Page 191 - HA Convention 2016 [Full Version]

Masterclasses HOSPITAL AUTHORITY CONVENTION 2016

M13.1 Hyperbaric Oxygen Therapy 13:15 Convention Hall A

Hospital-based Hyperbaric Oxygen Therapy in Hong Kong — Preparation and Service
Leung J
Accident and Emergency Department, Pamela Youde Nethersole Eastern Hospital, Hong Kong

Although hyperbaric oxygen therapy is not a new modality of treatment, hospital-based facility has not yet been established
in Hong Kong. In order to bridge this service gap in our healthcare system, a group of physicians from emergency services
and Intensive Care Unit at Pamela Youde Nethersole Eastern Hospital has planned to establish a new unit with Hyperbaric
Oxygen Chamber on site since 2010. After years of preparation and planning, we shall have the first hospital-based
Hyperbaric Oxygen Chamber in Hong Kong in 2018. In this presentation, the historical background, concepts of use of
Hyperbaric Oxygen Therapy in different diseases, and our preparation and planning in setting up this new unit will be shared.

M13.2 Hyperbaric Oxygen Therapy 13:15 Convention Hall A

Care of Critically Ill Patients for Hyperbaric Oxygen Treatment Wednesday, 4 May
Yan WW
Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, Hong Kong

In Hong Kong, public hyperbaric oxygen treatment (HBOT) service is provided at the Recompression Treatment Centre (RTC)
at Ngong Shuen Chau. The RTC has been operated by the Hong Kong Fire Services Department and medically supervised by
the Occupational Medicine Division of the Labour Department since 1994.

There are limitations in treating critically-ill patients with HBOT in Hong Kong because the RTC at Ngong Shuen Chau is
situated in a remote area, not attached to any hospital. There are only basic monitoring and resuscitative equipment and the
environment is not spacious. The escorting staff of the referral hospital has to deal with clinical emergencies or resuscitation.
Therefore, transferring a critically-ill patient for HBOT is very challenging in Hong Kong and hence many potential beneficial
HBO treatment might have been withheld in the past years.

The principles of managing a critically-ill patient for HBOT are decribed as below:

(1) Balance the potential benefit of HBOT with the related risks including transporting out of the hospital to a remote facility.

(2) Before HBOT, endotracheal tube cuff should be filled with water; need of myringotomy should be assessed, glass or
rigid bottles of intravenous fluid should be avoided; only hyperbaric compatible equipment and consumables are allowed
inside the chamber.

(3) During HBOT, adequate monitoring should be provided. Besides clinical monitoring by tender, multi-parameter
physiological monitoring of vital signs is essential. Tidal volume, ventilator pressures, signs of barotrauma and oxygen
toxicity are also important. Nitrogen narcosis and decompression illness should be very rare in nowadays treatment
protocols.

(4) After HBOT, check for any signs and symptoms of decompression illness, barotrauma and oxygen toxicity; any
therapeutic effect of HBOT.

In view of the current limitation in HBOT service in Hong Kong, the HA has planned to provide a hospital-based HBOT in early
2018. It is hoped that by then, HBOT can be freely available to HBOT indicated patients.

M13.3 Hyperbaric Oxygen Therapy 13:15 Convention Hall A

Hyperbaric Oxygen Therapy — Australia’s Experience
Au Yeung KL
Accident and Emergency Department, Queen Elizabeth Hospital, Hong Kong

Hyperbaric oxygen therapy (HBOT) is widely practised in most developed countries, and Australia is no doubt one of the
countries with the most well-established HBOT network and system. HBOT is not only the primary treatment modality for
decompression sickness and arterial gas embolism, but also indicated for a number of clinical conditions such as diabetic
wounds and radio-osteonecrosis. In this session, hands-on experience on HBOT in different centres of Australia will be
presented — from the indications of referral for HBOT, to the patient care path and work flow, to the practical aspect of
service delivery.

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