Question: Why is a hyperbaric facility maintenance program necessary?
The development of a comprehensive maintenance program for a hyperbaric system and its supporting equipment is essential for a safe and cost-effective operation. The chamber and its operational systems, the chamber room, and the equipment used in and around the chamber should be maintained at the highest operational level. This should also include the cleanliness of all elements of the interior and exterior systems.
Components of a Maintenance Program
Why is a maintenance program necessary?
It is important to understand and comply with applicable codes and standards in order to reduce the potential for:
- Chamber mishaps and patient/staff injury
- Costly repair expenses
- Lost revenue due to unexpected chamber shutdown
The National Fire Protection Association (NFPA) publishes one of the most important standards that apply to hyperbaric facilities. Chapter 14 of the NFPA 99 "covers the recognition of, and protection against, hazards of an electrical, explosive, or implosive nature, as well as fire hazards associated with hyperbaric chambers and associated facilities that are used, or intended to be used, for medical applications and experimental procedures at gauge pressures from 0 kPA to 690 kPA (0 psi to 100 psi)." Section 126.96.36.199.2 of the NFPA 2012 Edition specifies responsibility for administration and maintenance requirements, "each hyperbaric facility shall designate an on-site hyperbaric safety director to be in charge of all hyperbaric equipment and the operational safety requirements..." It continues on to explain that "the safety director shall participate with facility managment personnel and the hyperbaric physician(s) in developing procedures for operation and maintanence of the hyperbaric facility."
The Undersea and Hyperbaric Medical Society (UHMS) Guidelines for Hyperbaric Facility Operations (2004 edition) recommends minimum safety program elements:
- Documented safety procedures, which must address:
- General facility safety
- Specific chamber related operational safety procedures such as fire in the chamber and/or the area surrounding the chamber, patient evacuation, contaminated air, equipment failure
- How to deal with physiological reactions such as ear pain, sinus pain, oxygen toxicity reactions, claustrophobia
- Documented recurring in-service training for all full-time and part-time hyperbaric facility staff on selected safety topics. Training sessions shall consist of fire drills, mock patient emergencies, simulated equipment failure, contaminated air, updates on codes and standards, etc.
- Documented preventive maintenance program executed either by local technical personnel or by a third-party maintenance contractor.
- Documented major maintenance program for specific hyperbaric facility components such as compressors, control components, fire suppression system components, etc (as appropriate).
Chamber mishaps and patient/staff injuries serve as paramount reasons for establishing a comprehensive maintenance program. Catastrophic accidents such as the loss of chamber pressure due to acrylic cylinder or viewport failure, fire due to faulty equipment, or injury due to faulty instrumentation, all serve as reminderes that the hyperbaric environment is unforgiving. Even the inadvertent activation of the Fire Suppression System (FSS) in a multiplace system has the potential to injure a patient by possible wound contamination. For this reason alone the FSS tank and headers in a multiplace system should be drained and refilled at least monthly to reduce the amount of contaminants present in the FSS water reserve. Consequently, when setting up a maintenance program many of the activities can be developed to revolve around the prevention of mishaps.
We will continue the discussion on establishing a hyperbaric facility maintenance program in subsequent blog articles. Remember to subscribe to our blog to be notified when new articles are released!
NOTE: This article focuses on the establishment of a maintenance program. The examples presented within are not meant to serve as an in-depth or detailed account of every maintenance item that may be preformed for a hyperbaric maintenance program.
References: Workman, Wilbur T. Hyperbaric Facility Safety: A Practical Guide. Flagstaff, AZ: Best Publishing Company 2010. Workman, Wilbur T. UHMS Guidelines for Hyperbaric Facility Operations. Kensington, MD: Undersea and Hyperbaric Medical Society: 2004.
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