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Pressure is defined as - ansThe force per unit area acting on a surface in a direction perpendicular to that surface Gas is defined as - ansA phase of matter In the gas phase, the atoms or molecules basically move - ansRandomly Liquids change to a gas at - anstheir respective boiling points Hydraulics is a branch of science and engineering concerned with the mechanical properties of - ansLiquids When applying pressure to a fluid, the pressure is exerted - ansIn all directions equally A mechanical gauge is used when measuring gas pressure in a sealed container. For all common pressure gauges, the pressure indicated on the gauge is - ansLess than absolute pressure because gauges (and gauge pressures) ignore the ambient (barometric) pressure around us. They ony measure the extra pressure in the container. Absolute pressure can be defined as - ansThe amount of pressure within the sealed vessel + the amount of pressure outside the sealed vessel Absolute pressure can also be defined as - ansGauge pressure + atmosphere, total pressure and,true pressure. 1 atmosphere equals - ans760 mmHg
14.7 psi
33 fsw The barometric pressure in Denver (elevation 5000 ft) is less than barometric pressure at sea level - ansTrue To convert from ATA to fsw - anssubtract 1, then multiply by 33 To convert ATA to mmHg - ansmultiply by 760 mmHg To convert ATA to PSI - anssubtract 1, then multiply by 14. To convert FSW to ATA - ansdivide by 33, then add 1 Boyle's law is about the - anspressure-volume relationship Which gas law has an inversely proportional relationship - ansBoyle's law According to Boyle's law, (assuming the temperature remains constant) when the pressure increases, the volume - ansDecreases proportionally When applying boyle's Law to the human body, we worry about air-filled spaces being shrunk (or squeezed) when pressure around the body increases. This particular type of damage is known as. - ansBarotrauma Boyle's Equation is - ansP1xV1= P2xV Charles law is about the - anstemperature-volume relationship According to Charle's law, the volume in a flexible container,like a balloon, will ________ when the tempature increases (assuming the pressure remains constant). - ansIncrease proportionally According to Charle's law, the temperature in a flexible container, like a balloon, will______ when the volume increases (assuming the pressure remains constant) - ansIncrease proportionally Gay-Lussac's law is about - ansTemperature-pressure relationship According to Gay-Lussac's law, the temperature in a rigid container, like a scuba tank or a hyperbaric chamber, will______ when the pressure increases (assuming the volume remains constant) - ansIncrease proportionally
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According to Gay-Lussac's law, the temperature in a rigid container,like a scuba tank or a hyperbaric chamber, will _______ when the pressure decreases (assuming the volume remains constant) - ansDecrease proportionally Gay-Lussac's Law (in the hyperbaric chamber) is important to understand because when we start increasing the pressure in the chamber, the patient is likely to - ansComplain of being hot Gay-Lussac's Law (in the hyperbaric chamber) is important to understand because when we start decreasing the pressure in the chamber, the patient is likely to - ansComplain of being cold "Adiabatic heating" and "adiabatic cooling" refer to - ansThe temperature rise and temperature drop when chamber pressure changes GAy-Lussac's Law (in scuba diving) is important to understand because when we start increasing the pressure in a scuba tank (during a refill at the scuba shop), the tank will get _____ during the refill_____ while it sits at room temperature. This will cause the pressure of gas in the cylinder to _______ - ansWarmer;cool;decrease Gay-Lussac's Law ( in scuba diving) is important to understand because when we let a full scuba cyllinder lay in the sun and heat up, the pressure in the tank will _______. This could potentially cause_____. - ansIncrease; the scuba cyllinder to rupture When working mathematical problems involving Charles' law law or Gay-Lussac's law, it is necessary to convert the temperature from celcius to _____. To do this you _______ - ansKelvin; add 237 degrees When working mathematical problems involving Charles' law or Gay-Lussac's law, it is necessary to convert the temperature from fahrenheit to______. To do this you______ - ansRankine; add 460 degrees Henry's law is about - ansGas in solution A common example of Henry's law is - ansA newly opened bottle of soda Henry's law is involved in all of the following except; - ansIncreased intracrainal pressure The famous study that used the theory behind Henry's Law to keep pigs alive by dissolving oxygen in the plasma of the blood after all the red blood cells had been removed was done by
