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Standard Operating Procedures

CHARACTERISTICS OF A MONOPLACE CHAMBER

General Description

The Sechrist monoplace hyperbaric oxygen chambers are designed to administer 100% oxygen concentration or air at up to 3 atmospheres absolute (ATA) of pressure. The pressure chambers are built in accordance with the American Society of Mechanical Engineers (ASME) Codes. 

  Specifications: 3200 3600H 4100H
1  Internal diameter 32.5 inches 35.5 inches 41.0 inches
2 Internal length 90.0 inches 89.0 inches 90.0 inches
3 External length 105.5 inches 106.0 inches 106.0 inches
4 External width 45.5 inches 44.5 inches 46.75 inches
5 External height 57.5 inches 61.0 inches 69.75 inches
6 Chamber weight 1992 pounds 2,220 pounds  3,500 pounds
7  Max operating pressure 30.0 psig (3 ATA) 30.0 psig (3 ATA) 30.0 psig (3 ATA)
8 Maximum patient weight 500 pounds 700 pounds 700 pounds
9 Supply pressure 50-70 psig  50-70 psig 50-70 psig
10 Purge rate 80-400 lpm 80-400 lpm 80-400 lpm
11 Pressure change rate 1-5 psi/minute 1-5 psi/minute 1-5 psi/minute
12 *Emergency vent rate .5-1.0 psi/second 0.25 psi/second 0.25 psi/second
13 Ventilation rate 240-400 lpm 240-400 lpm 240-400 lpm
14 Operating temperature 50-100˚ F 50-100˚ F 50-100˚ F

* Approximate

Maximum patient comfort if room is maintained at 68-72˚ F

Specifications: The Perry Sigma Monoplace Chamber

  Specifications: Sigma 34 Sigma 36 Sigma 40
1 Internal diameter 33.5 inches 36.0 inches 40.5 inches
2 Internal length 90.0 inches 93.0 inches 93.0 inches
3 External length 105.0 inches 105.0 inches 105.0 inches
4 External width 40.0 inches 42.0 inches 46.0 inches
5 External height 61.0 inches 64.0 inches 68.5 inches
6 Chamber weight 2,200 pounds 2,420 pounds 2,850 pounds
7 Max. operating pressure 30.0 psig (3 ATA) 30.0 psig (3 ATA) 30.0 psig (3 ATA)
8 Maximum patient weight 700 pounds 700 pounds 700 pounds
9 Supply pressure 50-90 psig 50-90 psig 50-90 psig
10 Purge rate 30 scfm/ 850 lpm 40 scfm / 1130 lpm 40 scfm / 1130 lpm
11 Pressure change rate 1-5 psi/minute 1-5 psi/minute 1-5 psi/minute
12 *Emergency vent rate 0.33 psi/second 0.25 psi/second 0.25 psi/second
13 Ventilation rate 125-385 lpm 123-385 lpm 123-385 lpm
14 Operating temperature 32-100˚ F 32-100˚ F 32-100˚ F

* Approximate

Maximum patient comfort if room is maintained at 68-72˚ F

Pressure Conversion Scale

f.s.w

p.s.i.g

ATA

m.s.w.

p.s.i.s.

 

f.s.w

p.s.i.g

ATA

m.s.w.

p.s.i.s.

0

0.000

1.00

0.000

14.700

 

35

15.575

2.06

10.465

30.275

1

0.445

1.03

0.299

15.145

 

36

16.020

2.09

10764

30.720

2

0.890

1.06

0.598

15.590

 

37

16.465

2.12

11.063

31.165

3

1.335

1.09

0.897

16.035

 

38

16.910

2.15

11.362

31.610

4

1.780

1.12

1.196

16.480

 

39

17.355

2.18

11.661

32.055

5

2.225

1.15

1.495

16.925

 

40

17.800

2.21

11.960

32.500

6

2.670

1.18

1.794

17.370

 

41

18.245

2.24

12.259

32.945

7

3.115

1.21

2.093

17.815

 

42

18.690

2.27

12.558

33.390

8

3.560

1.24

2.392

18.260

 

43

19.135

2.30

12.857

33.835

9

4.005

1.27

2.691

18.705

 

44

19.580

2.33

13.156

34.280

10

4.450

1.30

2.990

19.150

 

