CHS Emergency Procedures & Regulatory Compliance Questions and Answe 3 — Questions and Answers
Question 1: When a patient experiences middle ear barotrauma and is unable to equalize at 0.5 ATA overpressure, the appropriate action is:
- Halt compression, ascend slightly, and assist the patient with equalization techniques (Correct answer)
- Continue pressurization and administer nasal decongestant via the chamber port
- Immediately abort treatment and surface at maximum rate
- Switch the patient to air breathing to reduce oxygen toxicity risk
Correct answer: Halt compression, ascend slightly, and assist the patient with equalization techniques
Standard protocol is to pause or slightly reduce pressure to allow equalization attempts before continuing or aborting treatment.
Question 2: The UHMS indications list for hyperbaric oxygen therapy is significant because it:
- Defines the conditions for which HBO is considered medically necessary and reimbursable by CMS (Correct answer)
- Establishes the maximum treatment pressure for each diagnosis
- Sets staffing ratios for hyperbaric facilities nationally
- Determines minimum chamber pressure specifications for Medicare compliance
Correct answer: Defines the conditions for which HBO is considered medically necessary and reimbursable by CMS
The UHMS-approved indications list directly influences CMS coverage decisions, making it the basis for reimbursement eligibility.
Question 3: A patient's chart reveals a history of spontaneous pneumothorax. This condition is considered:
- An absolute contraindication to hyperbaric oxygen therapy (Correct answer)
- A relative contraindication requiring chest tube placement before treatment
- Acceptable if the patient is treated at pressures below 1.5 ATA
- Not a contraindication if the pneumothorax occurred more than one year ago
Correct answer: An absolute contraindication to hyperbaric oxygen therapy
Untreated pneumothorax is an absolute contraindication because expansion during decompression can cause tension pneumothorax and death.
Question 4: In a hyperbaric facility, the purpose of a continuous oxygen monitoring system inside the chamber is to:
- Detect oxygen enrichment above 23.5% and trigger alarms to prevent fire hazard (Correct answer)
- Monitor patient SpO2 levels in real time
- Confirm that the patient is breathing 100% oxygen throughout treatment
- Ensure nitrogen levels remain below 5% during air breaks
Correct answer: Detect oxygen enrichment above 23.5% and trigger alarms to prevent fire hazard
Continuous O2 monitoring detects leaks from patient breathing circuits that could enrich chamber atmosphere to fire-hazard levels above 23.5%.
Question 5: Which OSHA standard most directly applies to hyperbaric workers regarding compressed air work environments?
- 29 CFR 1926.803 — Compressed Air (Correct answer)
- 29 CFR 1910.134 — Respiratory Protection
- 29 CFR 1910.146 — Permit-Required Confined Spaces
- 29 CFR 1910.1030 — Bloodborne Pathogens
Correct answer: 29 CFR 1926.803 — Compressed Air
OSHA 29 CFR 1926.803 governs workers in compressed air environments, including hyperbaric tunneling and construction, establishing decompression requirements.
Question 6: During emergency decompression of a multi-place chamber with an unconscious patient inside, the inside attendant should:
- Maintain airway, prevent breath-holding, and prepare for immediate post-decompression evaluation (Correct answer)
- Perform CPR continuously regardless of the patient's respiratory status
- Administer 100% oxygen via tight-fitting mask while monitoring ascent rate
- Secure all loose equipment and exit the chamber first for their own safety
Correct answer: Maintain airway, prevent breath-holding, and prepare for immediate post-decompression evaluation
During emergency decompression, airway management and preventing breath-holding are critical to avoid pulmonary barotrauma and arterial gas embolism.
Question 7: A hyperbaric facility must conduct fire drills at minimum every:
- 12 months per NFPA 99 and accreditation standards (Correct answer)
- 6 months per UHMS guidelines
- 3 months per OSHA 1926.803
- 24 months if no incidents have occurred
Correct answer: 12 months per NFPA 99 and accreditation standards
NFPA 99 and major accreditation bodies (TJC, ACHC) require hyperbaric facilities to conduct emergency response drills at least annually.
CHS Emergency Procedures & Regulatory Compliance Questions and Answe 3
When a patient experiences middle ear barotrauma and is unable to equalize at 0.5 ATA overpressure, the appropriate action is: