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Michael Natoli, MS, CHT Center for Hyperbaric Medicine and Environmental Physiology Duke University Medical Center Durham, NC 27710 Hyperbaric Chamber.

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Presentation on theme: "Michael Natoli, MS, CHT Center for Hyperbaric Medicine and Environmental Physiology Duke University Medical Center Durham, NC 27710 Hyperbaric Chamber."— Presentation transcript:

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2 Michael Natoli, MS, CHT Center for Hyperbaric Medicine and Environmental Physiology Duke University Medical Center Durham, NC Hyperbaric Chamber Overview

3 Duke Pilot Chamber

4 G Duke Chamber Complex A, B, C - Clinical D, E, F, G – Research H – no longer attached C E D F H A B Seven chambers can be operated independently or in combination

5 Bravo Alpha Charlie Delta Foxtrot Golf Main Deck Second Deck Echo Golf Duke Chamber Complex

6 Chamber Construction

7 Chamber Foundation

8 G-Chamber Addition

9 Main Control Console Don Bordeaux, 2005

10 Design Specifications and Operational Guidelines ASME: BPV sec. VIII & PVHO-1ASME: 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 CGA (multiple) CGA (multiple) Compressed Gas Association NFPA – 99 and 53 M NFPA – 99 and 53 M National Fire Protection Agency

11 Certifying Agencies US NavyUS Navy Inspected every three years Department of Health and Human Services 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 State of North Carolina Department of Labor – Boiler Safety Bureau

12 Certifying Agencies (cont.) Joint Commission on Accreditation of Healthcare Organizations (JCAHO)Joint Commission on Accreditation of Healthcare Organizations (JCAHO) College of American Pathologists (CAP) College of American Pathologists (CAP) Undersea and Hyperbaric Medical Society (UHMS) Undersea and Hyperbaric Medical Society (UHMS)

13 US Navy Pipe Color Coding OxygenNitrogen Special Gas HeliumAir ExhaustVacuum Potable Water Fire Deluge System Originally developed in 1928 Originally developed in 1928 American Standards Association. (Now ANSI)

14 Air Quality Standards US Navy Guidelines –O % –CO 2 < 500 ppm –CO < 20 ppm –Hydrocarbons < 25 ppm –Particulate and oil mist <.005 mg/liter –Moisture <.02 mg/liter Independent laboratory test every 6 months. Independent laboratory test every 6 months.

15 Compressors Built by Norwalk 1936 Built by Norwalk 1936 Four stage HP Water cooled 100 cuft/min Synthetic oil lubricated (Anderol 500)

16 Compressors and Filters Cyclone separator Drains Dew Pt. Monitor CO Monitor 1200 psig Back Press. Valve To chambers To storage #1 #2 #3 Compressors Intake filter Relief valve Charcoal filter Final filter Drying towers towers Coalescing filter Roughing filter Cooling coil

17 Air Storage Banks 42 cu. ft. per cylinder water capacity 218,000 cu. ft. at 3,000 psi 24 storage cylinders

18 Air Delivery FromCompressors Bank 1 Bank 2 Bank 3 ElectricallyOperated By-pass Tochambers Main Reducing Bypass Relief valve Back-up Control Emergency storage Reference Emergency

19 Air Delivery Reducing Station

20 Control Console Rate Selector Ventilation Rate Control Method Control Rate Controlling ValveDP Cell Polarity Spray Valve Emergency Stop GaugeDP Cell Isolation Reference

21 Pressurization Control Gauge on console Manual (back-up) Manual Muffler Emergency stop valve stop valve Fromreducingstation 450 psig Chamber wall Proportional control valve

22 Decompression Control Manual To exhaust duct Flow meter Ventilationvalve Proportional control valve Emergency stop valve stop valve

23 Pneumaticvalves Cold water Hot water Electric motor Blower Muffler Heating / Cooling Coils Temperatureindicator Thermistor Internal Environmental Control Shaft seal Lubricationlevel Air flow

24 Hot water Blower External Environmental Control Temperaturecontroller Thermistor CO 2 absorbent Cold water

25 Breathing Gas Systems AirAir Chamber compression, air breaks, emergency facemask, ventilator. Special Gas Special Gas 50/50 for Table 6A, Nitrox for various studies. Oxygen Oxygen Treatment protocols, tender decompression.

