Side Effects And Complications

Question 0

BG drops

Answer 0

Only in patients on medication, typically only those taking insulin
o Manifests as a seizure, difficult to discriminate form oxygen toxicity
o On average, there is a 50 point drop during a 2 hour treatment
o Must check pre and post tx FSBS

Question 1

4 potential problems

Answer 1

• Ear barotraumas
• Round window blowout
• Sinus squeeze
• Dental problems

Question 2

Visual refractory changes

Answer 2

o Typically see in patients who are older and receive greater than 20 treatments
o Myopia (distance vision) gets worse while presbyopia (close vision) gets better
o Typically reveres after treatment
o No new eyeglass prescriptions for at least 2 months

Question 3

Cataract formation

Answer 3

o Historically thought that HBO will not cause cataracts to form, but may cause them to “ripen” faster

Question 4

Claustrophobia

Answer 4

Ensure that patient understands that he/she is in control
o Educate, and provide a trial run
o Premedicate with benzodiazepine

Question 5

Pulmonary oxygen toxicity

Answer 5

o Oxygen poisoning in lung tissues
o Symptoms
• Substernal chest pain
• Dry cough
• Decrease in vital capacity
o Amount of oxygen intake can be calculated to reduce risk
o TID tx make this more likely
o Be aware of O2 use pretreatment – nasal canula, vent settings, etc
o Consult a pulmonologist

Question 6

CNS toxicity

Answer 6

• CNS oxygen toxicity
o Kindwell lists seizure rate at 0.7/10,000 treatments
o Very impressive looking
o Biggest concern is harm from flailing or aspiration
o Prevention
• Confirm BG values
• Ensure avoidance of CO2 rebreathing or retention
• Increased risk with fever or steroid use
• Premedicate with benzodiazepines
• Give more frequent air breaks or treat at a lower pressure
o Treatment is to remove from the oxygen
o NEVER DECOMPRESS A PATIENT WHILE THEY ARE IN THE TONIC PHASE