Hyperbaric Patient Evaluation
Many patients in hyperbaric centers have problem wounds or are felt to be risk for additional problems due to an element of underlying tissue hypoxia. In Osteomyelitis, radiation injury, and compromised flaps and grafts, substrate requirements in healing tissue frequently outstrip a limited supply of oxygen needed to provide metabolic energy for normal cellular function.
The majority of patients who are seen in our hyperbaric unit with problem wounds are seeing multiple physicians for various medical problems and frequently have lost contact with a primary coordinating physician. While willing and able to resume their day to day care, they may be overwhelmed by the complex nature of their hyperbaric care issues.
It is unrealistic to propose one set of guidelines for the evaluation, diagnosis and treatment of the diverse population of hyperbaric and wound care patients.
It must be remembered all the times that hyperbaric medicine is not a panacea. It is one aspect of a well coordinated medical, surgical and wound care plan aimed at optimizing patient outcome.
Accurate, current medical information is essential for proper patient evaluation. When consultation with the hyperbaric unit is arranged, requests for records of previous care, operative interventions, vascular evaluations and pathology reports which may be relevant to the patient’s underlying problem should be requested and forwarded to the wound care and hyperbaric center.
Patients before taking the hyperbaric treatment should also need to be examined for the TCOM procedure in case of the wound care management
Patients should also be requested to obtain all angiographic records. It is not unusual for patients to be seen at two or three different hospitals and delays in the institution therapy may result in failure to coordinate access to information.
When taking a wound history, it is imperative to ascertain possible underlying etiologies for the wound as well as reasons why the wound may be persisting.
There are many such parameters that need to be taken care while examining the patients before the hyperbaric treatment.