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Routine Inspection

Routine Inspection

Routine Inspection

DAILY INSPECTION

Each day, prior to beginning treatments, the following inspections should be performed.  Inspections should be performed and documented for each chamber with the corresponding serial number. 

  1. Turn on oxygen supply wall shut-off valve, ensure 50-70 psi and document. 
  2. Inspect and ensure the chamber exhaust hose is connected and not kinked  
  3. Inspect the chamber acrylic (interior and exterior) for cleanliness, scratches, crazing or defect. Signs of crazing, scratches or defect in the acrylic should be documented on the chamber acrylic blemish form and reported to the Safety Director immediately.
  4.  Inspect the chamber door gasket for degradation, damage, and cleanliness. Remove, clean and replace as needed.
  5. Perform and document chamber ground stud to wall continuity verification.
  6. Perform and document chamber patient ground to chamber stud ground continuity verification.
  7. Turn chamber on and visually verify safety pin system engaged.
  8. Confirm ventilation flow rate.
  9. Compress chamber and confirm emergency vent system operation and function.
  10. Confirm battery charger is plugged in and indicator light on. Verify communications.
  11. Confirm air BIB’s cylinder has adequate volume (500 psi minimum).
  12. All above checks should be documented on the Daily Inspection form

MONTHLY INSPECTION

Each month inspections should be conducted.  Specifically, the Monthly Chamber Inspection, Monthly Hyperbaric Unit Inspection and the Monthly Chamber Rate Verification. 

Chamber

  1. The chamber door seal should be removed from each chamber, cleaned and examined for any signs of cracks, defect or degradation. 
  2. Prior to replacing the door seal the door seal grove should be cleaned with a damp cloth.  Particular care should be taken when replacing the door seal, as not to cause damage to the seal. Clean out the seal groove and clean the seal with a damp cloth. Be careful not to stretch the seal by pulling.
  3. Examine the brass door lugs and lubricate with Krytox as indicated. 
  4. Clean the chamber rails with a damp cloth. 
  5. Examine the internal and external acrylic for scratches, crazing or defect.  Clean and polish the internal and external acrylic using appropriate grade of Novus polish. 
  6. Verify proper function of the chamber safety pin.
  7. Confirm proper function of the Emergency vent system.
  8. Clean each chamber stretcher with warm soapy water, including the arm rails and stretcher assembly.
  9. Perform ground continuity verification at all (3) points; hospital ground, chamber ground and patient ground.
  10. Perform and document the Monthly Rate Verification test for each chamber.
  11. Record cycle count for the chamber and document the corresponding Monthly check form.

PRE-TREATMENT: EQUIPMENT CHECKLIST

  1. After completion of the Daily Inspection the chamber can be prepared for patient care.
  2. Ensure that clean, 100% cotton linen is in place.
  3. Confirm the appropriate air break assembly (non-rebreather, demand valve/mask or trach collar) is in place and functional.
  4. For diabetic patients validate blood glucose (BG) machine has been calibrated in accordance with institutional policy.
  5. Confirm cardiac monitor is operational.
  6. If performing an in-chamber TCOM, connect the internal and external cables and calibrate the TCOM.
  7. Align the stretcher, lock the wheels and remove the chamber bed. 

PRE-TREATMENT CHECKLIST: PATIENT

  1. Confirm the equipment pre-treatment checks are complete and have been documented.
  2. Perform Patient pre-treatment safety checks and document.
  3. Attach ancillary equipment as indicated (e.g. cardiac monitor, TCOM, IV pump) to the patient and confirm proper function, delivery and / or alarm limits.
  4. Secure the patient ground and confirm that the patient is grounded.
  5. Confirm patient understanding of the "air mask" function.
  6. Provide the patient with a water bottle.
  7. Provide urinal or bedpan as indicated.
  8. Ensure door seal area is without obstructions (e.g. sheets, pillow or IV lines).
  9. Confirm IV pump (s),  monitoring devices and approved ancillary equipment is functioning properly.
  10. Check for IV blanks, secure if IV fluids are not to be administered. 
  11. Place patient into chamber
  12. Remove gurney, taking care not to strike chamber door.
  13. Slowly close door and secure cam assembly.
  14. Immediately turn control valve to the ON position.
  15. Confirm radio communications with patient and adjust volumes as necessary.
  16. Set pressure control to desired PSIG (or ATA).
  17. Begin compression - Inform the patient that you have begun compression.
  18. Document at the time compression has been initiated "left surface" (LS).
  19. Confirm the rate of compression is appropriate for patient.  All first time patients are to be compressed a 1-1.5 psi/min. (as tolerated for further treatments).
  20. Confirm Safety Pin has engaged (after 2 psi).
  21. Communicate with the patient and confirm ear equalization is taking place. If difficulties arise, STOP compression.
  22. 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.
  23. Document at the time the patient arrives at prescribed treatment pressure/ "at pressure" (AP).
  24. Set the timer for the prescribed "actual bottom time" (ABT).

POST-TREATMENT CHECKLIST: PATIENT AND EQUIPMENT

  1. Upon removal from the chamber discuss with the patient how the treatment was tolerated.
  2. Visualize tympanic membranes on all first time patients and in any case of patient difficulty or complaint. If barotrauma is observed, notify the hyperbaric physician.
  3. Ensure all treatment related documentation is completed in the patient record.
  4. Remove sheets, blanket and pillowcase.
  5. Clean the internal and external chamber acrylic, footplate chamber door,  mattress, mattress support and pillow with manufacturer approved cleanser.  Ensure that the cleaner is used in compliance with the necessary "kill time" and institutional infection control policy.
  6. Replace IV through-port blank if IV tubing was in use.


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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.
Topic 56 Version 1.0