HYPERBARIC MEDICINE

Arcila Nora, Carranza Gianfranco, Peña Sophia, Rodriguez Novoa Justiniano

1. INTRODUCTION
2. THEORETICAL
FRAMEWORK
2.1. Concepts
2.2. Uses / Treatments
2.3. Service Staff
2.4. equipment

3. DIAGNOSIS CURRENT SITUATION

3.1. Lawsuit in Trujillo
3.2. Offer in Trujillo
3.3. That demands offer
3.4. Attended / Not Attended
FUNCTIONAL ANALYSIS
4. 4.1. Processes / Functional Cycle
4.2. Environments
REFERENCES
5. 5.1. Within the Country
5.2. Out of the country
REGULATION
6. 6.1. RNE / Disabled
6.2. MINSA
6.3. Hospital Waste Management

7. CONCLUSIONS
8.
9.
RECOMMENDATIONS
ANNEXES/BIBLIOGRAPHY/LINKOGRAPHY INDEX
1. INTRODUCTION

Hyperbaric Chamber treatment was born more than 300 years ago, in 1662 the
English clergyman (physiologist and doctor) Henshaw sensed that increasing air
pressure could relieve some acute injuries. He built the first hyperbaric chamber and
years later it was called “compressed air baths.”

In 1930, Dr. Paul Bert used the Hyperbaric chamber for treatment purposes in
diseases caused by diving. From this date on, the work carried out
with HBO begin to have greater scientific rigor, and in 1976 the Advisory Council of
the Undersea and Hyperbaric Medical Society was established, which regulates the
indications for treatment with HBO.
2. THEORETICAL
FRAMEWORK
2.1. CONCEPTS
- HYPERBARIC MEDICINE:
Also known as HYPERBARIC OXYGENOTHERAPY, where oxygen is administered at a higher pressure than normal for the purpose of
primarily treating decompression sickness, wounds, chronic bone infections and radiation injuries.
- HYPERBARIC CHAMBER:
Closed cabin, generally made of metal or transparent, cylindrical acrylic that allows pressure to increase above atmospheric pressure.
- SINGLE SEAT:
When the Hyperbaric Chamber allows the introduction of a single patient.
- MULTI-SEAT:
When the Hyperbaric Chamber allows the introduction of two or more patients.
- ATA:
Absolute Atmospheres. Atmospheric pressure (PA) plus Barometric Pressure (PB), and it could be said that when treatment is
administered to a patient at 2 ATA it would be PA + PB.
2. THEORETICAL
FRAMEWORK
2.2. USES / TREATMENTS
- INDICATIONS IN ACUTE CASES: qd: txday / bd: 2xday / td: 3xday

PATHOLOGY PRESSURE TIME FREQUENCY DURATION

CO poisoning 2.5 / 3.0 90 / 150 qd/bd 5-7

Aeroembolism 2.8 / 4.0 150 1 session 2-3

Necrotizing infection 2.5 / 3.0 90 td/bd 7 - 30

Acute Ischemia 2.5 90 bd/qd 10 - 30

Sudden deafness 2.5 90 qd 15 - 25

Burns 2.0 / 2.5 90 td/bd 10 - 15

Ocular Ischemia 2.5 90 qd 15 - 20

Source: Manual of Underwater and Hyperbatic Medicine

2. THEORETICAL
FRAMEWORK
2.2. USES / TREATMENTS
- INDICATIONS IN CHRONIC PATHOLOGY:
PATHOLOGY PRESSURE TIME FREQUENCY DURATION

Isq Injury Diabetic 2.5 90 qd/bd 49

Chronic Osteomyelitis 2.5 90 1 session 60

Clostridial myonecrosis 3.0 90 td/bd 10

Sick Decompressive 2.8 / 6.0 90 qd 14

Transt. of Healing 2.0 / 2.5 90 qd/bd 60

Severe anemia 3.0 90 td/bd 50

Radionecrosis 2.0 / 2.4 90 qd 60

Skin Grafts 2.0 / 2.5 90 qd/bd 20 - 40

Intracranial Abscesses 2.5 90 qd/bd -

qd: txday / bd: 2xday / td: 3xday
Source: Manual of Underwater and Hyperbatic Medicine
2. THEORETICAL
FRAMEWORK
2.3. SERVICE STAFF

He is the doctor responsible for all the functions carried out at the Hyperbaric Medicine Center.
MED DIRECTOR

He is the doctor in charge of clinical activities related to hyperbaric treatments.

