HBOT Safety/Review Questions #8
You are about to place a gastric feeding tube in a cat with severe thermal burns.
You plan to treat this cat with adjuvant HBOT to speed healing of its wounds and assist in pain management. Which type stomach tube should you NOT select to use if the patient will be treated with HBOT, and why?
ANSWER: You can add another layer of 100% cotton stockinette over the tube. This will effectively cover the polyethylene or silicon tube with a layer of cotton (see image below). Remember, the rule of thumb: Anything other than the patient itself shall be covered with 100% cotton. The adjuvant HBOT modulates the genetic inflammatory response, shifting it toward the anti-inflammatory expression. This is especially useful in clinical processes such as "Triaditis". Measurements of human tissue cultures in vitro demonstrate changes in MRNA levels of inflammatory genes after HBOT (Reference, Kendall et al, UHM 2013, Volume 40, number 2, GPS. 115-123, Different oxygen treatment pressures alter inflammatory gene expression in human endothelial cells).
You have two patients in separate modules during an HBOT session.
Which circumstance below is an absolute indication for beginning a normal, gradual, but premature conclusion to the treatment session?
One patient, a cat, pulls off the ground wire connection on the grounding plate in his module and continues to chew on the wire without stopping.
One patient urinates in the module.
One patient defecates in the module.
One patient vomits in the module.
None of the above.
ANSWER: 1. One patient, a cat, pulls off the ground wire connection on the grounding plate in his module and continues to chew on the wire without stopping.
A gradual decompression should be started if a patient begins to act in a manner which may cause self harm or injury. In this case, we do not want the cat to swallow a piece or pieces of the wire and create a GI foreign body, or injure his mouth on the wire. The other answer options are not absolute indications for premature termination of a treatment session, and can usually be cleaned up after the session.
You are treating a canine with complete global ischemia secondary to cardiopulmonary arrest.
He is known to be a well-controlled idiopathic epileptic. His body temperature is below normal. Will the low body temperature increase or decrease the chance for CNS oxygen toxicity and seizures during an HBOT session?
ANSWER: A patient with a low body temperature will have a reduced chance for oxygen toxicity and thus oxygen induced seizures (Reference Kindwall and Whelan, Hyperbaric Medicine Practice, Second Edition Revised, Best, 2004, page 76). Conversely, elevated body temperature increases the possibility of oxygen toxicity.