Send Feedback

Print

Mobile

 Back

CDHB

Hyperbaric Medicine

A double-compartment, four-patient recompression chamber for treatment with Hyperbaric Oxygen (HBOT) is operational at Christchurch Hospital. The chamber is administered by the Hyperbaric Medicine Unit (HMU).

See also Hyperbaric Medicine (online at http://cdhb.health.nz under Specialist Care & Treatment).

Emergency Referrals to the Hyperbaric Unit

• Ring Christchurch Hospital operator (internal 80000 or external 03 364 0640) and request the Hyperbaric Unit Duty Doctor.
• Give the operator your name, contact phone number, and location.
• For acute in-patient referrals between 0830 and 1600 hours, try ringing HMU first 80045.

  Note: Trying to contact individual clinicians may result in delay.

Acute Emergency Indications for Hyperbaric Oxygen

• Decompression illness ('the bends' and cerebral arterial gas embolism):
  • Refer any patients with unexplained symptoms after scuba diving for an opinion. If decompression sickness is suspected, prescribe 100% oxygen by mask.
  • Patients are admitted via ED under General Medicine. The first hyperbaric oxygen treatment is completed before arriving on the ward.
  • These patients have neurological symptoms and need daily full neurological examination recorded. They do not usually require further oxygen and can be up and around on the ward. There is a small risk of deterioration in their symptoms and, following full examination, require consideration of early re-treatment by the Hyperbaric Duty Doctor.
• Arterial gas embolism (from any cause, including iatrogenic, e.g., cardiopulmonary bypass).
• Anaerobic necrotizing soft tissue infections, irrespective of the suspected causative organism (e.g., clostridial myonecrosis, streptococcal necrotizing fasciitis); consider hyperbaric oxygen therapy combined in a planned way with surgery and antibiotics.
• Carbon monoxide poisoning (possibly cyanide and H₂S also); smoke inhalation.
• Crush injury with acute traumatic ischaemia.
• Intracerebral abscess.
• Compromised skin grafts and flaps.
• Thermal burns (referral from Regional Burns Unit only).

Referral for these conditions is URGENT. The Hyperbaric Medicine Unit has the capability to care for critically ill patients. Other indications may be considered on a one-off basis.

Non-Emergency Referrals to the Hyperbaric Unit

Patient referrals and any further information or non-urgent enquiries should be directed to:

• Fax: 03 364 0187 80187
• Phone: 03 364 0045 80045
• Email: hyperbaric.medicine@cdhb.health.nz
• Mail: Duty Medical Officer, Hyperbaric Medicine Unit, Christchurch Hospital, Private Bag 4710, CHRISTCHURCH.

Non-Acute Indications for Hyperbaric Oxygen

Refer to the HMU section of the CDHB intranet. Think hyperbaric for people with diabetes or post-radiation injury.

• Osteo- and soft-tissue radionecrosis, including planned surgery in a previously irradiated area. Consider hyperbaric oxygen therapy in any patient with a wound, surgical or not, after radiation treatment. Patients with proctitis, colitis or cystitis gain marked symptom relief from treatment.
• Diabetes-related ulcer and other selected "problem" wounds (including preparation for grafting). Refer any patient with a lower leg wound to the Diabetes Centre and copy to the Hyperbaric Medicine Unit.
• Refractory osteomyelitis.
• Non-healing chronic wounds. The nursing staff in HMU are wound care experts and many chronic wounds heal more quickly with a combined approach with hyperbaric oxygen therapy. Refer any patient with a problem wound not healing with usual measures.

These conditions require extended treatment courses (4-8 weeks, 2 hours daily). Referrals will be considered from both General Practitioners and Hospital Specialists. It is a big time commitment for patients and their families. The cost of treatment to the health system of additional referrals is very low, as treatment uses few consumables and the staffing and equipment is the same irrespective of the number of patients treated.

Some other conditions may be considered on an individual patient basis.

Risks

Hyperbaric oxygen therapy is usually safe and well tolerated. Risks include claustrophobia and anxiety about closed spaces; injured ear drums, sinuses and teeth (painful but usually heal); reduced eyesight (temporary); blood pressure rise (temporary); cough and sore chest with long treatments; oxygen convulsions (uncommon and rarely lethal); fire (very rare but lethal); collapsed lung (uncommon and rarely lethal).

Reference: Cochrane Database (search term 'hyperbaric oxygen')

Topic Code: 1724