M. HYPERBARIC
She is the nurse responsible for the practical implementation of patient care during treatment
with AND. HYPERBARIC hyperbaric medicine.

You are responsible for all safety during the hyperbaric session.
C SUPERVISOR

Source: Baromedicine – Paula Burchard

 2. THEORETICAL
3.
FRAMEWORK
SERVICE STAFF

He is responsible for the direct care of patients within the hyperbaric chamber.
ASSISTANT OF S.

Responsible for the safe operation of the hyperbaric chamber system in accordance with operational procedures.

He is C OPERATOR
CH TECHNICIAN responsible for the maintenance and repair of the equipment that operates in the hyperbaric
medicine center.

SECRETARY OF S. She is in charge of the center's administrative procedures.

Source: Baromedicine – Paula Burchard

2. THEORETICAL
FRAMEWORK
2.4. EQUIPMENT

- HYPERBARIC CHAMBERS:
Chambers pressurized with compressed air and the oxygen supply is carried out through special masks or diving suits. All
hyperbaric chambers, in addition to the chamber compartment, have an additional compartment, called antechamber.

- CLASSIFICATION OF HYPERBARIC CHAMBERS:

A. Single-seat: Chambers for a single patient.
B. Two-seater: Chambers for two patients.
C. Multiplace: Chambers for more than three patients.

Hyperbaric Chambers are used to perform treatments that allow patients to recover
and rehabilitate through breathing pure oxygen.

Source: Hiperbaric Medicine, Nina Subbotina

2. THEORETICAL
FRAMEWORK
2.3. EQUIPMENT

- SINGLE-SEAT R270:
Internal and external air release valve
DOUBLE FILTER Compressor
Comfortable Medical Mattress
Air Supply Hose

Specifications:
Length = 2.28m
Broad = 1. 04m
Weight = 15.0kg
Diam. Int. = 28.5cm
T. Electrical = 10.0 v

Source: Hybaric SAC Laboratory - Oxycap

2. THEORETICAL
FRAMEWORK
2.4. EQUIPMENT
- SINGLE-SEAT FD1:
Hermetically Closed Capsule
Comfortable Medical Mattress

Specifications:
Long. Abroad = 2.30 m
Long. Inside = 2. 20m

Diam. Outside = 1.10 m

Diam. Inside = 1.06 m
Height = 1.30m
Weight = 450kg
Max pressure = ATA 3.0
T. Electrical = 12.0v

Source: Hybaric SAC Laboratory - Oxycap

2. THEORETICAL
FRAMEWORK
2.4. EQUIPMENT
- SINGLE-SEAT MO-12:
Regulation of treatment pressure for automatic operation.
Automatic pressurization speed regulation.

Specifications:
Length = 2.56m
Broad = 1. 07m
Weight = 1300 kg
Diam. Int. = 85cm
T. Electrical = 80.0 v

Source: Hybaric SAC Laboratory - Oxycap

2. THEORETICAL
FRAMEWORK
2.4. EQUIPMENT
- MULTI-SEAT ML100:
Hermetically Closed Capsule
Max. Capacity between 8 and 12 pcts.

Specifications:
Long. Abroad = 6.00 m
Long. Inside = 5.00 m
Diam. Abroad = 2.10m
Diam. Inside = 2.06m
Height = 2.20m
Weight = 9,000 kg
Max pressure = 3.0 – 6.0 ATA
T. Electrical = 48.0v

Source: Hybaric SAC Laboratory - Oxycap

2. THEORETICAL
FRAMEWORK
2.4. EQUIPMENT
- MULTI-SEAT ML60:
Hermetically Closed Capsule
Max. Capacity between 4 and 8 pctes.

Specifications:
Long. Abroad = 4.00 m
Long. Inside = 3.00 m
Diam. Abroad = 2.10m
Diam. Inside = 2.06m
Height = 2.20m
Weight = 5,000 kg
Max pressure = 3.0 – 6.0 ATA
T. Electrical = 52.0v

Source: Hybaric SAC Laboratory - Oxycap

2. THEORETICAL
FRAMEWORK
2.4. EQUIPMENT
- MULTI-SEAT ML80:
Hermetically Closed Capsule
Max. Capacity between 8 and 12 pcts.

