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Division of Underwater & Hyperbaric Medicine Vachira Phuket Hospital

Phuket is well known for being one of the most magnificent places for diving in the world. Qualified sports divers suffer few accidents. But studies show that, because more and more people are taking up diving as a leisure activity, sicknesses relating to diving activities are increasing.

The Ministry of Public Health has provided the first hyperbaric chamber in Phuket, located at Vachira Phuket Hospital. This is used for diving accidents and is also used to treat other illnesses that require hyperbaric oxygen therapy. The chamber has been in operation since 4 November 2002.

The staff at the Underwater and Hyperbaric Medicine, Vachira Phuket Hospital, are on duty 24 hours a day for decompression illness, so there are no delays, offering the best chance of recovery with no residual damage. Nursing staff are present inside the chamber to provide emergency life support for the patient.

The chamber is committed to promoting safe diving by providing an education program for divers, fitness to dive physical evaluation, and counseling for diving-related health issues. Staff also treat common diving problems such as barotraumas and marine-animal injuries or poisonings.

Additional occasions for treatment by hyperbaric oxygen therapy specified by the Undersea and Hyperbaric Medical Society (UHMS)

1. Air or gas embolism
2. CO poisoning and smoke inhalation
3. Clostridial gas gangrene 4. Crush injury: Compartment syndrome, acute traumatic ischemia
5.Decompression sickness
6.Problem wound
  • Diabetic ulcer
  • Decubitus ulcer (bed sore)
  • Vascular disease
7.Exceptional blood loss
8.Necrotizig soft tissue infection
9.Refractory osteomyelitis
10.Compromised skin graft or flap
11.Radiation injury
12.Thermal burn

Pulmonary over-inflation syndrome (POIS)

This can occur during diving when an ascent happens too rapidly, causing the lungs to over-inflate, resulting in damage to the lungs.

POIS can result in;

1. Interstitial emphysema
2. Pneumothorax
3. Arterial gas embolism. The symptoms usually only last for 10 minutes.
4. Depending on the symptoms, patient have been divided into two groups:

Group 1  Neurological symptoms: Can range from changes in mood to immediate unconsciousness.
Group 2 Cardiac symptoms: Apnea, loss of consciousness, and cardiac dysrhythemai or arrest.

Definitive treatment  of any gas embolism require a recompression facility.

Miscellaneous pressure effects: tooth squeeze, mask squeeze and G-I squeeze.

Decompression sickness (DCS) is also known as “the bends“ or Caisson Disease. DCS can be divided into two categories:

* Type I (mild form of DCS)
Joint pain, tissue swelling, itchy skin, and weakness.

* Type II (serious form of DCS)
Pain in head, neck and body; seizure; hemiplegia.
Visual symptoms and headaches, substemal pain, cough, dyspnea (trouble breathing).

Decompression sickness treatment:

Early recognition and therapy is essential for successful treatment. Type II DCS needs recompression treatment as soon as possible.

Design description of Vachira Phuket Hospital Hyperbaric Chamber:

  • Multiplace chamber, two compartments, 14 seats.
  • Cylindrical hyperbaric oxygen treatment unit.
  • Overall size: length 6,880 mm, width 2,524 mm.
  • Design pressure 560 k-Pa(g).
  • Two doorways, view port and camera port.
  • Internal/external PA system communication, internal auxiliary headset, electronic sound-powered phones.
  • BIBS and HOOD oxygen with overboard exhaust

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