Absolute Contraindications

The only absolute contraindication to receiving hyperbaric oxygen therapy is an untreated pneumothorax, due to the possibility of converting it to a tension pneumothorax as the intra-pleural air expands on decompressing. All other contraindications are, to a more or lesser degree, relative.

Relative Contraindications

Bleomycin

Cases of fatal interstitial pneumonitis have been reported in clients who were administered elevated oxygen concentrations months to years after receiving bleomycin therapy. Elective therapy with HBOT is contraindicated in clients with even a remote history of bleomycin administration. However, in emergency, life-threatening situations, the benefits of HBOT might outweigh the possibility of bleomycin toxicity.

Doxorubicin

Administering HBOT concurrently with doxorubicin was associated with cardiac toxicity. It is advisable to wait until the drug has been cleared from the body before initiating HBOT.

Cis-Platinum

In animals, concurrent administration of HBOT and cis-platinum was associated with an increase in wound breakdown. HBOT should be held off until cis-platinum therapy is finished if possible.

Disulfiram

Disulfiram blocks the production of superoxide dismutase, which could lead to decreased free radical scavenging in hyperbaric environments.

Mafenide Acetate (Sulfamylon)

Increases the possibility of oxygen toxicity seizures.

Upper Respiratory Tract Infections or Chronic Sinusitis

These conditions can make it hard to clear the ears and/or can lead to significant sinus squeeze.

Seizure Disorders

Increased risk of oxygen-induced seizures.

Emphysema with CO₂ Retention

Small risk of blunting hypoxic respiratory drive and/or rupturing of a bleb during ascent leading to pneumothorax. This is contested by some Physicians, so while it is scientifically possible it is not observed that often.

Pregnancy

There are at least theoretical concerns with the administration of hyperbaric oxygen therapy during pregnancy. These primarily centre around the possible deleterious effects of hyperoxia on the foetus. Clinical experience has failed to support these concerns and there is no evidence that hyperbaric sessions cause harm to the mother or child. The use of HBOT to treat emergency, life-threatening conditions is deemed safe, but elective therapy should probably be held off until after delivery if possible.

Known Malignancies

There is some theoretical concern that HBOT might enhance the growth of some tumours, especially those that have outgrown their blood supply. However, there is no clinical or experimental evidence that this occurs. Currently, known or active malignancies are not considered a contraindication to HBOT, but close monitoring of the lesion is probably indicated.

Implanted Devices Such as Pacemakers

Early pacemakers, such as those made in the 1960s, contained air-filled voids that did not tolerate pressurisation well and led to damage or malfunction of the devices. Most currently produced pacemakers do not suffer from these problems and their manufacturers have certified them as safe in hyperbaric environments. Other implanted devices such as medicine pumps and nerve stimulators are often not certified for greater than one atmosphere of pressure. If there is any question about a device’s suitability, the manufacturer should be contacted before HBOT treatments are initiated.

Fevers

This is discouraged as HBOT may exacerbate a high fever to a degree.

Mobile Phones

Mobiles have successfully and safely been taken into low pressure chambers and have presented no problem as reported by many. Notwithstanding that, a punctured mobile battery can release toxic chemicals and can be an immediate source of fire. The internal chemistry of a mobile battery is such that exposure to air will cause it to ignite. Due to this we recommend mobile phones are not taken into the chamber.

How to Complete Logbook

It is recommended that you complete your log book after each HBOT session to help you and your clinician to monitor and track your progress.

1. Ensure you log the period of time it took you to pressurise.
2. Note what pressure you were able to achieve. It is not always necessary to reach full pressure, being comfortable and taking your time is what is most important.
3. Log the total time it took to depressurise. Ensure this is at a comfortable speed for you.
4. Log the total time spent in the chamber from the start of pressurisation through to depressurisation.
5. Complete the questions, both you and your clinician may wish to refer back to this in due course.

I hereby consent and authorise the hyperbaric oxygen therapy (HBOT) staff at: J G DICKSON CHEMIST

to administer hyperbaric oxygen therapy and/or oxygen therapy to me. In doing so, I hereby acknowledge the following:

• If I am undergoing HBOT for general health and wellness, then I understand that HBOT at this centre is not being prescribed to treat a medical condition, but only as an aid to help improve my physiological oxygen levels, with the goal of helping to improve my general wellbeing.
• If I have a signed physician form/prescription from a doctor that believes that this will help my condition, I understand this is considered “off-label” (unless the condition is altitude sickness). For this reason, the nature and purpose of hyperbaric oxygen therapy has been explained to me and I understand the explanation. The consequences, risks, costs of sessions, and alternatives to HBOT have also been explained to me and I have been informed that HBOT may need to be repeated in the future, either by repeated sets of sessions or by frequent maintenance sessions, in order to help maintain the benefits.

Further Acknowledgements

• I have been given the opportunity to ask any question I might have regarding HBOT and/or oxygen therapy, and the provider has answered my questions.
• I have informed the attendant of my current health status, all current medications, and therapies, and I agree that it is my responsibility to keep the attendant aware of any changes in my condition, medication, or therapies, for every session.
• I have been informed that I may refuse HBOT at any time, or even terminate a session while in the chamber, and exit the chamber within minutes.
• I will follow the instructions of the chamber attendant and I will inform the attendant of any concerns during the treatment, such as pain, nausea, diarrhoea, dizziness, visual changes, ringing or other noises in the ears, unusual smells, fear or anxiety reaction, unusual sweating, changes in heart rhythm, hiccups, chest pain, faintness, mood changes, difficulty breathing, or any discomfort.
• I have read and understand the FAQ and will comply with its instructions.
• The benefits of HBOT may be much greater if I follow a healthy lifestyle, which includes not smoking, weight control, exercise, proper nutrition, and stress management.
• Potential risks of HBOT: Ear drum/sinus discomfort or pain, reversible myopia, confinement anxiety/claustrophobia, fatigue, collapsed lung/pneumothorax, severe lung diseases/lung damage from pressure, heart failure, blood sugars may drop in diabetics, cataract maturation.
• If any unforeseen conditions arise during the course of this therapy, I do hereby authorise/request the staff to perform such additional procedures and/or to render such assistance as may be deemed necessary at that time.