Guide to hyperbaric oxygen therapy

Hyperbaric oxygen therapy involves breathing 100 per cent oxygen in a high-pressure environment.

A hyperbaric chamber is a clear plastic cylinder designed for patients to receive hyperbaric oxygen. Inside the chamber, air pressure is two to three times higher than normal air pressure. This increased pressure gives your body more oxygen than normal to help you heal.

Conditions

Hyperbaric oxygen therapy is used to treat a range of illnesses, including: 

• carbon monoxide poisoning (from inhaling smoke or car exhaust)
• crush injuries, compartment syndrome and other acute traumatic problems where blood flow is reduced or cut off (e.g., frostbite)
• decompression sickness (the bends)
• delayed radiation injuries (e.g., radiation burns that develop after cancer therapy)
• embolisms (air or gas bubbles in the blood stream, which may travel to the brain or lungs)
• exceptional blood loss (anemia)
• gas gangrene
• idiopathic sudden sensorineural hearing loss
• intracranial abscess (an accumulation of pus in the brain)
• necrotizing soft tissue infections (flesh-eating disease)
• osteomyelitis (bone infection)
• select problem wounds
• skin grafts and flaps that are not healing well
• thermal burns (e.g., from fire or electrical sources)

What to expect

Treatment length and frequency

The length of your treatments and how many treatments you need will depend on you and your condition. Often, patients will have one or two treatments in a day (Monday through Friday). Treatments may last two to two and a half hours. 

For wound healing support, patients may need 20 – 40 treatments. However, some emergency conditions will require only one or two treatments.

Please give as much notice as possible if you need to cancel your appointment.

Care team

Our physician team includes emergency physicians, surgeons and intensivists. 

While in the chamber, your treatment is managed by a respiratory therapist with specialized training in hyperbaric medicine. This therapist will always be in the room, and you will be able to see and talk to the therapist throughout your treatment.

During treatment

When your treatment begins, you will hear the oxygen coming into the chamber. It may sound like hissing or a waterfall. You will feel a fullness in your ears as they adjust to the change in pressure, similar to when you are in an airplane or elevator. Your respiratory therapist will teach you how to clear your ears, or equalize the pressure, before you start your treatments.

As the chamber is pressurized you may feel the air get warmer. It will return to normal once the treatment pressure is reached. 

You may also have to use a mask intermittently for a procedure we will teach you called an air break.

If you have any problems while the chamber is being pressurized or during the treatment, tell the respiratory therapist immediately.

Get ready for your treatment

Eating and drinking

You may eat a light meal before treatment. Do not have carbonated drinks (such as pop or sparkling water) two hours before treatment. 

Smoking and vaping

Do not smoke or vape two hours before and two hours after treatment. Smoking and vaping decrease the amount of oxygen that can be transported by your blood. 

We strongly recommended that you do not smoke or vape during the course of treatment.

Diabetes & insulin

If you have diabetes and are insulin dependent, take your insulin and eat as you usually do.

Personal items

You may not take in:

• cigarettes    
• jewelry or watches
• lighters
• metal objects
• matches    
• contact lenses
• anything paper    
• hearing aids

Products containing oil

We will ask you to remove anything with oil in it, such as:

• lipstick
• makeup
• hair oil    
• cream
• hair spray    
• nail polish
• ointments    
• cologne or perfume
• liniments    
• deodorant

Clothing

We will give you a special gown to wear during the treatment. It is made of 100% cotton to reduce the risk of fire. Please do not wear any other clothing into the hyperbaric oxygen chamber without checking with the therapist. You may not wear nylons or synthetic clothing during treatment. 

Risks

Like many treatments, there are risks with hyperbaric oxygen therapy. However, most of them can be dramatically reduced with proper management. 

Ear discomfort

You may experience ear discomfort as pressure increases in the chamber. If you are unable to equalize the pressure by swallowing or yawning, you can have a small hole made in your eardrum. This is called myringotomy and will heal quickly once your treatments are finished.

Oxygen toxicity

Oxygen toxicity can happen if you are very sensitive to oxygen. This is very rare and affects only 1 person in 10,000. Signs of oxygen toxicity are tingling in the fingers, nausea, dry cough, seizures and chest pain.

Visual changes

After many treatments, you may notice some changes in your vision. If this happens, your vision will usually return to normal within six weeks to six-months.

Fire

Fire is the biggest safety risk because of the 100 per cent oxygen level in the hyperbaric chamber. You will be asked not to take anything into the hyperbaric chamber without asking the therapist.