Hyperbaric chamber treatment protocols for patients are termed “tables.” Treatment tables are selected depending on the condition treated. The most common tables are for wound healing, decompression sickness and carbon monoxide poisoning.
The most common treatment protocol used at the Center for Hyperbaric Medicine is the “45 for 90” table. It is often used for the treatment of selected non-healing wounds, tissue damage from radiation, osteomyelitis and compromised skin grafts and flaps. It delivers 90 minutes of oxygen at a pressure equal to being beneath 45 feet of seawater or about 35 pounds per square inch. The oxygen is given in intervals of 20 or 30 minutes, with five minute air breaks in between. During the air breaks, the patient may take off the head hood and drink water or other beverages. The treatment duration is two hours and includes time to pressurize and depressurize the chamber, as well as time for air breaks. It may be repeated daily for up to 40 days.
The protocol most commonly used to treat divers with decompression sickness (the “bends”) is the “United States Navy Treatment Table 6.” It varies in length, depending on the patient’s symptoms, from about five hours up to eight hours. At first, the chamber is compressed to the pressure equivalent of being beneath 60 feet of seawater and the patient receives 60 to 100 minutes of oxygen. Then the chamber is slowly depressurized to the equivalent of being beneath 30 feet of seawater and the patient receives two to four additional hours of oxygen. Less commonly, a diver may initially need the chamber to be pressurized to the equivalent of being beneath 165 feet of seawater. Follow-up treatments for divers may be another “United States Navy Treatment Table 6” or a “45 for 90” table as described above.
Patients with carbon monoxide poisoning may be treated at pressures equal to being beneath 66 or 45 feet of seawater, depending on the severity of their symptoms. These treatments provide 90 minutes of oxygen at the treatment pressure and last about two hours.