Equipment It seems that not all hyperbaric chambers are created equally

[Duke Dive Medicine]

I'm not sure what the title of this thread means, but the photo of the facility shows Sechrist monoplace chambers, which are an industry standard.

Monoplace chambers are used for medical treatments and not really suitable for treating DCS in divers.

What makes you say this?

Best regards,
DDM

 

[Waterwulf]

I'm not sure what the title of this thread means, but the photo of the facility shows Sechrist monoplace chambers, which are an industry standard.

What makes you say this?

Best regards,
DDM

I'm going to throw out a guess here and say it's the difference in pressure capabilities. Many monoplace chamber are made out of clear plastic and are used to treat things like necrotizing skin diseases with high pressure oxygen therapy. However, that "high pressure" is only about 1 1/2 atmospheres and isn't enough to treat DCS. There probably are monoplace chambers that can handle higher pressures but the "mono" part of that might cause problems for something like DCS which can require immediate medical intervention. The bigger chambers allow a medical person to be inside with you. That's all just a guess.

 

[Capt Jim Wyatt]

A typical monoplace hyperbaric chamber can reach a depth equivalent to a pressure of around 3 atmospheres absolute (ATA), however, some high-end models may be able to reach deeper pressures, up to 6 ATA or 165 feet of water depth depending on the design and safety regulations followed.

Google search results.

 

[Duke Dive Medicine]

I'm going to throw out a guess here and say it's the difference in pressure capabilities. Many monoplace chamber are made out of clear plastic and are used to treat things like necrotizing skin diseases with high pressure oxygen therapy. However, that "high pressure" is only about 1 1/2 atmospheres and isn't enough to treat DCS. There probably are monoplace chambers that can handle higher pressures but the "mono" part of that might cause problems for something like DCS which can require immediate medical intervention. The bigger chambers allow a medical person to be inside with you. That's all just a guess.

These are good callouts. There are a lot of soft-sided chambers out there that are marketed as "hyperbaric chambers" that you'll see in places like nail spas and holistic health clinics. Those are typically capable of 1.2-1.5 ATA like you mentioned and are pressurized with a small air compressor. Many of those groups advertise hyperbaric therapy on their websites and link studies that involve true hyperbaric oxygen therapy in order to appear legitimate. When hyperbaric medicine groups like UHMS and NBDHMT pointed out that disparity, some groups started adding oxygen concentrators to the setup so that they could call it hyperbaric oxygen therapy. This caused alarm in the hyperbaric medicine community because of the increased risk of fire. When I first read the headline about this event, that's the type of setup I thought was involved. The website for the Oxford Center where the explosion/fire happened suggests that they use Sechrist monoplace hyperbaric chambers, which are made for true hyperbaric oxygen therapy. If one of these chambers was involved, that means that the root cause is likely something besides the chamber itself.

Re treating DCS in monoplace chambers, I can understand the hesitation, and can state unequivocally that it's very safe and it's done all the time. On top of that, if we resorted to using only multiplace chambers to treat emergent indications like DCS, we'd cut the number of available emergency facilities by at least 50%.

As you noted, if the patient decompensates in a monoplace chamber, the care team doesn't have immediate access. The community has developed emergency decompression protocols that minimize that risk. There are a lot of monoplace facilities out there that treat critically ill patients on ventilators, cardiac monitors, and IV drips. Dr. Lin Weaver and his team at Intermountain Health in Utah are a great example.

Best regards,
DDM

 

[DogDiver]

I'm not sure what the title of this thread means, but the photo of the facility shows Sechrist monoplace chambers, which are an industry standard.

What makes you say this?

Best regards,
DDM

With a typical Navy IV table dive lasting 5+ hours. A multi place chamber is definitely the appropriate choice for treating DCS. Where as wound and burn treatments lasting 90 minutes at 45 feet they are more suitable and physically take up way less space than a multi place chamber. Plus monoplace chambers require less staff you can treat 2-3 separate chambers with one tech. Where as a multi place chamber you have the patient. Internal chamber Tec. 2 outside chamber technicians and 1 physician

 

[Duke Dive Medicine]

With a typical Navy IV table dive lasting 5+ hours. A multi place chamber is definitely the appropriate choice for treating DCS. Where as wound and burn treatments lasting 90 minutes at 45 feet they are more suitable and physically take up way less space than a multi place chamber. Plus monoplace chambers require less staff you can treat 2-3 separate chambers with one tech. Where as a multi place chamber you have the patient. Internal chamber Tec. 2 outside chamber technicians and 1 physician

Are you talking about a Navy Treatment Table 6? Table 4 is 36+ hours long, which would be pretty much impossible in a monoplace. Standard TT6 without extensions is 4 hours 48 minutes lock to lock. In a facility with both types (like Advent Health Orlando nearest you), a multiplace is usually first choice for treating divers just so they have some space to stand up and stretch, eat, and hydrate, but if a monoplace is the only option, it's perfectly safe. Re staffing, an MD is required onsite for both types.

Best regards,
DDM

 

[Jared0425]

Rumor around here is saying that the facility technician wasn't qualified and that the "treatments" were not approved by the FDA.

 

[John the Pom]

Given the dreadful tragedy that has occurred, which was completely unrelated to SCUBA diving, and all of the rumours flying around the internet about it, maybe this is a thread that should be quietly put to bed.

 

[DogDiver]

Are you talking about a Navy Treatment Table 6? Table 4 is 36+ hours long, which would be pretty much impossible in a monoplace. Standard TT6 without extensions is 4 hours 48 minutes lock to lock. In a facility with both types (like Advent Health Orlando nearest you), a multiplace is usually first choice for treating divers just so they have some space to stand up and stretch, eat, and hydrate, but if a monoplace is the only option, it's perfectly safe. Re staffing, an MD is required onsite for both types.

Best regards,
DDM

Yes ment VI 6