- ansBoerema in 1960 Nitrogen nicrosis is often referred to as - ansRapture of the deep true or false; Nitrogen narcosis is caused by breathing an increased partial pressure of nitrogen above 2,000 mmHg - anstrue true or false; Central nervous system oxygen toxicity is caused by breathing an increased partial pressure of oxygen - ansTrue true or false; Dalton's law states that the total pressure exerted by a mixture will increase proportionally as the total pressure increases - ansTrue Pascal's law is about - ansHydraulic pressure "A bubble deep within the body's tissues responds to the pressure applied outside the body" is a statement that exemplifies - ansPascal's Law Graham's law is about - ansDiffusion of gases Diffusion can be defined as - ansthe movement of particles from higher concentration to lower concentration
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A six cubic ft gas cylinder has 3000 PSI at 72F. A fire nearby causes the temperature of the cylinder to reach 170F. What is the pressure inside the cylinder? - ans3554 PSI
Gay- Lussac's Law P1/T1=P2/T2
What is the inspired PO2 in mmHg breathing air at 1 ATA
- ans160 mmHg What is the inspired PO2 in mmHg breathing air at 2 ATA - ans320 mmHg What is the inspired PO2 in mmHg breathing O2 at sealevel - ans760 mmHg What is the PO2 in mmHg in the patient's O2 hood while breathing O2 at 33 fsw - ans mmHg What is the PO2 in mmHg in the patient's mask while breathing O2 at 66 fsw - ans mmHg What is the inspired PO2 breathing 50/50 Nitrox at 2 ATA - ans760 mmHg What is the PO2 in the lung of a person breathing air at sea level - ans100 mmHg What is the PO2 in the lung of a person breathing O2 at sea level - ans673 mmHg What is the PO2 in the lung of a person breathing O2 at 33 fsw - ans1433 mmHg What is the PO2 in the lung of a person breathing O2 at 66 fsw - ans2193 mmHg At 10 fsw, what is the pressure in ATA mmHg, and psi - ans1.3 ATA,988 mmHg, 4.4 psi Priestley published his discovery of O2 in - ans The gas containing spaces in the human body are at risk for barotrauma - ansAny time the pressure is changing Barotrauma is defined as - ansTissue damage resulting from a pressure inequality between the environment and a gas-filled space within the body Otic Barotrauma - anspain, in the ear, the tympanic membrane is reddened, and fluid may b present behind it in the middle ear space Reasons behind Otic barotrauma - ansBarotrauma can occur at any time the pressure is changing. Swelling in the eustachain tube, due to allergies or an URI The most common barotrauma that occurs in the hyperbaric environment is - ansMiddle ear barotrauma Middle ear barotrauma can usually be avoided with good patient education and training. All of the following are acceptable methods for equalizing the middle ear except: - ansInsertion of a chest tube Signs and Symptoms of middle ear barotrauma include all the following except: - anspopping noises The most likely point during pressurization of the hyperbaric chamber for middle ear barotrauma to occur is - ansfrom sea level (0 psi) to the first 10fsw (5 psi) true or false; It is not possible to cause an outer ear barotrauma in the hyperbaric chamber since the ear canal is not a trapped air space. - ansfalse The anatomical apparatus through which the middle ear equalizes is the - ansEustachain tubes The treatment for complaints of ear pain during pressurization is - ansstop compressing the chamber True or false; The patient with the cleft palate will most likely be able to equalize the middle ear - ansFalse true or false; An intubated pt can equalize the middle ear - ansfalse Medications that might help with eustachain tube dysfunction are all of the following except - ansverapamile HCL
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A patietn who aggressively uses the Valsalva technique to equalize pressure in the middle ear risks causing - ansRound window rupture Another term for round window (or oval window) rupture is - ansperilymph fistula Perilymph fistula or round window (or oval window) rupture is - ansinner barotrauma Sometimes a patient is unable to ezualize one ear but not the other ear. This can lead to a condition known as - ansAlternobaric vertigo If a patient can't equalize the pressure in the inner ear they may need a tube that is inserted into the tympanic membrane this allows the pressure to passively equalize the middle ear - ansMyringotomy is preformed The most likely point during pressurization of thr hyperbaric chamber sinus barotrauma to occur - ansfrom sealevel (0 psi) to the first 10 fsw (5 psi) Barotrauma involving a tooth can be called a tooth squeeze or - ansbarodontalgia A tooth squeeze involving the upper teeth might be masked as - anssinus squeeze GI barotrauma is very rare; however, swallowed air or gas produced from digestion can expand in the stomach and intestines and cause abdominal pain during; - ansascent The path that air takes to the lungs is - anstrachea, bronchi,bronchioles, alveoli Pulmonary barotrauma is the _____ _____ form of hyperbaric barotrauma - ansMost dangerous During a hyperbaric treatment, pulmonary barotrauma is most likely to occur during - ansbreath holding on ascent True or false; Pulmonary barotrauma can occur in the hyperbaric chamber or while scuba diving - ansfalse, because pulmonary barotrauma may also occur as a result as a result of trauma or over pressure from a ventilator.