Specifications:
Long. Abroad = 5.00 m
Long. Inside = 4.00 m
Diam. Abroad = 2.10m
Diam. Inside = 2.06m
Height = 2.20m
Weight = 7,000kg
Max pressure = 3.0 – 6.0 ATA
T. Electrical = 50.0v

Source: Hybaric SAC Laboratory - Oxycap

2. THEORETICAL FRAMEWORK
=
2.4. EQUIPMENT
- MULTI-SEAT 456FD:
Hermetically Closed Capsule
Max. Capacity between 8 and 12 pcts.

Specifications:
Long. Abroad
Long. Inside
Diam. Abroad
Diam. Inside
Height
Weight
Max pressure
T. Electrical 2.08m
= 13.00 m
= 2.31m
= 12.12 m
= 14,500 kg
= 2.10m
= 3.0 – 6.0 ATA
= 50.0v
Source: Hybaric SAC Laboratory - Oxycap
2. THEORETICAL
FRAMEWORK
2.4. EQUIPMENT
- 3.5HP ELECTRIC COMPRESSOR

Sound absorption of 72 dB(A) at 1 meter away.

- Filling device with security system.
- Clean and silent condensate drainage.
- The air quality exceeds the requirements of DIN EN 12021.

• Technical data:

1.52M
• FAD: 630 L/min
• Pt max: 330 bar
• Rpm: 1320
• Engine power: 15 Kw
• Weight approx. : 480 kg
• Height: 152cm
• Width: 148
• Depth: 83cm

Source: Hiperbaric Medicine, Nina Subbotina

2. THEORETICAL
FRAMEWORK
2.4. EQUIPMENT
- 10HP ELECTRIC COMPRESSOR
The air purification system is achieved thanks to the large volume of
air inlet per filter and 2 oil/water decanters with integrated active
carbon molecular cartridge, achieving
thus, an air quality in accordance with the DIN EN 12021 standard.

• Technical data:
• FAD: 320 l/min
• Rpm: 1530
•

0.50M
Cubic Capacity : 273 m³
• Height = 0.50m
• Weight = 4,500kg
• Max pressure = 0.5 – 1.ooATA
• T. Electrical = 25.0v 0.60M

Source: Hiperbaric Medicine, Nina Subbotina

2. THEORETICAL
FRAMEWORK
2.4. EQUIPMENT
- OXYGEN TANKS OF 1700 and 3500 liters.

Complete equipment for oxygen therapy.

• Aluminum cylinder.
• Very light and practical.
• High security with protection devices integrated into the regulator
and the cylinder.
• 100% certified quality, complying with ISO9001, 13,845
standards;
ASTM-G175, DOT-3AL AND TC-3ALM.
• Detachable regulator.

Source: Dimeer and Life

2. THEORETICAL
FRAMEWORK
2.4. EQUIPMENT
• OXYGEN TANKS OF 425 and 680 liters.

• Complete equipment for oxygen therapy.

• Aluminum cylinder.
• Very light and practical.
• High security with protection devices integrated into the regulator
and the cylinder.
• 100% certified quality, complying with ISO9001, 13,845 standards;
ASTM-G175, DOT-3AL AND TC-3ALM.
• Detachable regulator.

2.4. EQUIPMENT

WHAT SPECIAL INSTALLATION SHOULD I HAVE TO INSTALL A

HYPERBARIC CHAMBER?
Source: Dimeer and Life
2. THEORETICAL
FRAMEWORK
- For a portable camera, only a well-ventilated and air-conditioned room.
2. THEORETICAL
FRAMEWORK
2.4. EQUIPMENT
WHAT SPECIAL INSTALLATION SHOULD I HAVE TO INSTALL A HYPERBARIC CHAMBER?

- For a single-seat rigid chamber, in general, you only need adequate space no larger than a stretcher and an open
area where the compressor is installed.
2. THEORETICAL FRAMEWORK
2.4. EQUIPMENT

WHAT SPECIAL INSTALLATION SHOULD I HAVE TO INSTALL A HYPERBARIC CHAMBER?

