Hyperbaric Chamber Overview

Report
Hyperbaric Chamber
Overview
Michael Natoli, MS, CHT
Center for Hyperbaric Medicine and Environmental Physiology
Duke University Medical Center
Durham, NC 27710
Duke Pilot Chamber
Duke Chamber Complex
G
C
H
D
F
B
A
E
Seven chambers can
be operated
independently or in
combination
A, B, C - Clinical
D, E, F, G – Research
H – no longer attached
Duke Chamber Complex
Main Deck
Second Deck
Golf
Foxtrot
Golf
Delta
Echo
Charlie
Bravo
Alpha
Chamber Construction
Chamber Foundation
G-Chamber Addition
Main Control Console
Don Bordeaux, 2005
Design Specifications and
Operational Guidelines
• ASME: BPV sec. VIII & PVHO-1
American Society of Mech. Eng.
Boiler and Pressure Vessel Code
Pressure Vessels for Human Occupancy
PVHO-2: In service guidelines for PVHO
acrylic windows
• NFPA – 99 and 53 M
National Fire Protection Agency
• CGA (multiple)
Compressed Gas Association
Certifying Agencies
• US Navy
Inspected every three years
• Department of Health and Human Services
Food and Drug Administration (FDA)
Center for Medicare and Medicaid Services
Clinical Laboratory Improvement Amendments (CLIA)
• State of North Carolina
Department of Labor – Boiler Safety Bureau
Certifying Agencies (cont.)
• Joint Commission on Accreditation of
Healthcare Organizations (JCAHO)
• College of American Pathologists (CAP)
• Undersea and Hyperbaric Medical Society
(UHMS)
US Navy
Pipe Color Coding
• Originally developed in 1928
American Standards Association. (Now ANSI)
Oxygen
Nitrogen
Special Gas
Helium
Air
Exhaust
Vacuum
Potable Water
Fire Deluge System
Air Quality Standards
US Navy Guidelines
–
–
–
–
–
–
O2
CO2
CO
Hydrocarbons
Particulate and oil mist
Moisture
<
<
<
<
<
20 - 22 %
500 ppm
20 ppm
25 ppm
.005 mg/liter
.02 mg/liter
• Independent laboratory test every 6 months.
Compressors
• Built by Norwalk 1936
Four stage HP
Water cooled
100 cuft/min
Synthetic oil lubricated (Anderol 500)
Compressors and Filters
Intake
filter
Relief
valve
Dew Pt. Monitor
Compressors
CO Monitor
#1
1200 psig
Back Press.
Valve
Charcoal
filter
To
chambers
#2
Cooling
coil
Coalescing
filter
Drying
towers
To
storage
Roughing
filter
#3
Final filter
Cyclone separator
Drains
Air Storage Banks
24 storage cylinders
42 cu. ft. per cylinder water capacity
218,000 cu. ft. at 3,000 psi
To
chambers
Reference
Emergency
Air Delivery
Control
Main
Reducing
Back-up
Emergency
storage
Bypass
Relief valve
From
Compressors
By-pass
Bank 1
Bank 2
Electrically
Operated
Bank 3
Air Delivery
Reducing Station
Control Console
Rate Selector
Spray Valve
Ventilation Rate
Emergency Stop
Control Method
Reference
Control Rate
Controlling Valve
DP Cell Polarity
Gauge
DP Cell Isolation
Pressurization Control
Gauge on
console
Proportional
control valve
Muffler
Emergency
stop valve
Chamber wall
Manual
Manual (back-up)
From
reducing
station
450 psig
Decompression Control
Manual
Proportional
control valve
To exhaust
duct
Emergency
stop valve
Ventilation
valve
Flow meter
Internal Environmental Control
Pneumatic
valves
Muffler
Cold water
Hot water
Heating / Cooling
Coils
Lubrication
level
Electric motor
Blower
Air flow
Shaft seal
Temperature
indicator
Thermistor
External Environmental Control
Blower
Thermistor
Temperature
controller
Cold water
CO2 absorbent
Hot water
Breathing Gas Systems
• Air
Chamber compression, air breaks, emergency facemask,
ventilator.
• Oxygen
Treatment protocols, tender decompression.
• Special Gas
50/50 for Table 6A, Nitrox for various studies.
Breathing Gas Systems
BIBS Panel
Oxygen System
O2 manifold
Liquid
level
Evaporators
O2. reg.