* remember only, always, and never in a T/F question usually makes it false One of the possible effects of a pulmonary barotrauma is - ansPneumothorax Treating the patient with unrelated Pneumo in the hyperbaric chamber can lead to - anstension pneumo The patient with a chest tube can be treated in the hyperbaric chamber. The device that is most commonly used in place of suction or waterseal to ensure air or fluid does not travel back up the tube into the pleural cavity is - ansHemlich valve Pulmonary barotrauma can cause a tear in the alveoli and arterioles that surround the alveoli resulting in - ansarterial gas embolism The definitive treatment of AGE is - ansHBOT The 1878 classic book,Barometric Pressure was written by - ansBert The book Barometric Pressure described what is now known as the bubble theory of decompression illness. What physiologic occurrence is the hallmark of decompression illness
- ansA buildup of nitrogen bubbles in the tissues Which person is credited with developing stage decompression to get divers safely out of the water - ansHaldane The work developing stage decompression was commissioned by the Brittish Royal Navy in - ansearly 1900's Stage decompression means - ansAscending at a fixed rate from maximum depth to a decompression stop at some shallower depth and then sending a given period of time prior to ascent to the next shallower depth
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true or false; Haldane, and others after him have redifined his decompression theory after exhaustive research into the tissue half-time concept. They have been able to identify which tissues are the 5min tissues, which are the 10 min tissues, and so on - ansfalse Current dive tables that recreational scuba divers use are designed to be used - ansat depth less than 130 fsw, breathing air, starting at sea level true or false; For a recreational scuba diver to dive in a lake located at an altitude > 2,000 ft, a special set of dving tables should be used - anstrue Which of the following is the most at risk to get DCS - ansThe scuba diver who just completed a photoshoot at 130 fsw in a rapid current As a scuba diver, the ways you could minimize the risk of DCS are all of the following EXCEPT: - ansFlying within 4 hours of finishing your last dive Theoretically, the mechanical compression of bubbles during a HBO treatment for DCS - ansForces nitrogen back into solution and diminishes blood flow blockage Flying after diving presents extra risks for decompression sickness because - ansFlying causes further decompression stress Heavy Exercise while at increased pressure _______ the risk of decompression sickness - ansincreases The definition of hyperbaric oxygen is - ansThe patient breathes 100% oxygen intermittently while inside a treatment chamber at a pressure higher than sea level pressure At 1 ATA breathing air, the normal arterial PO2 (PaO2) in the average person will be - ans80-100 mmHg The component of which whole blood that normally carries the most oxygen molecules and accounts for the value in the previous quesion is - ansthe red blood cells Oxygen molecules get from the air we breathe into our blood through our - ansLungs The component of RBC's that carries the oxygen is - ansHemoglobin A pulse oximeter is used to measure the oxygen _______ of the blood - anssaturation A normal readign you mght get with a pulse ox is - ans98% The component of whole blood that carries extra oxygen molecules when the patent is placed in the hyperbaric chamber is the - ansplasma One of the theraputic mechanisms of hyperbaric oxygen therapy is to dissolve more oxygen in the blood. Which gas law is the theoretical basis for this phenomenon - ansHenry's law Which piece of equiptment would provide the evidence that extra oxygen is dissolved into the blood and tissues while the patient is recieving HBOT - ansTcOM HBOT for a chronic wound requires the whole patient to be exposed to pressure while breathing 100% oxygen. One positive effect of this combination is - ansIncrease the PO2 in the plasma of the blood The researcher who used exanguinated pigs to prove that a hyperbaric oxygen treatment would provide enough oxygen to keep the pigs alive despite their lack of RBC's was - ansI. Boerema Following the Krogh Erlang mathematical model of oxygen diffusion into tissues, at 1 ATA on air, capillary PO2 of about 100 mmHg diffuses about 64 microns form functioning capillaries. At a PO2 of 2000 mmHg, oxygen diffusion distance increases - ans4 times It is possible to get a PO2 of 2000 mmHg by - ansbreathing 100% O2 at 2 ATA and breathing 100% O2 at 3 ATA