- In the case of a Multiplace chamber, the manufacturer must be consulted to make the foundations according to the specifications.

CONSIDERATIONS OF
WEIGHT PER MACHINE
MULTI-SEAT
(DEPENDING
CAPACITY) FOR THE
CALCULATION OF
FOUNDATIONS AND
STRUCTURES
2. THEORETICAL FRAMEWORK
2.4. EQUIPMENT
WHAT SPECIAL INSTALLATION SHOULD I HAVE TO INSTALL A HYPERBARIC CHAMBER?

- It is advisable to have air compressors, such as oxygen tanks, in a separate space (Machine Room), as well as having adequate
protection against fires.

and battery
oxygen
18X50L air bottles
bench 98 6x50L
compressor
room
 Source: Government of the Region - Health
3. CURRENT DIAGNOSIS
Men □ Women □ Total
3.1. DEMAND IN TRUJILLO
 Source: Medical Survey
3. CURRENT DIAGNOSIS
3.2. OFFER IN TRUJILLO

□ □ F. of Diffusion □ F. of personal

□ High Costs Others

 Source: Ministry of Health
3. CURRENT DIAGNOSIS
3.3. THAT DEMANDS 3.4. ATTENDED / NOT ATTENDED
OFFER

Ferrer Palms American

4. FUNCTIONAL
ANALYSIS
4.1. PROCESSES
- FUNCTIONAL COURSE OF THE PATIENT UNDER TREATMENT

Source: Functional Procedures in Hospital Architecture (Thesis)

4. FUNCTIONAL
ANALYSIS
4.1. PROCESSES
- FUNCTIONAL COURSE OF THE DOCTOR IN THE TREATMENT STAGE

Source: Functional Procedures in Hospital Architecture (Thesis)

4. FUNCTIONAL
ANALYSIS
4.1. PROCESSES
FLOW CHART

INCOME ADMISSION FILES

CLINICAL
LAB

WAITING ROOM CONSULTING

ROOM

PHARMACY
EXIT

Source: Functional Procedures in Hospital Architecture (Thesis)

4. FUNCTIONAL
ANALYSIS
4.1. PROCESSES
- RELATIONSHIP OF SPACES
Direct
ENVIRONMENTS
Hint
Admission

Files

Waiting room

Consulting room

Z. by Camaras H.

SSHH / Changing
rooms

Lab. Clinical

Pharmacy
4. FUNCTIONAL
ANALYSIS
4.2. ENVIRONMENTS

- ADMISSION
1. Cash/Right of Payments
2. Administrative Pool (Hall)
3. Waiting area
4. File (H. Clinic)

- CONSULTATIONS
1. Waiting room
2. Camera Area
3. SSHH / Dressing room
4. Patient Care
5. Examine the Patient
4. FUNCTIONAL
ANALYSIS
4.2. ENVIRONMENTS / AREAS

PATIENT RECEPTION AREA WAITING ROOM AREAS

Computer Station Mobile Furniture

Public service desk TV shelves 30m2

10 m2

Trash cans, swivel chairs Litter bins

4. FUNCTIONAL
ANALYSIS
4. FUNCTIONAL
ANALYSIS
4.2. ENVIRONMENTS /
AREAS
CARE AREA/ PATIENT RECEPTION AREA

Control and reception 10.00 m2

Waiting room 20.00 m2

Sanitary facilities 12.00 m2

Locker room 10.00 m2

STAFF AREA

Living room 8.00m2

Hygienic Service 3.00m2

Locker room 8m2

4. FUNCTIONAL
ANALYSIS
4.2. ENVIRONMENTS /
AREAS
TREATMENT AREA

Consulting room 10.00 m2

Individual Therapy Room 20.00 m2

Collective Therapy Room 50.00 m2

MACHINE ROOM AREA

Air compressors and gas supply and exchange

10 m2
system
4. FUNCTIONAL
ANALYSIS
4.2. ENVIRONMENTS / AREAS

TECHNICAL SUPPORT AREA

Materials and medicines

6m2
warehouse

equipment warehouse 15m2

Cleaning room 5m2

waste deposit 3m2

5. REFERENCES

5.1. within the country

- Chiclayo:
- Trujillo:
- Chiclayo Clinic
- “Sanchez Ferrer” Clinic
- Arequipa:
- “Las Palmeras” Hospital (La
- Hyperbatic Medical Center
Ezperansa)
“Oximedical ”

- Lime:
- Cusco:
- Child Hospital
- “Cima” hyperbaric clinic
- Naval Hospital
- Javier Prado Clinic
- Piura:
- medicine center
- Hiperbarica Piura Clinic
Regenerative
5. REFERENCES

Hermetically Closed Capsule Comfortable

Medical Mattress
Capacity 1 patient Weight 450 kg.

