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By Working Group Safety of the COST Action B 14 Hyperbaric Oxygen Therapy

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2. Control and operation of the mechanisms for compression and decompression, and for delivering gas mixtures and oxygen. 3. Control and application of the safety regulations concerning prevention of fire, and oxygen toxicity. 4. Calculation, application and control of compression and decompression schedules for patients, Specialists and/or Doctors, Nurses and Attendants, applying decompression stops, when necessary. 5. Sometimes, interventions inside the Chamber under pressure, in order to control or check the correct operation of determined parts of the pneumatic circuits or devices.

X 4 3, 4 2, 3, 4 3, 4, 6 4, 6 2, 4, 6 2, 4, 6 2, 4, 6 54 A EUROPEAN CODE OF GOOD PRACTICE FOR HBO THERAPY Battery systems electrical Hydrogen gas/ insufficient power / time UPS electrical Not working when systems required, Sufficient time/power for emergency requirements Emergency Not working when generator electrical required, Sufficient systems time/power for emergency requirements Chamber Inadequate ventilation ventilation, failure Infection Control Poor standards/ inadequate Door seals/ "O" Damage rings Door Lack of door stops / weight/handles doors not hung correctly Silencers Dirty/ Blocked / corroded Pipework Inadequate Pressure valves Reducers Annex 3 Explosion, Fire, Inability X to complete exposition safely Inability to complete X exposition safely X X 2, 4, 6 Inability to complete X exposition safely X 2, 4, 6 Intoxication, X X Cross infection X X No Compression / loss X of pressure Physical Injury X X 3, 4, 5, 6 3, 4, 5, 6 2, 4, 5, 6 2, 4, 6 X X X X X X X X X X X X X X electrical X X Noise, O2 pockets, X suction injury, DCS X Explosion, physical Injury Injury/ damage/ explosion relief Not large enough / Explosion, Damage to incorrectly set / Faulty pressure hull, Injury Failure open / free- Unintentional Increase flow of pressure Equipment charging areas X Fumes/off gassing Electrical faults Heat Inadequate construction, malfunction Malfunction, shortcircuit Intoxication, shock, fire Poor quality care to X patients, fire X X Heat Source Over, lack of heat Fire / Burn Hypothermia risk / X X X Loose Cables/Wires Trapped/ Chaffing/Sparks Electrical Shock, fire X X X contaminated Infection, intoxication X X Exhausts Chamber Lights Compressor pressure May 2004 high Faulty, air X 2, 4, 6 2, 4, 6 2, 4, 6 2, 4, 6 2, 3, 4, 5,6 2, 3, 4, 6 2, 3, 4, 6 2, 3, 4, 5, 6 2, 3, 4, 5, 6 2, 3, 4, 5, 6 2, 3, 4, 5, 6 55 A EUROPEAN CODE OF GOOD PRACTICE FOR HBO THERAPY Compressor pressure Low Faulty, air Oxygen supply Computers outside Manifolds contaminated Infection, intoxication X X X X Inability to complete X treatment safely Wrong position / Asphyxia, hypoxia, X inappropriate material intoxication, DCI / rating / erroneous labeling X Malfunction, amount Failure purity, Hypoxia, DCI, fire INTERNAL EQUIPMENT Internal fixed Not ergonomic equipment Internal equipment Un-allowed air pockets, malfunction Internal battery Malfunction, sparks equipment Patient Ventilator Malfunction, affected by pressure & density of gas Infusion Pumps Malfunction, affected by pressure / density of ambient pressure Patient Monitoring Malfunction, affected by pressure / density of ambient pressure Diabetic monitors Affected by pressure May 2004 Annex 3 X Personnel injury X X Damage, health hazard X X Fire, health hazard X X Hypo- hyperventilation, X lung overpressure X 2, 3, 4, 5, 6 2, 3, 4, 6 2, 4, 5, 6 2, 4, 5, 6 X X 4 4, 5, 6 2, 3, 4, 6 3, 4, 5, 6 Patient inadequately X supplied with drug doses prescribed Poor quality care to X patients 3, 4, 5, 6 Inaccurate 3, 4, 5, 6 X 3, 4, 5, 6 56 A EUROPEAN CODE OF GOOD PRACTICE FOR HBO THERAPY C5 Annex 3 Hazards related to the use of a medical device Chambers for Hyperbaric Oxygen Therapy a) Inadequate labelling Items Hazard/Type of error Harm/Consequences P A O Cross Ref.

Further two to three members are nominated by the chairmen on the basis of their special competence and experience in one of the relevant topics. As the chairmen each represent a specific subcommittee, any major changes or decisions must be discussed within these subcommittees before going to the meetings of the EDTC or ECHM respectively. Each country interested in educational courses recognised by EDTC/ECHM should be represented by a member who has been acknowledged by the national hyperbaric medicine authority (or of all such authorities if there are more than one such authority in a country).

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