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one of the common side effects of a HBOT is - ansvasoconstriction If an HBOtreatment causes _____, this will have the indirect effect of _____/ - ansVasoconstriction and reducing edema Increasing pressure makes gas bubbles shrink. This ______ bubble surface tension - ansEliminates Increasing pressure outside the human body makes gas bubbles inside the human body shrink. This phenomenon is best described by - ansPascal's Law Decreasing pressure outside the human body can make gas bubbles appear in the blood and other tissues. If the person is breathing air before the pressure is decreased, these gas bubbles are composed almost entirely of - ansnitrogen A treatment in a hyperbaric oxygen chamber involves 2 main mechanisms: increasing pressure and increasing oxygen percent. This results in 2 main effects - ansTo mechanically shrink bubbles and to hyeroxygenate the blood True or false; Oxygen is a drug - anstrue What do we hope will be the outcome of increasing the tissue PO2 in a hypoxic wound on a daily basis by giving the patient HBOT - ansincrease angiogensis Cells need a minimum of __ mmHg oxygen to carry out normal functions - ans30 mmHg HBO causes vasoconstriction. This vasoconstriction will help reduce - anscerebral edema Since HBO causes vasoconstruction, it is thought to be useful therapy in certain burn patients. What is the value of vasoconstriction in the burn patient - ansReduction of fluid loss in the burned area; reduction of tissue edema resulting in less tissue damage, and reduced number of surgical interventions HBO has been shown to increase leukocyte phagocytosis. This process in which - ansWBC's fight infection true or false; HOB improves bacterial killing by neutrophil- generated high energy oxygen radicals - anstrue true or false; White blood cells (leukocytes) are dependent on oxygen tension to function properly - anstrue The human body has a way of getting rid of extra, unnecessary oxygen radicals. This is called
- ansthe superoxide dismutase enzyme system Mader,et al, in 19887, showed that HBO combined with _______ was the best combination for eradicating, Pseudomonas aeruginosa from infected bone - ansTobramycin HBO is commonly said to "attentuate" reperfusion injury. This means that ot - ansMakes reperfusion injury less Reperfusion injury can be described as - ansInjury form prolonged ischemia followed by restoration of blood flow The definition of hypoxia - ansNot enough oxygen The definition of ischemia is - ansNot enough blood The role of HBO in treating reperfusion injury is - ansto diminish the damage caused by neutrophils, to oxygenate hypoxic tissues, and to reduce edema The 4 phases of wound healing, in order, are - anshemostasis, inflammation, proliferation, and maturation If a wound stops healing itself and gets "stuck" becoming a chronic wound, it is usually stuck in which phase - ansInflammation
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A compartment syndrome shares some pathological similarities with - ansATPI The primary treatment for compartment syndrome is - ansfaciotomy Frostbite is considered to be similar to ATPI. The best time to treat the patient with frostbite is - ansduring rewarming true or false; Acute osteomyelitis is an accepted indication for treatments given for the treatment of osteomyelitis is - ansimproved leukocyte function The main mechanism of action of hyperbaric oxygen treatment of ostermylitis should be done at - ans2-2.5 ATA Treatment for chronic refractory osteomyelitis is likely to take - ans30-40 treatments Treatment for chronic refractory osteomyelitis with HBO considered to be - ansadjunctive therapy CAGE is the acronym for - ansAn arterial gas embolism that occurs in the cerebral circulation An AGE can occur during - ansHymodialysis and vascular procedure, endoscopic and cariac bypass procedures, pulmonary overpressure syndromes true or false; It is easy to differentiate neurological DCS and AGE - ansfalse The following are supportive measures for AGE prior to HBO EXCEPT: - ansCPR if indicated, supine position (flat), 100% oxygen by non-rebreather, trendelenburg position (head down) The current thinking for recompression therapy for AGE is to - ansstart treating on a table 6 , and tailor the treatment based on response You are treating a patient for DCS. The patient has had a good response to the treatment at 60 fsw but has not fully resolved his sypmtoms after the third oxygen breathing period. What is the right course of action. - ansExtend the treatment by adding at least one more breathing period at 60 fsw When is a patient with mediastinal emphysema treated in the hyperbaric chamber - answhen AGE is also present CO2 poisoning is also called - anscarbon dioxide poisoning Carbon monoxide poisoning primarly affects all the following EXCEPT: - ansstomach Carbon monoxide is - anscolorless ordorless, taseless, non-irritating carbon monoxide is a b-product of - ansincomplete combustion Carbon monoxide's affinity for hemoglobin is _______ greater than oxygen - ans200 times true or false;A pulse oximeter will give you reliable oxygen level values in a patient with carbon monoxide poisoning - ansfalse true or false; Cherry red skin or lips are commonly seen in carbon monoxide poisoning - ansfalse The patient with carbon monoxide poisoning who has cerebral symptoms might have all the following EXCEPT: - anscough true or false; The carbon monoxide patient who presents with a COHgb level 20% should be treated - ansfalse
true or false;The healthy, 22 year-old pregnant patient that presents with a history of mild exposureto CO and a COHgb level of 15% should be treated.