Source: Sanchez Ferrer Clinic

5. REFERENCES
5.1. within the country
5. REFERENCES
- DEFICIENCIES:
5. REFERENCES
Bad relationship
Lack of space
No Prevention Measures
Lack of Engine Room

- CONSULTING ROOM:

Z. of service

- Z. of Patient

- Z. of Doctor

Source: Sanchez Ferrer Clinic

5. REFERENCES
5.1. within the country
- OUTPATIENT CARE AT SANCHEZ FERRER
CLINIC:

• Previous Analysis

Source: Sanchez Ferrer Clinic

5. REFERENCES
5.1. within the country
“Las Palmeras” Hospital

Z. of Patient
Z. of service

Z. of Doctor

“Las Palmeras” Hospital

5. REFERENCES
5.1. within the country

“Las Palmeras” Hospital

5. REFERENCES
5.2. OUT OF THE COUNTRY

- Cuba:
- Naval Hospital, City of Havana
- Naval Hospital, Santiago de Cuba
5. REFERENCES
5.2. OUT OF THE
COUNTRY
- Venezuela:
- “San Bernardino” Hyperbaric Center
5. REFERENCES
5.2. OUT OF THE COUNTRY

Hyperbaric Chamber, CUBA Hyperbaric Chamber,

MEXICO
5. REFERENCES
5.3. OUT OF THE COUNTRY

Hyperbaric Chamber, Multiplace in Mexico, Spain, USA.

5. REFERENCES
5.2. OUT OF THE
COUNTRY

In-camera entertainment Antechamber that precedes the entrance

6. REGULATION

According to the equipment Features of the

Atmosphere

-energy hazards, electricity and contributing factors.

-Infrastructure and fire-resistant
constructions.
-Compressor installation, gas supply systems.

-Additional environment for

-Daily maintenance of the Hyperbaric chamber.
compressor.

-The equipment must be on the first level to avoid

-Additional space for tools and
overloading the floor.
cleaning.
-The camera must be installed in the middle of the
space for better manipulation
-Topical Environment.

-Waste deposit.
6. REGULATION
6.2. MINSA/DISABLED

ACCESS

CIRCULATIONS

DRESSING ROOMS

SERVICES
HYGIENIC
6. REGULATION
6.3. MINSA/DISABLED

INTERIOR ACCESS EXTERIOR ACCESS

-Minimum width of doors: 1.00 m - It will have a ground level entrance
- The door must swing towards the nearest wall - Use of ramps: 1.20 m wide,
non-slip floor.
- Minimum door width:
1.20m
6. REGULATION
6.4. MINSA/DISABLED PEOPLE

CIRCULATIONS - RAMPS
Ramp inclination:
-5% slope – Diff. Level: 1.8m to 2.00m – RECOMMENDED.

-8% slope- Diff. Level: 0.76m to 1.20m RECOMMENDED MAXIMUM

Type of user Ramp Length

0.3m 3 to 6 meters More than 6
meters
People with disabilities 11% 8% 8%

People with Disabilities with 10% 6% 5%

assistance
6. REGULATION
6.2. MINSA/DISABLED PEOPLE

STAIRS
Minimum Passed Countersteps Texture
width 0,
90

1.80m 32cm 14cm -Different from the

predominant floor -
Non-slip floor
6. REGULATION
6.2. MINSA/DISABLED

ELEVATORS
Location Minimum Minimum Railings door closure
interior area door size

- Close to the 1.50 x 1.50 1.00m - 2 interior 15 seconds of

main railings: at 75 opening for the
entrance and 90 cm passage of a
Person with
Disability
6. REGULATION
6. REGULATION
6.2. MINSA/DISABLED PEOPLE

