Hyperbaric Medicine

Overview

The Department of Hyperbaric Medicine utilizes a multidisciplinary team approach to provide a valuable and unique therapy for certain medical conditions for which no other treatment is available. For many other medical conditions, hyperbaric therapy is used in conjunction with other medical or surgical treatments, particularly when those treatments alone have been unsuccessful. For example, hyperbaric therapy can enhance the effectiveness of certain surgical procedures and wound healing treatments.

Hyperbaric Oxygen Therapy (HBO Therapy) is a medical treatment during which patients breathe pure oxygen while sitting inside a pressurized chamber. Alone and in combination with standard treatment protocols, it contributes to optimal outcomes for patients because when a patient receives 100% oxygen in a pressurized environment, it increases the amount of oxygen in the blood. The treatment helps new blood vessels grow and more oxygen is delivered to tissues and organs of the body. This helps to promote the healing process of wounds and damaged tissue. Typically, the pressure in the chamber is 2.5 times normal atmospheric pressure, and hyperbaric oxygen activates white blood cells to fight infection and enhances the benefits of some antibiotics.

The 12-person hyperbaric chamber is the largest, most state-of-the-art hyperbaric chamber in the northeastern United States, measuring 9 feet in diameter and 28 feet long. It is a double-lock chamber that allows two compartments to compress and decompress independently, permitting the team to go into and out of the chamber without interrupting patient treatment. A third lock, called a medi-lock, allows the transfer of medical and non-medical items into and out of the chamber without interrupting patient treatment.

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Conditions

The Undersea and Hyperbaric Medical Society (UHMS) Hyperbaric Oxygen Therapy and Education Committee has published a compendium of diagnostic conditions for which HBO therapy is indicated, and backed by evidence-based literature. Current evidence-based medical diagnoses treated with hyperbaric oxygen therapy are:

1. Delayed radiation injury (soft tissue and bone necrosis including but not limited to the urinary bladder, rectal and sigmoid colon, female pelvic organs, upper respiratory tract, head and neck structures, brain, spinal cord, and skin)
2. Sub-acute radiation soft tissue damage in areas of planned surgery especially of the head & neck (Marx-Johnson Protocol)
3. Wounds in patients with diabetes or vascular disease. In conjunction with advanced wound care, hyperbaric treatment can decrease the need for amputation and heal conditions previously thought incurable.
4. Enhancement of healing in selected problem wounds
5. Chronic refractory osteomyelitis
6. Compromised skin (subcutaneous) and muscle flaps and grafts
7. Idiopathic sudden neurologic hearing loss
8. Arterial insufficiencies
9. Clostridial myositis and myonecrosis (gas gangrene)
10. Crush injury, compartment syndrome and other acute traumatic ischemias
11. Carbon monoxide poisoning (entire families can receive treatments together) and carbon monoxide poisoning complicated by cyanide poisoning
12. Air or gas embolism
13. Central retinal artery occlusion
14. Central retinal vein occlusion
15. Intracranial abscess
16. Necrotizing soft tissue infections
17. Decompression sickness
18. Severe anemia
19. Acute thermal burn injury

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Treatment

Care is provided in a state-of-the-art multi-place hyperbaric chamber. The chamber accommodates up to 12 patients at once and provides an extremely comfortable environment when compared to the more common single-person units. Most importantly, the spaciousness allows hyperbaric team members to accompany patients inside the chamber during treatment.

Treatment consists of high-dose, short-term oxygen inhalation. It is administered by having the patient breathe 100% oxygen while being exposed to elevated atmospheric pressure. Physicians trained and certified in hyperbaric medicine prescribe treatment protocols, oxygen dose and course of therapy, according to the diagnosis being treated.

Patients typically come in for one 90-minute treatment daily, five days a week, for several weeks. Patients sit in a comfortable chair and breathe oxygen throughout the treatment.

Hyperbaric treatments are very safe. Patients often report positive effects, such as a decrease in pain or improved sleeping patterns. And it is common to experience a temporary fullness or “popping” in the ears, easily relieved by methods such as yawning and swallowing.

A member of the Hyperbaric Center team always remains in the chamber with patients during treatments, and the hyperbaric physician is always present during treatments.

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Candidacy

A specialist in hyperbaric medicine will evaluate your condition, determine if HBO Therapy would be appropriate, discuss alternative treatments with you, and explain risks and benefits. The hyperbaric physician will communicate with your primary physician throughout the treatment period.

Many insurance companies will provide coverage for treatment. Call the Department of Hyperbaric Medicine and speak to a member of our Hyperbaric Center team.

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The Hyperbaric Medicine Team

Hyperbaric oxygen treatments at Phelps are performed by a team of certified physicians, nurses and technologists with more than 80 years’ combined experience in hyperbaric medicine. They are the longest practicing, board-certified hyperbaric team in the area with unsurpassed training and safety record. The physicians, nurses and technologists work inside the chamber with the patients during treatments.

Owen Joseph O’Neill, MD, CDME, UHM, FACHM, FAPWCA, CHT, medical director of the Hyperbaric Medicine Center at Phelps, was instrumental in its establishment. He completed primary post-graduate training in internal medicine, a fellowship in burn research, and specialty training in undersea and hyperbaric medicine.

He is elected a Fellow of the American College of Hyperbaric Medicine. For his accomplishments in his field. He is also board certified in wound care and elected a Fellow of the American Professional Wound Care Association. Dr. O’Neill is a certified diving medical examiner with the UHMS and qualified to perform commercial, technical, safety, and sport scuba diving physical examinations. He is also Board Certified by the National Board of Diving and Hyperbaric Medical Technology (NBDHMT).

All of the hyperbaric team technologists are certified and licensed Emergency Medical Technicians with either New York State or the National Registry of Emergency Medical Technicians (NREMT) and also hold board certification as hyperbaric technologists through the NBDHMT.

Elizabeth Smykowski, RN, ACHRN, CHT is the Nurse Manager and holds advanced certification in hyperbaric nursing from the National Board of Diving and Hyperbaric Medical Technology and additional certification from the same organization as a hyperbaric technologist.

All Registered Nurses have clinical experience in either critical care or emergency nursing; all full-time RNs and one per-diem RN hold certification in hyperbaric nursing.

The Safety Director is a Certified Hyperbaric Technologist (CHT) and also holds certification as a Dive Medical Technician (DMT) and as an Emergency Medical Technician by the NREMP. Most team members hold credentials at Safety Director level, having completed formal hyperbaric safety education as recognized by the NBDHMT.

All team members have attended Hyperbaric Team Training, a formal course recognized by the Undersea and Hyperbaric Medical Society, leading to board certification.

All physicians are board certified by the NBDHMT, the only physicians in New York State to hold that credential. The Medical Director holds triple certification in hyperbaric medicine, wound care and dive medicine.

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Contact

Patients and referring physicians may contact the Hyperbaric Medicine Center by calling (914) 366-3690 to arrange for a consultation.

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