- anstrue The half-hour of CO breathing air at sea level is - ans5 hours, 20 min The half-life of CO breathing 100% oxygen at sea level is - ans1 hour, 30 min
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The half-life of CO breathing 100 % oxygen at 3 ATA is 23 - ans23 min The half-life of fetal carboxyhemoglobin - anslonger than the mother's Delayed neurologic sequelae (DNS) may present as - anssubtle cognitive deficits, memory,attention, affect, or personality changes, movement disorders, aphasia, apraxia DNS will most likely become apparent - ans7-21 days after the CO posoning episode Treating exceptional blood loss anemia (EBLA) with HBO is best described by - ansBoerema's study, life without blood ELBA is defined as - ansAn uncommon disorder that occurs when the patient has lost sufficent red-cell mass to compromise respiratory and cellular requirements, and cannot or will not recieve red-cell replacement for medical or religous reasons The treatment of exceptional blood loss anemia with HBO should occur - ansAs often as necessary to reduce the symptoms of hypoxia/ischemia ORN stands for - ansosteoradionecrosis The etiology of ORN is - ansradiation-induced bone degradation ORN, is it is going to occur, happens - ansmonths to years after completion of radiation therapy One of the terms used to describe radiation-damage tissues is - ans3-H Tissue damage caused by radiation normally requires in excess of - ans5000 cGy of radiation HBO's prime theraputic mechanism in the treatment of radiation-induced tissue damage is - ansencouraging angiogenesis The HBO treatment profile that was developed by Marx and Johnson to treat ORN is commonly called - ansThe Marx protocol From research data and from clinical experience, the most effective protocol for the application of HBO as an adjunct to healing in radiated tissue is - ans20 treatments prior to surgery, 10 treatments after surgery So, the best treatment option for healing radiation-induced tissue damage is - ansHBO therapy ture or false; HBOT is the primary treatment for thermal burns - ansfalse A thermal burn can be caused by - ansopen fire,steam, hot surfaces, hot liquids Which of the theraputic mechanisms is most important in the treatment of the thermal burn patient with HBOT - anscausing vasoconstriction Support of a skin graft or flap can be accomplished with HBOT. To be the most successful in supporting the transplant tissues, the HBO treatments should be given - ansImmediately following surgery within a few hours true or false; A split thickness skin graft, like those done for thermal burns, takes the vascular supply with the tissue when transplanted - ansfalse, it takes only the top layers of the skin The Chokes can be defined as - ansA type of decompression sickness that is theorized to be due to an overwhelming amount of venous gas emboli leading to pulmonary edema true or false; DCS can be caused in a hyperbaric chamber and treated in a hyperbaric chamber
- anstrue True or false; the goal of HBOin treating DCS is to eliminate inert gas from the body - ansTrue The mechanical decompression of bubbles during a hyperbaric treatment for DCS is best described by which gas law - ansBoyles
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Exceptional blood loss anemia is defined as - ansAn uncommon disorder that occurs when the patient has lost sufficent red-cell mass to compromise respiratory and cellular requirements, and cannot or will not recieve recieve red-cell a The treatment for EBLA (exceptional blood loss anemia) with HBOT shouls occur - ansAs often as necessary to reduce the Symptoms of hypoxia/ischemia ORN stands for - ansOsteoradionecrosis The etiology of ORN is - ansRadiation-induced bone degradation ORN, if it is going to occur, happens - ansMonths to years after compleation of radiation therapy
Marx and Johnson explained that radiation damages healthy tissues that we would prefer to keep undamaged. Sometimes it kills the cells outright; other times it may incapacitate a cell so that it doesn't produce daughter cells or may produce defective cells. Over time cells become unable to sustain life or rapair themselves. One of the terms used to describe radiation-damaged tissues is - ans3-H tissues,they are hypervascular, hypocellular and hypoxic. Tissue damage caused by radiation normally requires in excess of - ans5000 cGy of radiation HBO's prime therapeutic mechanism in the treatment of radiation-induced tissue damage is: - ansEncouraging angiogenesis, The HO treatment profile that was developed by Marx and Johnson to treat ORN is commonly called:
- ansThe Marx protocol From research data and from clinical experience, the most effective protocol for the application of HBO as an adjunct to healing irradiated tissue is: - ans20 treatments prior to surgery, 10 treatments after surgery
The best treatment option for healing radiation-induced tissue damage is: - ansHBOT HBOT is the primary treatment for thermal burns: - ansFalse, aggressive surgery and fluid resuscitation are the primary treatments for thermal burns during the early phase. HBO can be used as an adjunctive therapy for those patient who have sustained a large total body surface area burn or burn involving the face, hands, feet, or perineum.