45

20.025

2.36

13.455

34.725

11

4.895

1.33

3.289

19.595

 

46

20.470

2.39

13.754

35.170

12

5.340

1.36

3.588

20.040

 

47

20.915

2.42

14.053

35.615

13

5.785

1.39

3.887

20.485

 

48

21.360

2.45

14.352

36.060

14

6.230

1.42

4.186

20.930

 

49

21.805

2.48

14.651

36.505

15

6.675

1.45

4.485

21.375

 

50

22.250

2.51

14.950

36.950

16

7.120

1.48

4.784

21.820

 

51

22.695

2.54

15.249

37.395

17

7.565

1.51

5.083

22.265

 

52

23.140

2.57

15.548

37.840

18

8.010

1.54

5.382

22.710

 

53

23.585

2.60

15.847

38.285

19

8.455

1.57

5.681

23.155

 

54

24.030

2.63

16.146

38.730

20

8.900

1.60

5.980

23.600

 

55

24.475

2.66

16.445

39.175

21

9.345

1.63

6.279

24.045

 

56

24.920

2.69

16.744

39.620

22

9.790

1.66

6.877

24.935

 

57

25.365

2.72

17.043

40.065

23

10.235

1.69

6.877

24.935

 

58

25.810

2.75

17.342

40.510

24

10.680

1.72

7.176

25.380

 

59

26.255

2.78

17.641

40.955

25

11.125

1.75

7.475

25.825

 

60

26.700

2.81

17.940

41.400

26

11.570

1.78

7.774

26.270

 

61

27.145

2.84

18.239

41.845

27

12.015

1.81

8.073

26.715

 

62

27.590

2.87

18.538

42.290

28

12.460

1.84

8.372

27.160

 

63

28.035

2.90

18.837

42.735

29

12.905

1.87

8.671

27.605

 

64

28.480

2.93

19.136

43.180

30

13.350

1.90

8.970

28.050

 

65

28.925

2.96

19.435

43.625

31

13.795

1.93

9.269

28.495

 

66

29.370

2.99

19.734

44.070

32

14.240

1,97

9.568

28.940

 

67

29.815

3.02

20.033

44.515

33

14.685

2.00

9.867

29.385

 

68

30.260

3.05

20.332

44.960

34

15.130

2.03

10.166

29.830

           

CHAMBER DOOR OPERATIONS

Opening

  1. Chamber pressure must be at 1 psi or less.
  2. Turn chamber control knob to the OFF position.
  3. Ensure the pressure indicator shows zero pressure (complete black eye).
  4. Confirm pressure safety lock has retracted.
  5. Slowly Rotate swing arm (clockwise) the full extent of travel.
  6. Open door with handle.

NOTE: No attempt should be made to open the chamber door until the pressure indicator eye is completely black.

Closing

  1. Ensure the door seal is clear of obstructions, slowly move the door to the closed position.
  2. Rotate the swing arm assembly to the closed position.
  3. Ensure the swing is in the closed position, then rotate to the locked position.

NOTE: When the chamber is occupied, Immediately turn the control knob to the ON position.

COMMUNICATION SYSTEMS OPERATIONS

The Intercommunication System allows a two-way private conversation between the patient and hyperbaric technician. Auxiliary sound input is accessed thru two standard RCA connections located at the rear of the chamber. The system is comprised of the following components: Intercom Assembly located on the Chamber Control Panel,  Intercom Power Supply/ Battery Charger, Built-in battery back-up.   

Two (2) speakers are provided within the Chamber for an auxiliary audio program source (e.g., television sound or music). Connections to the Speakers are made through two Auxiliary Input Connectors (a standard RCA Jack) located at the Base. 

The chamber (intercom) is equipped with a battery back-up system that is used in case of a power failure. The electrical service is only necessary to power the intercom system and will continue normal operation of the intercom for a minimum of 30 minutes.  An indicator light confirms that the charger is in operation and functioning correctly. [1]

NOTE: Be aware of the potential for excessive noise resulting from the entertainment source. Particular attention should be given when decreasing the external speaker volume to ensure that communication with the patient is not compromised. 

