Specialised Services National Definition Set: 28 Hyperbaric treatment services (adult)

Hyperbaric oxygen treatment (HBOT) involves delivery of 100% oxygen inside a treatment chamber at a pressure greater than sea level. There are both monoplace and multiplace chambers available across the UK.

Details of the location of services are set out in Appendix 1. The service centres are not evenly distributed on a geographical basis, and they provide different categories of services:

• Category 1
  Facilities should be capable of receiving patients in any diagnostic category who may require Advanced Life Support either immediately or during HBOT.
• Category 2
  Facilities should be capable of receiving patients in any diagnostic category who are judged by the referring medical officer not to be likely to require Advanced Life Support during HBOT.
• Category 3
  Facilities should be capable of receiving emergency referrals of divers and compressed air tunnel workers. These facilities should also be capable of providing elective treatment of residual symptoms of decompression illness. Patients may be accepted, in the name of the Medical Director (whose role is defined in paragraph 24 of the Cox Report, 1994), even when no Hyperbaric Duty Doctor is available at the time of referral provided, in the view of the referring clinician, the patient's condition demands immediate action. This does not obviate the need for discussion with the Hyperbaric Duty Doctor who should attend the patient as soon as is practicable.
• Category 4
  Facilities should be capable of receiving elective and emergency referrals of patients in any diagnostic category who are judged by the referring medical officer, on the advice of the Hyperbaric Duty Doctor, not to be likely to require access during HBOT.

Normally monoplace chambers are not suitable for the immediate treatment of acute decompression illness.

Hyperbaric chambers are currently provided in a number of places, including a small number of hospitals, private organisations including a charitable unit, Royal Navy Centres, police diving units, professional diver training schools, and sites associated with the North Sea oil industry.

The services deal with both emergency and elective requirements covering treatment of decompression accidents and a wider range of disorders, such as particular wound problems and some infection as well as emergency requirements. The majority of units providing services to the NHS are registered with the British Hyperbaric Association which is not regulatory, but aims to provide standards for benchmarking purposes and to facilitate research.

The requirements of the NHS are met by accessing the hyperbaric chamber services in the different units across the country. The capacity of the current service is likely to meet present and future needs.

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