A thermal burn can be caused by: - ansOpen fire, steam, hot surfaces, hot liquids Which of the therapeutic mechanisms is most important in the treatment of the thermal burn patient with HBOT: - ansCausing vasoconstriction, HBO can reduce the fluid loss by inducing vasoconstriction. Support of a skin graft flap can be accomplished with HBOT. To be the most successful in supporting the transplant tissues the HBOT should be given: - ansImmediately following surgery within a few hours. A split-thickness or partial-thickness skin graft takes the vascular supply with the tissue when transplanted:
- ansFalse,The graft only takes the top layers of the skin leaving behind enough skin cells at the donor site to regrow skin. Blood vessels and supporting tissue are not translated. The Chokes can be defined as: - ansA type of compression sickness that is theorised to be due to an overwhelming amount of venous gas emboli leading to pulmonary edema. DCS can be caused in a hyperbaric chamber AND treated in a hyperbaric chamber: - ansTrue,It's about the reduction of pressure and the gas being breathed. The goal of HBO in treating DCS is to eliminate inert gas from the body: - ansTrue, DCS is a combination of the amount of inert gas in the body and the rate of pressure reduction. The
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problem is corrected by eliminating the inert. We use oxygen. If breathed in a hyperbaric environment, nitrogen elimination is accelerated. The combination of both pressure and breathing oxygen has added benefits of shrinking bubbles and correcting hypoxia by both restored blood flow and greater oxygen diffusion distance, in the tissues compromised by bubbles.
The mechanical compression of bubbles during a hyperbaric treatment for DCS is best described by which gas law:
- ansBoyle's law Which of the following treatment profiles is used to treat DCS: - ansUS Navy table 5 and 6. Treatment for pain only is table 5 or Type 1 symptoms. Table 6 is used for serious neurological DCS or Type 2 symptoms.
Which of the following treatment profiles is commonly used to treat AGE: - ansUS Navy Table 6 Which of the following treatment profiles include a maximum depth of 60 FSW (2.8 ATA) - ansUS Navy table 5 and 6 THe most common offending organism in the condition of gas gangrene is the: - ansClostridial genus, Clostridial myonecrosis, GAS Gangrene is most commonly caused by c.perfringens. C.Perfringens is: - ansAn anaerobic organism, prefers low oxygen C. Perfringens is: - ansGram positive C.perfringens produces an alpha toxin that: - ansKills mucus cells, which provides food for the bacteria C.Perfringnes stops producing the alpha toxin at ______ mmHg oxygen tension: - ans250, The original research established the need for the tissue pO2 to be at least 250 mmHg. Using HBO to help control C. perfringens is considered: - ansBacteriostatic to the organism, it slows the growth Necrotising fasciitis is another name for gas gangrene: - ansFalse, nec fash attacks the facia C.Perfringens attacks the muscles. Fournier's gangrene is another name for necrotising fasciitis. - ansTrue,it involves the pelvic area usually the genitalia. The causative organism of necrotising fasciitis is: - ansUsually a mixture of organisms Utilizing HBO in the treatment of nec fash is appropriate primary therapy. - ansFalse, the organism is a mixture of organisms
Intracranial abscess is defined as: - ansAn infection inside the skull Actinomycosis is - ansAn infection of the face and neck
Actinomycosis is caused by a fungal organism: - ansFalse, it is anaerobic bacterium The causative organism in actinomycosis is:
- ansActinomyces israelii
The acronym "NFPA" stands for: - ansNational Fire Protection Association The NFPA 99 standard addresses: - ansDesign of chambers, design of facilities housing chambers, and operational safety practices According to NFPA 99,a Class A chamber is defined as: - ansMultiplace, Multiple human occupancy According to NFPA 99, class B chamber is defined as: - ansSingle human occupancy (Monoplace) According to NFPA 99, a class C chamber is defined as - ansNo human occupancy (animal)
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According to NFPA 99, which of the following is a limitation on electrical equipment inside a Class B chamber:
- ansLimited to communications and patient physiologic monitoring leads According to NFPA 99, what is the power limitation on a communication system inside a hyperbaric chamber: - ansNo more than 28 volts, this applies to multiplace and to monoplace chambers. For multiplace chambers, the limit is 28 volts and 0.5 watts. The UHMS guidelines address: - ansClinical practice of hyperbaric medicine The acronym "ASME" stands for: - ansAmerican Society of Mechanical Engineers The acronym "PVOH" stands for:
- ansPressure Vessels for Human Occupancy The ASME Boiler and Pressure Vessel Code addresses: - ansSteam boilers, diving bells, hyperbaric chambers, and other pressure vessels ASME PVHO-2 is the newer edition of ASME PVHO-1. - ansFalse, PVHO-1 addresses the design, construction, and testing of acrylic windows in pressure vessels for human occupancy. PVHO-2 is a "post construction" document, and addresses the inspection and service life of acrylic windows that are in use in PVHO. What is a viewpoint: - ansAn assembly consisting of flange, retaining ring, seals, and an acrylic windows According to ASME PVHO-2, how often should the acrylics on a clinical hyperbaric chamber be inspected for scratches and crazing: - ansdaily According to the ASME PVHO-2, how often should a maintenance inspection be performed on the acrylics on a clinical hyperbaric chamber: - ansEvery 2-3 years According to ASME PVHO-2, how often should a seat and seal inspection be performed:
- ansEvery 10 years Proper cleaning and disinfection of chamber acrylics requires: - ansNever allow organic solvents, because they can cause crazing The acronym "CGA" stands for - ansCompressed Gas Association, it has several safety guidelines related to compressed gases The CGA guidelines address: - ansSafe handling of compressed gases According to CGA guidelines, a cylinder of air should be colored, - ansYellow According to CGA guidelines, a cylinder of O2 should be colored: - ansGreen According to CGA guidelines, a cylinder of nitrogen should be colored: - ansBlack The acronym BIBS stands for - ansBuilt in breathing system An overboard dump system: - ansExhausts exhaled Oxygen and CO2 outside of a hyperbaric chamber Inside the hyperbaric chamber, suction injury is prevented by
- ansUsing a vacuum relief device To use an IV pump with a monoplace chamber: - ansThe pump must have greater pumping force than the chamber pressure The best method to defibrillate a monoplace chamber patient is: - ansDecompress the chamber, unload the patient, strip off the patient's clothing, then defibrillate TcOM can be performed during hyperbaric treatment in a multiplace chamber, but not in a monoplace chamber. - ansFalse, for either chambers we have TcOM outside the chamber and pass the electrode through the pressure boundary using an electrical penetrator.
