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VOL. 127 | NO. 243 | Thursday, December 13, 2012

Critical Care

After earning accreditation, The MED’s hyperbaric chamber to be upgraded

By MICHAEL WADDELL

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As it passes 20 years of service in the Mid-South, the hyperbaric facility within the Regional Medical Center at Memphis’ Wound Care Center recently received a full three-year accreditation from the Undersea and Hyperbaric Medical Society, and the hospital plans to perform upgrades next year that will increase efficiencies and improve patient experiences.

Technician Travis Jenkins exits an entrance lock on a hyperbaric chamber at The MED. The Hyperbaric Facility, within the Regional Medical Center’s Wound Care Center, has received full accreditation from the Undersea and Hyperbaric Medical Society. 

(Photo: Lance Murphey)

The facility’s 12-person hyperbaric chamber, which cost $1.8 million in 1991, is the largest of its kind in the state of Tennessee. The MED began using hyperbaric oxygen in 1991 with three single-patient chambers and upgraded to the larger, submarine-like chamber in 1993. Conditions inside the chamber are pressurized to provide treatment of acute, chronic and non-healing wounds.

“We wanted a facility that could treat critical care patients and we wanted one that was large enough so we could put in multiple stretcher patients and have room for a critical care nurse and a physician to be in there with them,” said Dr. Stephen King of the Wound Center, a regional referral center for wound care and hyperbaric oxygen therapy for the treatment of acute, chronic and non-healing wounds.

The accreditation system began in 2005. A survey team from the Undersea and Hyperbaric Medical Society comprised of a physician, nurse and technician spent two days reviewing and surveying The MED’s hyperbaric chamber before unanimously approving the chamber for accreditation this month.

There are approximately 200 multi-place chambers in the U.S., and the one at The MED is only the second in Tennessee to receive accreditation and the only hyperbaric chamber in the area to be accredited by the society. Overall, The MED hyperbaric chamber is the 145th facility in the U.S. to receive the distinction.

Hyperbaric oxygen therapy is used to treat a myriad of ailments at the Wound Care Center, including acute air or gas embolisms, carbon monoxide poisoning, cyanide poisoning, crash injuries, decompression sickness, anemia, gas gangrene, necrotizing soft tissues infections, and radiation necrosis.

“Treatments last about 110 minutes,” said Bud Rannou, hyperbaric facility technician, who explained many treatments take place at a compression depth of 45 feet. “We have the capability to get to 165 feet, which is three atmospheres, for Type II decompression sickness or an arterial gas embolism.”

The MED regularly receives calls from Fort Campbell, Ky., when special forces units conduct diving operations for the U.S. Army Corps of Engineers and from Columbia, Miss., when the U.S. Air Force conducts rapid decompression training exercises for pilots.

The center also treats many children from St. Jude Children’s Research Hospital. For those that have had radiation treatment, a side effect is the closing off of blood vessels, causing something as simple as having a tooth pulled to be problematic because the wound in the mandible can have trouble healing due to decreased blood supply.

“Another wound that is an approved indication for treatment in the chamber would be diabetic foot ulcers where the reason the wound is not healing is the lack of oxygen,” King said. “You need a certain amount of oxygen for the cells that create new tissue to work and for white blood cells to fight infection. In some diabetics, their circulation is so poor that the tissue does not get enough oxygen to be able to heal.”

The Wound Center treats an estimated 750 to 800 patients per month, and the hyperbaric chamber dives as many as 10 patients per day now and as many as 27 patients per day before Medicare restrictions of the 1990s.

Over the past two decades, Medicare has placed more restrictions on reimbursements for treatment.

“Since 1992 there’s been a rash of changes in reimbursement, which has tightened restrictions on treatment of the problem wounds and lowered the population that go into the chamber,” Rannou said.

Next year a 32-inch flat screen LCD television will be added inside the chamber to increase patient comfort and a new control system outside the chamber will replace the older pneumatic controls with faster electronic gear. Interestingly, the new television must be a LCD (liquid crystal display) because the liquid in the display will not be affected by the pressure changes inside the chamber.

Other future plans for the chamber include the installation of a self-contained air conditioner and the training additional nurses for hyperbaric certification.

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