26 Breathing Gas Systems BIBS Panel

27 Liquid O 2 Tank High press. reg. 180 psig Check valves Main O 2 reg. 250 psig Liquid level High Press. O 2 back-up Oxygen System Fill point point O 2 manifold O 2. reg. 80 psi over bottom Evaporators Relief valves

28 Patient Oxygen Delivery Systems Head tent Head tentRecirculating Single Pass Ventilator / Ambu-bag Ventilator / Ambu-bag Scott Duo-Seal Face mask Scott Duo-Seal Face mask Single hose Overboard dump

29 Oxygen Delivery - Recirculating Head Tent Venturi SodasorbCanister EductionLine Purge Line SampleLine IceBucket Bubbler LatexNeckseal Ice Water Drain CondensateDrain PurgeVenturi Oxygen Eduction Sample

30 Oxygen Delivery - Single Pass Head Tent Oxygen Eduction LatexNeckseal Patient Sample Line Oxygen Supply Regulator Regulator Oxygen Dump Regulator

31 Exhaust from patient 5 L Bag Filter 20 psig Reducing valve 100 psig Signal air Diaphragm Oxygen Eduction System Drain Valve Differential Pressure Converter Safety Shut Off Flow Fuse

32 O 2 Eduction

33 Eduction Manifold Description Bravo Alpha Charlie Delta Foxtrot 1 pipe 3 pipe Outside Building 4 ft 2 Chamber Exhaust Duct Air Amplifier Inlet Manifold 50 ft

34 Oxygen Eduction Air Amplifier A differential pressure gauge is used to verify suction at the inlet of the O 2 eduction manifold Air Amplifier O 2 eductionmanifold Building Exhaust Duct

35 Fire Suppression Tank Pump Fire Suppression System Reliefvalve 200 psig reg. 450 psig air Drain checkvalve Muffler Pneumatic valve Manual Air mask OFF ON Levelsensor Hand-held hose Overhead sprinklers

36 FireSuppression Water Source

37 Fire Suppression Equipment Inside the Chamber

38 Nitrogen Purge

39 Ground fault indicator 120 volts Groundfaultinterrupter Isolationtransformer Power and Lighting Doppler Canty Light Explosion proof housing low wattage

40 Telex Wireless System Plantronics Headset Two-way Mic/Speaker Box Sound- powered Phone Redundant Communication Systems

41 Closed Circuit Patient Monitoring

42 Breathing Gas Analysis Documents that patients are receivingproper treatment Documents that patients are receivingproper treatment Vital for fire safety and personnel safety Vital for fire safety and personnel safety Patients O2 > 98.0% CO2 < 1.0% SEV Chamber Atmosphere O2 = 20.5% % CO2 < 1.0% SEV

43 Patient O 2 Chamber Patient CO Chamber sample Patient sample Breathing Gas Analysis 21.0 zerospan % O 2 Oxygen Analyzer % O 2 zerospan Oxygen Analyzer 572 Servomex

44 Breathing Gas Analysis

45 Critical Care Monitoring –EKG –Blood pressure –Respirations –Temperature –Cardiac Output and wedge pressure –Oxygen Saturation –Transcutaneous O2 monitors

46 Defibrillator

47 Blood Gas Determination at Pressure

48 Two-dimensional ultrasonic arterial bubble detector Doppler ultrasonic venous bubble detector Ultrasonic Assessment

49 Suction

50 Medical Lock

51 Special Equipment Considerations Patient Chair Patient Stretcher

52 Altitude Controls

53 Chamber Cleaning Ultraviolet lightsUltraviolet 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 Acceptable agents Sanimaster 3 Benzalkonium choloride swabs Up to 10% Clorox solution Pressure washing Pressure washing

54 Chambers Here, There, and Everywhere

55 Toronto Canada: Toronto General Hospital

56 Bermuda: King Edward II Hospital

57 Providenciales: Menzies Medical Clinic

58 Panama Canal: ACP Panama Canal Authority

59 QUESTIONS ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?

60 References US Navy Diving Manual US Navy Diving Manual Revision 5 15 August National Fire Protection Association National Fire Protection Association NFPA 99 NFPA 53 Safety Standards for Pressure Vessels for Human Occupancy Safety Standards for Pressure Vessels for Human Occupancy ASME PVHO – 1 – Compressed Gas Association Compressed Gas Associationwww.cganet.com

61 Outline Duke Chamber Complex Design Specifications and Operational Guidelines Certifying Agencies Chamber Operations Breathing Gas Systems Fire Suppression Systems Communications Patient care equipment References


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