber acrylic, footplate and door
  6. Replace IV blank through-port blank if IV tubing was in use.
  7. Restock supplies (linen, IV Tubing, dressing supplies, O2 and air cylinders as necessary).


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