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Standard Operating Procedures

CHARACTERISTICS OF A MONOPLACE CHAMBER

General Description

The hyperbaric delivery system involves the Monoplace Chamber. This chamber type consists of a pressure vessel (acrylic walled with aluminum end heads), a double acting quick opening door, a pneumatic pressure control system and communication system.

  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 rate0.33 psi/second0.25 psi/second0.25 psi/second
13Ventilation rate125-385 lpm123-385 lpm123-385 lpm
14Operating temperature32-100˚ F32-100˚ F32-100˚ 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 at 1 psi or less.
  2. Turn chamber control switch to the OFF position.
  3. Allow sufficient time for chamber pressure indicator to show zero pressure (complete black face).
  4. Ensure pressure safety lock has withdrawn.
  5. Maintaining swing arm in present location, slowly rotate lever (clockwise) the maximum travel.
  6. Rotate swing arm the full extent of travel.
  7. Open door with handle.

NOTE: Never attempt to open the chamber door when any orange color is visible on the chamber pressure indicator. It MUST show all BLACK.

Closing

  1. Having verified that the door seal is clear of obstructions, swing door to its closed position.
  2. While applying light pressure on the door handle, rotate swing arm assembly to the locked position.
  3. Rotate door lever (counter-clockwise) the maximum extent of its travel, to the locked position.

NOTE: Immediately turn the control switch to ON once the door is closed and the chamber occupied.

COMMUNICATION SYSTEMS OPERATIONS

The communications system allows two-way conversation between the patient and operator during treatments. Communications from the patient are relayed from an internal "open-mike" and a "volume out" control to a speaker on the control console. A microphone permits voice communication from the operator to the patient. The microphone button is pressed in order to speak to the patient in the chamber, and is released in order to hear the patient.

Under normal operating conditions, the control switch must be in the ON position to activate the communication circuit. The systems can be tested in the OFF position by pressing the "intercom test" button.

A built-in battery pack provides power for this system. It is maintained on constant charge via a remote battery charger, which is plugged into a standard wall socket (110/115 VAC). An indicator light confirms that the charger is in operation and functioning correctly.

During long periods of non-chamber use (over two weeks) the charger may be unplugged. Always unplug the wall socket connection first.

Should a power failure occur, the battery pack is capable of providing approximately four hours of intercom.

NOTE: Due to the close proximity of the internal communication speaker to the entertainments speaker, distracting audio often emanates from the console speaker. This may result in the chamber operator turning the patient speaker volume down to a level that cuts off all audio communications from the patient.

Care is to be taken when lowering patient volume, and a check of patient volume is often necessary before leaving the console. It may be necessary to lower entertainment volume for adequate communications.

CHAMBER OPERATION

Compression

  1. Equipment pre-treatment checks complete and documented.
  2. Patient pre-treatment checks complete and documented.
  3. Place patient into chamber, secure and test patient ground.
  4. Confirm door seal area free of obstructions, such as sheets or pillow corners.
  5. Check, and tape if necessary, any part of IV line that might be caught in door closure.
  6. Remove gurney, taking care not to strike chamber door.
  7. Confirm that all monitoring devices and other ancillary equipment are on and functional.
  8. Slowly close door and secure cam assembly.
  9. Immediately turn control valve to the ON position, confirm radio communications with patient and adjust volumes as necessary.
  10. Inform patient you are about to begin compression.
  11. Set pressure control to desired PSIG (or ATA). Note and document time.
  12. Adjust rate control. (1-1.5 psi/minute all new patients, then as tolerated for future treatments. Acute patients as ordered.)
  13. Check interlock has set (after 2 psi).
  14. Watch patient closely, confirm ear equalization is taking place. (If difficulties arise, halt compression – refer to ear equalization procedure.)
  15. Note and record time that patient arrives at treatment pressure.
  16. Provide audio entertainment as requested. Adjust “volume out” to reduce, but not cancel, chamber sounds.

NOTES:

The chamber operator should remain near the chamber console throughout the compression phase, regardless of the rate at which pressure is set to change and 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 necessary.
  2. Confirm chamber pressure corresponds with that ordered on patient consult. Converse with patient to appraise his/her status. Confirm no ear discomfort remains. Inform patient that no further pressure change will take place.
  3. Adjust flow rate for patient comfort. Range 240-400 liters per minute.
  4. Provide entertainment (TV or radio) as requested. Check chamber audio level does not "drown out" patient's voice communications.
  5. Chart patient's progress per policy and procedures manual.
  6. Routinely check ancillary equipment.

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

Decompression

  1. Inform patient that you are about to begin reducing pressure.
  2. Confirm rate control setting as necessary.
  3. Back off set pressure gauge (counter-clockwise) to slightly below zero. Note and document time.
  4. Observe patient continually during ascent to ensure normal/adequate ventilation and pressure compensation.
  5. Turn off audio entertainment if noise level interferes with patient's attempt to communicate.
  6. Check rate of ascent occurring as planned.
  7. Discourage patient from attempting to equalize ears. Halt ascent if difficulty arises.
  8. At 1 psi chamber pressure, confirm safety interlock has retracted. Inform patient you are about to open door.
  9. Switch control valve to OFF. Wait until chamber pressure reaches zero and orange panel indicator is BLACK. Note and record time.
  10. Slowly remove locking cam and open door.
  11. Connect gurney and secure wheel lock.
  12. Tell patient you are about to remove them, ensure patient's arms are clear of monitor cable (if in use).
  13. Remove stretcher to the lock position on gurney.
  14. Switch over biomedical monitoring equipment as necessary.
  15. Record and monitor patient's vital signs, if indicated.
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