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How does Boyle's law affect an ET tube in the hyperbaric chamber.
- ansThe volume of the cuff, if filled with air will reduce during compression, causing the seal to be lost and the tube to dislodge. inside the hyperbaric chambers, glass IV bottles, - ansShould not be used because, there is a risk of implosion or explosion of the glass bottle inside the hyperbaric chamber. If the bottle does not break, it will fill with chamber air as it delivers fluid to the patient, then when the chamber is decompressed, the bottle will contain compressed air. If the bottle doesn't explode during decompression, it may forcefully inject the patient with fluid or air.
On a hyperbaric chamber, the term lock refers to, - ansA chamber compartment used for treatment, transfer of personnel, or transfer of equipment and supplies. A definition of " caisson" is - ansA pressurized container that allows people to work under water There 3 types of equipment that allow a human to remain underwater while breathing air. Which of the following is NOT one of these 3.
- ansAir balloons. The first recorded use of pressure was called a "domicillium", which was a cottage that had bellows to increase and decrease pressure for respiratory problems. This was in,
- ans1662 by N Henshaw
Doctor______ operated the "hyperbaric hotel" in Cleveland, Ohio in 1928 - ansO. Cunningham Modern Hyperbaric chambers use O2 for treating patients. Who was known for using a chamber with an acrylic port for radiation therapy cancer patients? - ansChurchill-Davidson, The safety of a patient receiving HBO therapy is the responsibility of: - ansThe Dr., RN, and Tech Even though our patients breath oxygen while undergoing an HBO treatment, attendants in a multiplace chamber breath air. Which of the following is a risk for the attendant?
- ansDecompression sickness, barotrauma, nitrogen narcosis. Who determines the ventilator settings while diving a vented patient? - ansThe respiratory therapist outside the chamber. While treating a patient who is receiving IV therapy, as the chamber pressure starts to build, you notice that the air/fluid level of the drip chamber appears to be filling with fluid ( the air space is becoming smaller) You know that is: - ansNormal, because of Boyle's Law will affect the air volume in the drip chamber.
What should you do if the IV drip chamber is almost completely full of fluid? - ansStop the infusion by clamping the line, Invert the IV bag so that the remaining air in the bag is at the opening to the drip chamber, squeeze some of the fluid in the drip chamber back into the bag and pull some air into the drip chamber so it is about half full, re-hang the bag and unclamp At the end of an in-chamber IV treatment, what steps should you take regarding the IV: - ansAdd a small amount of fluid to the drip chamber so air does not travel down the IV line to the patient. Regarding an in-chamber Monoplace IV treatment, as the treatment begins and pressure starts to build in the chamber, the air/fluid level of the drip chamber of the IV should remain:
- ansUnchanged. In a monoplace chamber the IV is outside the chamber, so you don't have to worry about changes in the drip chamber
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A no-hyperbaric trained DR. requested treatment for a patient with a history of congenital spherocytosis. What complications would you worry about this patient:
- ansHemolysis of red blood cells, Congenital spherocytosis is a condition in which the red blood cells are fragile and can burst if exposed to increased oxygen. What is the risk of doing a forceful valsalva maneuver? - ansRound or oval window blowout What are the symptoms of a round or oval window blowout: - ansDeafness in the affected ear, tinnitus, vertigo What is the most common barotrauma in patients undergoing HBOT: - ansMiddle ear barotrauma An ocular side effect of receiving HBOT is: - ansA worsening of myopia, difficulty in focusing on distant objects. And An improvement of presbyopia is an age-related difficulty focusing on close objects.