80 psi
over bottom
High press. reg.
180 psig
Main O2 reg.
250 psig
Check valves
Relief valves
High Press. O2 back-up
Liquid
O2
Tank
Fill
point
Patient Oxygen Delivery Systems
 Head tent
Recirculating
Single Pass
• Scott Duo-Seal Face mask
Single hose
Overboard dump
• Ventilator / Ambu-bag
Oxygen Delivery - Recirculating Head Tent
Eduction
Oxygen
Purge
Eduction
Line
Venturi
20
Purge Line
10
0
Venturi
30
40
50
60
Sample
Sample
Line
Bubbler
Sodasorb
Canister
Ice
Bucket
Condensate
Drain
Ice Water
Drain
Latex
Neckseal
Oxygen Delivery - Single Pass Head Tent
Eduction
Oxygen
Patient
Sample Line
Oxygen Dump
Regulator
Oxygen Supply
Regulator
Latex
Neckseal
Oxygen Eduction System
Reducing
Differential Pressure
valve
Converter
20 psig
Safety Shut Off
Flow Fuse
Exhaust
from
patient
5 L Bag
Diaphragm
100 psig
Signal air
Filter
Drain Valve
O2 Eduction
Eduction Manifold Description
Outside
Building
50 ft
Foxtrot
Delta
Air Amplifier
1” pipe
Charlie
Bravo
3” pipe
Alpha
4 ft2 Chamber Exhaust Duct
Manifold
Inlet
Oxygen Eduction
O2
Building Exhaust Duct
Air
eduction
Amplifier manifold
Air Amplifier
A differential pressure gauge is used
to verify suction at the inlet of the
O2 eduction manifold
Fire Suppression System
Relief
valve
200 psig reg.
check
valve
Muffler
450 psig air
OFF
Fire
Suppression
Tank
Pneumatic valve
Air mask
Overhead
sprinklers
Manual
Pump
ON
Level
sensor
Drain
Hand-held
hose
Fire
Suppression
Water
Source
Fire Suppression Equipment
Inside the Chamber
Nitrogen Purge
Power and Lighting
Canty Light
Ground
fault
interrupter
Explosion
proof housing
low wattage
Isolation
transformer
Doppler
120
volts
Ground
fault
indicator
Redundant Communication
Systems
Plantronics Headset
Telex Wireless
System
Soundpowered
Phone
Two-way Mic/Speaker Box
Closed Circuit Patient Monitoring
Breathing Gas Analysis
• Vital for fire safety and personnel safety
Chamber Atmosphere
O2 = 20.5% - 23.5%
CO2 < 1.0% SEV
• Documents that patients are receiving proper
treatment
Patients
O2 > 98.0%
CO2 < 1.0% SEV
Breathing Gas Analysis
Chamber
O2
Servomex
21.0
Patient
O2
Patient
CO2
Servomex
% O2
zero span
Oxygen Analyzer 572
Dwyer
98.0
% O2
0.0
5.0
zero span
Oxygen Analyzer 572
Dwyer
Dwyer
50
50
50
40
40
40
30
30
30
20
20
20
10
10
LPM AIR
LPM AIR
10
LPM AIR
Patient sample
Chamber sample
Breathing Gas Analysis
Critical Care Monitoring
–
–
–
–
–
EKG
Blood pressure
Respirations
Temperature
Cardiac Output and wedge
pressure
– Oxygen Saturation
–Transcutaneous O2 monitors
Defibrillator
Blood Gas Determination at
Pressure
Ultrasonic Assessment
Doppler ultrasonic venous bubble
detector
Two-dimensional ultrasonic
arterial bubble detector
Suction
Medical Lock
Special Equipment Considerations
Patient Stretcher
Patient Chair
Altitude Controls
Chamber Cleaning
• Ultraviolet lights
UV lights have been used in the past to disinfect a
chamber after treating patients with bacterial infections
UV light can degrade acrylic viewports
• Acceptable agents
Sanimaster 3
Benzalkonium choloride swabs
Up to 10% Clorox solution
• Pressure washing
Chambers Here, There, and Everywhere
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Toronto Canada: Toronto General
Hospital
Bermuda: King Edward II Hospital
Providenciales: Menzies Medical Clinic
Panama Canal: ACP Panama
Canal Authority
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QUESTIONS
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