Real HBO2 vs. Soft HBO – When will this end?

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Let me paint a picture for you.  A patient comes into a hospital based HBO unit with a re-attached finger (re-attachment was a week ago), the finger is black and the patient says hyperbaric oxygen therapy did not help the finger – in fact it made it worse and why am I here?  I ask the patient, what kind of hyperbaric chamber did you go into?  The response (although not shocking) was, a portable soft, blue and white chamber, we went to 1.3 atmospheres for many hours a day for a whole week and the finger is worse, it was pink after surgery and now its grayish black.  There were a couple of responses that came to mind (all of them were negative), but instead of adding to a patient’s anxiety level, I decided to focus on what we can do now – I got the doctor to do the HBO consult, got all the paperwork done, and immediately treated the patient twice a day for two days, over the weekend, and by today (8 treatments in) the finger was completely black and the physician had to give the patient a realistic assessment that the index finger is no longer salvageable and may have to be amputated.

QUESTION 1: Do you think this patients finger could have been saved if the patient went to a hospital based or a free standing non-soft chamber facility and got the appropriate HBO treatment?

QUESTION 2: Do you think the soft-chamber facility is liable for this patient losing their finger because they “assumed” they can actually treat a post surgical reattachment of a finger at 1.3 ATA in a soft chamber and actually expect a good outcome?

QUESTION 3: Do you think this soft chamber facility will get shut down by the District Attorney and the Feds? I will answer that one for you – YES, and in fact the owners may face jail time & a lifetime of fines to boot.

So why do these places continue to parade around as if they can actually treat such indications?  Don’t get me wrong, I am sure there are certain “none life & limb threatening” indications that these soft chambers are magically indicated for & there probably is a place for them…somewhere.

Do I sound bitter?  Yes I am bitter! This is not the first time I have seen this happen and it will not be the last.  This time it was different.  This time it was a little girl who will grow up without a right index finger for the rest of her life because “someone” thought that their soft chamber could do exactly what a hard chamber can do.  Was it for money?  Was it to say that their chamber can treat basically every indication a hard chamber can treat? Or was it medical malpractice?  I believe it was all of the above and that it was wrong.

The hyperbaric community needs to send a strong message to those soft chamber facilities in their communities that treating indications requiring at least 2 Atmospheres for 90 to 120 minutes on 100% oxygen inside of a soft chamber at 1.3 ATA on AIR IS WRONG! Otherwise more and more patients will fall victim to this type of tragedy. Here is a hint: Send these patients to an appropriate facility and save yourself a lawsuit!

The FDA is now aware of this situation and so is the local FBI office – so here is a WARNING to those with soft chambers that think they can get away with treating medicare approved indications in their chambers at 1.3 ATA, it is only a matter of time before you make this type of mistake and go down for it – do not risk short term income for a long term jail sentence, it isn’t worth the risk or the lawsuit!

Last QUESTION: How would you feel if this was your child?

Comments welcome & so is hate mail so bring it!

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5 thoughts on “Real HBO2 vs. Soft HBO – When will this end?

  1. It is important to make the distinction between Hyperbaric Oxygen Therapy (HBOT) and mild Hyperbaric Oxygen Therapy (mHBOT) and not between hard and soft shell chambers on the market as there are soft hyperbaric chambers that produce 100% oxygen to patients at 2 ATA, exactly the same as hospital facility chambers. For example the SOS Hyperlite, (www.hyperlite.co.uk) has been producing the only ASME/PVHO approved (US National standard) soft shell chambers for over 20 years and supplies US Government & Military Services. There are great differences between this and a soft shell 1.3 ATA air filled system, but the main two are that 1.It goes to a Maximum working pressure of 2.3 bar.. enough for all hyperbaric oxygen therapies and 2. it provides 100% oxygen through a mask, rather than just an air filled environment. Paul

    • Paul,

      Thank you for your comment. Yes I agree that there is definitely a difference between soft mild hyperbaric chambers and the collapsible SOS Hyperlite chambers (which in the USA are used mainly for diving injuries). Although the SOS Hyperlite chambers “may” be considered soft chambers – and, as you pointed out go to a deeper working pressure that would be above 2 ATA. Yes, these (SOS) chambers are capable of treating the said approved indications here in the USA. Without having to announce the name of the mild chamber manufacturer, I decided to refer to them as “soft chambers” (probably better to call them mild soft chambers) in the blog post.

      Thank you,
      RW

    • Michie,

      Thank you for commenting. I have been extremely busy over the past year and I will continue to post when I come across interesting things in hyperbarics. The biggest issue is that people in the community like to stay mute when it comes to being proactive about safety or anything else related to HBOT – which makes running the blog similar to talking to an empty wall.

      Thank you,
      RW

      • Funny you should offer this opinion. I am completely amazed by the lack of understanding of physics, physiology, mechanisms of tx, simple mechanics, operations etc with those solely trained in an introductory course. I am baffeld that hands on, operations training is lacking in some curriculums. When you take nurses and techs (particularly techs) who have no point of reference, and little comprehension of the aforementioned areas of study, and put them in charge of patient treatment dives with no hands on experience, an accident is being summoned. It is just a matter of time when the luck runs out!
        There is a lack of comprehension regarding the highly pressurized and oxygenated environment we work with by administrators as well.Particularly in a hospital based facility. $ takes precedence over adequate training and staffing.

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