Risk factors that increase the likelihood of an oxygen toxicity seizures are all of the following EXCEPT: - ansAlpha tocopherial, (Vitamin E) it appears to provide a protective mechanism against pulmonary oxygen toxicity and to raise the seizure threshold. All of the following will decrease the likelihood of an oxygen toxicity seizure EXCEPT: - ansLevothyroxine (Synthroid), The pill itself will not increase risk of seizure, increased amount of thyroid hormone will increase the risk of an O2 toxicity seizure. An oxygen toxicity seizure is easily confused with a: - ansHypoglycemic reaction If your patient starts to become unresponsive and seizing you should: - ansRemove the oxygen source On average, a person taking anti-hyperglycemics will drop their blood sugar - ans50 mg/dL per treatment The treatment for a hypoglycemic reaction is:
- ansFeed the patient if he/she is conscious If the patient has a hypoglycemic reaction and is seizing, how would you proceed: - ansAdminister 50% dextrose IV A valsalva or Frenzel Maneuver are methods of:
- ansMinimizing ear barotrauma on compression Pulmonary oxygen toxicity presents as - ansDifficulty breathing, cough, substernal pain If your patient shows up complaining that they are stuffy, you should remind them to: - ansEqualize both ears before starting treatment. Diving a patient with an URI upon decompression they can have:
- ansProblems with equalization, because the URI causes swelling in the eustachian tube to swell which is what caused the decompression difficulty. All the work equalizing can cause more swelling. The eustachian tube cannot vent the compressed cag to escape, which will expand due to Boyle's law. A pt states that his vision is getting better and can read without glasses. - ansYou can remind the patient that if you receive over 20 treatments this is common, However the effect won't last, and to not get a new prescription for about 2 months. It is common practice to have a patient take a nasal decongestant prior to HBOT. You should:
- ansRemind the patient that if taken too early it could wear off before the 2hr treatment ends, increasing the likelihood of a reverse ear block.
Decompressing the chamber while a patient is in the tonic phase of a seizure: - ansCan cause a pulmonary barotrauma
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Who is considered the father of pressure physiology: - ansBert
Paul Bert is known for studies in all of the following EXCEPT: - ansStaged decompression Pulmonary Oxygen toxicity was described by: - ansLorraine-Smith 1899 The person credited with establishing oxygen tolerance limits in the man is: - ansBehnke in 1973 When heated TcOM electrode is attached to the skin, the arterioles and capillaries dilate, there is an increase in the cutaneous pore size, and hemoglobin more readily releases the oxygen molecule. - anstrue The range of normal Tcpo2 values for the torso when breathing normobaric air is: - ans50- 90 - mmHg A TcpO2 reading of 23 mmHg on the oor is considered normal: - ansFalse, values below 30 are considered hypoxic. Values between 30-40 are considered moderately hypoxic. Values above 40 are considered normal. Which of the following electrode sites are considered to be the most inaccurate: - ansPlantar surface of the foot An increase in TcpO2 values near the wound after two weeks of hyperbaric treatments indicates that healing potential is improving: - ansTrue If the normobaric air TcpO2 value recorded at the chest is 130 mmHg after the electrode is equilibrated, it is most likely that: - ansThe electrode fixation to the skin has a leak Periwound TcOM values that exceed 50 mmHg under air breathing conditions: - ansAre considered normal Which of the following body areas may complicate TcOM data collections: - ansBony prominence, over and arterial pulse, on a concave surface On a patient with low blood flow, the Tcom electrode may burn the skin, secondary to inadequate heat dissipation, if it remains in place for extended periods of time. - anstrue Which of the following does NOT serve to optimize electrode adhesion:
- ansApplying lotion
To determine if air is leaking into a TcOm lead, blow oxygen around the site, if the value rises, you may assume there is a leak: - anstrue Which of the following statements are true: - ansRPI means Regional Perfusion Index It is acceptable for a patient to be sitting throughout the TcpO2 study as long as the lower extremities are below the heart:
- ansFalse, The ideal position for the patient is lying on the back with the head flat or only slightly elevated The TcOm electrode should be re-membraned: - ansIf the monitor has been out of service for several weeks, if the calibration procedure fails, if error codes indicate a problem If a patient returns for a repeat TcOm study it is NOT necessary to repeat the reference site: - ansFalse Which of the following products listed below is unlikely to affect TcOm oxygen values: - ansPhenergan What is the recommended time to wait between placement of electrode and recording initial room air readings:
- ansIt is best to wait 15 min after cessation of the supplemental oxygen prior to recording any room air value Which statement regarding supplemental oxygen: - ansWait 15 min
