Slide 1

Slide 2 Michael Natoli, MS, CHT Center for Hyperbaric Medicine and Environmental Physiology Duke University Medical Center Durham, NC 27710 Hyperbaric Chamber Overview Slide 3 Duke Pilot Chamber Slide 4 G Duke Chamber Complex A, B, C - Clinical D, E, F, G Research H no longer attached C E D F H A B Seven chambers can be operated independently or in combination Slide 5 Bravo Alpha Charlie Delta Foxtrot Golf Main Deck Second Deck Echo Golf Duke Chamber Complex Slide 6 Chamber Construction Slide 7 Chamber Foundation Slide 8 G-Chamber Addition Slide 9 Main Control Console Don Bordeaux, 2005 Slide 10 Design Specifications and Operational Guidelines ASME: BPV sec. VIII & PVHO-1ASME: BPV sec. VIII & PVHO-1 American Society of Mech. Eng. Boiler and Pressure Vessel Code Pressure Vessels for Human Occupancy PVHO-2: In service guidelines for PVHO acrylic windows CGA (multiple) CGA (multiple) Compressed Gas Association NFPA 99 and 53 M NFPA 99 and 53 M National Fire Protection Agency Slide 11 Certifying Agencies US NavyUS Navy Inspected every three years Department of Health and Human Services Department of Health and Human Services Food and Drug Administration (FDA) Center for Medicare and Medicaid Services Clinical Laboratory Improvement Amendments (CLIA) State of North Carolina State of North Carolina Department of Labor Boiler Safety Bureau Slide 12 Certifying Agencies (cont.) Joint Commission on Accreditation of Healthcare Organizations (JCAHO)Joint Commission on Accreditation of Healthcare Organizations (JCAHO) College of American Pathologists (CAP) College of American Pathologists (CAP) Undersea and Hyperbaric Medical Society (UHMS) Undersea and Hyperbaric Medical Society (UHMS) Slide 13 US Navy Pipe Color Coding OxygenNitrogen Special Gas HeliumAir ExhaustVacuum Potable Water Fire Deluge System Originally developed in 1928 Originally developed in 1928 American Standards Association. (Now ANSI) Slide 14 Air Quality Standards US Navy Guidelines O 2 20 - 22 % CO 2 < 500 ppm CO < 20 ppm Hydrocarbons < 25 ppm Particulate and oil mist98.0% CO2 < 1.0% SEV Chamber Atmosphere O2 = 20.5% - 23.5% CO2 < 1.0% SEV Slide 43 Patient O 2 Chamber Patient CO 2 0.05.0 Chamber sample Patient sample Breathing Gas Analysis 21.0 zerospan % O 2 Oxygen Analyzer 572 98.0 % O 2 zerospan Oxygen Analyzer 572 Servomex Slide 44 Breathing Gas Analysis Slide 45 Critical Care Monitoring EKG Blood pressure Respirations Temperature Cardiac Output and wedge pressure Oxygen Saturation Transcutaneous O2 monitors Slide 46 Defibrillator Slide 47 Blood Gas Determination at Pressure Slide 48 Two-dimensional ultrasonic arterial bubble detector Doppler ultrasonic venous bubble detector Ultrasonic Assessment Slide 49 Suction Slide 50 Medical Lock Slide 51 Special Equipment Considerations Patient Chair Patient Stretcher Slide 52 Altitude Controls Slide 53 Chamber Cleaning Ultraviolet lightsUltraviolet lights UV lights have been used in the past to disinfect a chamber after treating patients with bacterial infections UV light can degrade acrylic viewports Acceptable agents Acceptable agents Sanimaster 3 Benzalkonium choloride swabs Up to 10% Clorox solution Pressure washing Pressure washing Slide 54 Chambers Here, There, and Everywhere Slide 55 Toronto Canada: Toronto General Hospital Slide 56 Bermuda: King Edward II Hospital Slide 57 Providenciales: Menzies Medical Clinic Slide 58 Panama Canal: ACP Panama Canal Authority Slide 59 QUESTIONS ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? Slide 60 References US Navy Diving Manual US Navy Diving Manual Revision 5 15 August 2005 www.bestpub.com National Fire Protection Association National Fire Protection Association NFPA 99 NFPA 53 www.nfpa.org Safety Standards for Pressure Vessels for Human Occupancy Safety Standards for Pressure Vessels for Human Occupancy ASME PVHO 1 1997 www.asme.org Compressed Gas Association Compressed Gas Associationwww.cganet.com Slide 61 Outline Duke Chamber Complex Design Specifications and Operational Guidelines Certifying Agencies Chamber Operations Breathing Gas Systems Fire Suppression Systems Communications Patient care equipment References