Fire-safety standards for hyperbaric oxygen facilities

Abstract

Bruno Simini (Nov 8, p 1375)1Simini B Fire fuels concern over hyperbaric oxygen facilities.Lancet. 1997; 350: 1375Summary Full Text Full Text PDF Google Scholar reports on a fire in a hyperbaric chamber in Milan. This tragedy highlights the need in Italy for specific fire-safety standards for the operation of such facilities. Since its formation in 1990, the British Hyperbaric Association (BHA) has represented those who provide an emergency hyperbaric chamber service to the UK National Health Service. All members undertake to achieve certain levels of medical, technical, attendant, and nurse staffing and training. The standards are defined in a Code of Good Working Practice (1994),2Faculty of Occupational MedicineA code of good working practice for the operation and staffing of hyperbaric chambers for therapeutic chambers. Faculty of Occupational Medicine, London1994Google Scholar to which key documents on fire and electrical safety were added in 1996.3Gough-Allen R Abrahams J Allen M Elner D McClue G Middlebrook I Guide to fire safety standards for hyperbaric treatment centres. British Hyperbaric Association Technical Working Party Report. British Hyperbaric Association, Aberdeen1996Google Scholar, 4Ross JAS Nieman M Florio JT Guide to electrical safety standards for hyperbaric treatment centres. British Hyperbaric Association Technical Working Party Report. British Hypebaric Association, Aberdeen1996Google Scholar The BHA Health and Safety Committee, in collaboration with representation by the Health and Safety Executive, is due to publish its guidelines soon, and these will also address fire safety.Fire as a potential risk within hyperbaric chambers is well known. However, analysis of 73 years of clinical hyperbaric oxygen therapy in North America (where there are published fire safety standards) has revealed no deaths as a result of fire. Purchasers and providers of hyperbaric oxygen therapy should assure themselves that staff are aware of the fire risk and that facilities have access to and enforce the standards needed to avoid accidents such as the one in Milan.Simini notes that only one patient in the Milan chamber was being treated for a classic indication hyperbaric oxygen therapy. The 1st European Consensus Document on Hyperbaric Medicine, agreed by 350 representatives from 21 countries, lists approved conditions thought, on the basis of clinical research and clinical experience, to benefit from hyperbaric oxygen.5Wattel F Matthieu D Proceedings 1st European Consensus Conference on Hyperbaric Medicine. European Committee for Hyperbaric Medicine, Lille1994Google Scholar These indications are virtually identical to those proposed in 1996 by the Hyperbaric Oxygen Therapy Committee, which reports on behalf of the US Undersea and Hyperbaric Medical Society. Thus there is now consensus on the use of hyperbaric oxygen in many conditions other than the so-called classic indications, and readers need further information on the Milan patients before passing judgment. Bruno Simini (Nov 8, p 1375)1Simini B Fire fuels concern over hyperbaric oxygen facilities.Lancet. 1997; 350: 1375Summary Full Text Full Text PDF Google Scholar reports on a fire in a hyperbaric chamber in Milan. This tragedy highlights the need in Italy for specific fire-safety standards for the operation of such facilities. Since its formation in 1990, the British Hyperbaric Association (BHA) has represented those who provide an emergency hyperbaric chamber service to the UK National Health Service. All members undertake to achieve certain levels of medical, technical, attendant, and nurse staffing and training. The standards are defined in a Code of Good Working Practice (1994),2Faculty of Occupational MedicineA code of good working practice for the operation and staffing of hyperbaric chambers for therapeutic chambers. Faculty of Occupational Medicine, London1994Google Scholar to which key documents on fire and electrical safety were added in 1996.3Gough-Allen R Abrahams J Allen M Elner D McClue G Middlebrook I Guide to fire safety standards for hyperbaric treatment centres. British Hyperbaric Association Technical Working Party Report. British Hyperbaric Association, Aberdeen1996Google Scholar, 4Ross JAS Nieman M Florio JT Guide to electrical safety standards for hyperbaric treatment centres. British Hyperbaric Association Technical Working Party Report. British Hypebaric Association, Aberdeen1996Google Scholar The BHA Health and Safety Committee, in collaboration with representation by the Health and Safety Executive, is due to publish its guidelines soon, and these will also address fire safety. Fire as a potential risk within hyperbaric chambers is well known. However, analysis of 73 years of clinical hyperbaric oxygen therapy in North America (where there are published fire safety standards) has revealed no deaths as a result of fire. Purchasers and providers of hyperbaric oxygen therapy should assure themselves that staff are aware of the fire risk and that facilities have access to and enforce the standards needed to avoid accidents such as the one in Milan. Simini notes that only one patient in the Milan chamber was being treated for a classic indication hyperbaric oxygen therapy. The 1st European Consensus Document on Hyperbaric Medicine, agreed by 350 representatives from 21 countries, lists approved conditions thought, on the basis of clinical research and clinical experience, to benefit from hyperbaric oxygen.5Wattel F Matthieu D Proceedings 1st European Consensus Conference on Hyperbaric Medicine. European Committee for Hyperbaric Medicine, Lille1994Google Scholar These indications are virtually identical to those proposed in 1996 by the Hyperbaric Oxygen Therapy Committee, which reports on behalf of the US Undersea and Hyperbaric Medical Society. Thus there is now consensus on the use of hyperbaric oxygen in many conditions other than the so-called classic indications, and readers need further information on the Milan patients before passing judgment.