DRESSING ROOMS
Dimensions: Minimum Door Width: -It will have bars
horizontal and
vertical support
-There must be a 1.80mx1.80m 1.00m
adjacent to the
dressing room bench
for patients with
disabilities in the
Diagnostic and
Treatment units.
6. REGULATION
6.2. MINSA/DISABLED PEOPLE

SANITARY FACILITIES
• • Cubicle doors • 1 1/2” • Non-slip
swing diameter floors.
Internal
outwards. enamelled
circulations 9
galvanized O
1.50 meters er
iron support
wide.
bars.
 SUPPORT BAR ON SUPPORT BAR ON
BOTH SIDES BOTH SIDES

too cms.
95
c
80 cm.
m
6. REGULATION
6.3. MANAGEMENT OF
HOSPITAL WASTE
6. REGULATION
6.4. MANAGEMENT OF HOSPITAL WASTE

TYPES OF WASTE
GENERATED

DANGEROUS RESIDUES NON-HAZARDOUS WASTE

Biocontaminated Waste Common Waste:

Latex gloves, gauze, cotton swabs, masks, needles paper, cardboard, jars,
baguette, paper towels,
Special Waste bags
6. REGULATION
6.2. MANAGEMENT OF HOSPITAL WASTE

the distances for the transfer

due to the pace and volume
ATMOSPHERE of them to
of waste generation
Storage final storage.
intermediate

1.Minimum area of 2.50 m2.

FEATURES —<
2. Floors and walls covered with smooth, resistant, washable and
waterproof material.

3. Ventilation through ducts or opening with a minimum of 1/20 of the

floor area
6. REGULATION
6.2. MANAGEMENT OF HOSPITAL WASTE

-Area of 60 m2 approx.
ATMOSPHERE
Storage CHARACTERISTICS - The area must have enough space to store 2 days' worth of
FINAL waste.
7. CONCLUSIONS
The number of people who could be treated is not covered by the service
(offer) due to the shortage of private and state centers that provide and
inform their patients of this type of treatment.

The city of Trujillo has only one Hyperbaric Medicine center, taking this into
account we can say that the treatment does not have massive dissemination
about its benefits and positive results in people.

Oxygen therapy services have high costs per session, and this is why its
treatment is also unknown.
7. RECOMMENDATIONS
7. RECOMMENDATIONS
In the case of multi-seat hyperbaric chambers for 12 people, considering the weight, they must sit on a base and foundation different from
the rest of the environments, which is much more resistant and of greater
support.
7. RECOMMENDATIONS

Settlement of hyperbaric chamber at the base

7. RECOMMENDATIONS

The appropriate environment to place the camera must be in the center of the
environment for its operation and a fluid circulation of doctors, technicians
and/or patients.

It must be located in an environment free of humidity and with anti-corrosion

protection.
7. RECOMMENDATIONS

Install the air compressor and the gas supply and exchange system in an
area adjacent to the office. This is also called the engine room.

This engine room must be covered with anti-flammable insulation.

7. RECOMMENDATIONS

The engine room must have enough space to house gas exchange pumps,
these can be 4m x 4m (16m2) or (20m2).
7.7.RECOMMENDATIONS
RECOMMENDATIONS

Sánchez Ferrer Clinic

In order to enter the Hyperbaric Chamber, the following recommendations must
be taken into account:

- Keys
- Batteries
- Cell phones
- Jewelry
- Cigar
- Lighters
- metal items
- Make-up
- Earphones
- Perfumes
- Newspapers
- Do not wear clothes that are not 100% cotton
9.7.BIBLIOGRAPHY / LINKOGRAPHY
RECOMMENDATIONS

- “Manual of Hyperbatic and Underwater Medicine”

- “Hyperbaric Medicine” – Ninna Subottina
- Functional Procedures in Hospital Architecture (Thesis)
- Hybaric SAC Laboratory – Oxycap
- http://www.ohbcoppola.com/preguntas.html
- http://www.portalesmedicos.com/publicaciones/articles/1310/2/Tratamiento-con-oxigenacion-hyperbarica-(OHB)-y-regimen-
de-marcha-progresivo-para-la-claudicacion-intermitente
- National Building Regulations
- Manual for Hospital Waste Management
- Baromedicine – Paula Burchard (blog)