CHAMBER OPERATION

Compression

  1. Equipment pre-treatment checks complete and documented.
  2. Patient pre-treatment checks complete and documented.
  3. Confirm the equipment pre-treatment checks are complete and have been documented.
  4. Confirm that the patient is grounded.
  5. Confirm patient understanding of the "air mask" function.
  6. Ensure door seal area is without obstructions (e.g. sheets, pillow or IV lines).
  7. Confirm IV pump(s),  monitoring devices and approved ancillary equipment is functioning properly.
  8. Check for IV blanks, secure if IV fluids are not to be administered. 
  9. Place patient into chamber
  10. Remove gurney, taking care not to strike chamber door.
  11. Slowly close door and secure cam assembly.
  12. Immediately turn control valve to the ON position.
  13. Confirm radio communications with patient and adjust volumes as necessary.
  14. Set pressure control to desired psig (or ATA).
  15. Begin compression - Inform the patient that you have started compression.
  16. Document at the time compression has been initiated "left surface" (LS).
  17. 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).
  18. Confirm Safety Pin has engaged (after 2 psi).
  19. Communicate with the patient and confirm ear equalization is taking place. If difficulties arise, STOP compression.
  20. 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.
  21. Document at the time the patient arrives at prescribed treatment pressure/ "at pressure" (AP).
  22. Set the timer for the prescribed "total bottom time" (TBT).
  23. Observe and maintain visual contact with the patient at all times during treatment

NOTES:

The chamber operator should remain near the chamber console with visual contact throughout the compression phase. This is irregardless of the pressure rate set or the experience level of the patient.

In the event you are required to leave the controls during compression (equipment alarm, telephone, attend to another patient, etc.), halt further compression and confirm that the patient is stable. Ensure the volume control is adjusted so the patient can be heard. Resume compression as soon as possible. Audio from the TV or radio is not to be provided to the patient until the chamber has reached treatment pressure and the patient confirms he/she is comfortable.

At Pressure

  1. Confirm chamber pressure gauge reads desired pressure and adjust set pressure as indicated.
  2. Confirm chamber pressure corresponds with the prescribed treatment pressure.
  3. Communicate throughout the treatment to ensure the patient is not experiencing ear pain, shortness of breath or confinement anxiety.
  4. Adjust flow rate if necessary for patient comfort. This should be performed in  accordance with institutional policy. 
  5. Provide entertainment (TV or audio) as requested. Check chamber audio level does not "drown out" patient's voice communications.
  6. Chart patient's progress per institutional policy.
  7. Routinely check ancillary equipment during the entire treatment.

NOTE: Under NO circumstances is the chamber room to be left unattended (by hyperbaric trained personnel) during a treatment.

Decompression

  • Inform the patient that you are about to begin ascent and will be decreasing the pressure.
  • Confirm rate control setting.
  • Turn the set pressure gauge (counter-clockwise) below zero. Document time - left pressure (LS).
  • Observe the patient during ascent. Communicating throughout to confirm that the ascent is being tolerated well.
  • Decrease the volume of entertainment as needed to ensure clear communication with the patient. 
  • Remind the patient that ear equalization techniques are not required during ascent.
  • Stop and hold ascent if difficulty arises.
  • Upon arrival at 1 psi (chamber pressure), confirm safety pin has retracted.
  • Inform patient you will be removing them from the chamber.
  • Chamber pressure must be at 1 psi or less.
  • Ensure the pressure indicator shows zero pressure (complete black eye).
  • Turn chamber control knob to the OFF position.
  • Confirm pressure safety lock has retracted.
  • Slowly Rotate swing arm (clockwise) the full extent of travel.
  • Open door with handle.
  • Connect gurney and secure wheel lock.
  • Tell patient you are about to remove them, ensure patient's arms are clear of monitor cable (if in use).
  • Remove stretcher to the lock position on gurney.
  • Document the time the patient is "at surface" (AS).

Primary Sources Sechrist Industries Monoplace Hyperbaric Chamber users Manual[1] National Baromedical Services[2]

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REFERENCES

  1. Sechrist Industries. Sechrist Industries Monoplace Hyperbaric Chamber Users Manual . Date of publication ;volume ():.
  2. National Baromedical Services. Introduction to Hyperbaric Medicine Primary Training Manual . Date of publication ;volume ():.