Authors (including presenting author) :
Mak HM(1), Suen HK(1), Mok FS(1), Yan WW(2)
Affiliation :
(1)Accident and Emergency Department, Pamela Youde Nethersole Eastern Hospital, (2)Intensive Care Unit, Pamela Youde Nethersole Eastern Hospital
Introduction :
Since September 2018, Pamela Youde Nethersole Eastern Hospital (PYNEH) Hyperbaric Oxygen Therapy Centre (HBOTC) became the first hyperbaric oxygen therapy (HBOT) facility in Hospital Authority (HA) and provides 24/7 HBOT service (HAHO, 2018). There were no existing local standards for clinical HBOT. With 3 years of experience and collaboration with different parties including chamber manufacturer & biomedical engineers, a local set of HBOT standards was formed with reference to international standards and guidelines.
Objectives :
Training
Since 2015, PYNEH started deploying staff to Australia for training for inside attendants, nurse technologists & physicians. The training included theory input and clinical attachment provided by the Alfred Hospital in Melbourne. The training program aligned with Australian standards, AS 4774.2 Work in Compressed Air and Hyperbaric Facilities – Part 2: Hyperbaric Oxygen Facilities.
Staffing
Staffing of each HBOT session in PYNEH HBOTC includes one inside attendant, one outside attendant, one physician & two nurse technologists which is comparable to US, Australian, European and Canadian standards.
Methodology :
Patient Treatment
For patient selection, PYNEH HBOTC follows the 14 indications recommended by Undersea & Hyperbaric Medical Society (UHMS) from US (UHMS, 2019). Patient treatment plan aligns with UHMS suggestions. Treatment profiles used are mainly adopted from US Navy Diving Manual (Naval Sea System Command, 2018).
Safety
With additional fire risk and possible risk of inside attendant decompression sickness, safety was the main concern in HBOT. For fire safety, PYNEH HBOTC follows US National Fire Protection Association (NFPA) ’s NFPA 99 Health Care Facilities Code (NFPA, 2021). For occupational risks, other guidelines e.g. Multiplace Inside Attendants Medical Fitness to Work (Alleman, 2018) & Clinical Multiplace Hyperbaric Facilities (UHMS, 1994) were adopted.
Medical Device
PYNEH HBOTC chamber was manufactured in Germany. It complies with European standards, e.g. EN 14931 Pressure Vessels for Human Occupancy (PVHO) – Multiplace Pressure Chambers for Hyperbaric Therapy – Performance, Safety Requirements and Testing. For chamber operation, in-chamber environment, e.g. oxygen level, is controlled within a safe and comfortable range based on EN 14931 (European Standard, 2006).
Result & Outcome :
Conclusion
Being the first HBOT facility in HA, PYNEH HBOTC plays a major role in establishing the HA standard for clinical HBOT. With input from the up-coming New Acute Hospital at Kai Tak, the standard can be further consolidated as Hong Kong clinical HBOT standard.
