CHS Patient Evaluation & Treatment Protocols 2

Question 1

A patient with a tympanic membrane perforation is referred for hyperbaric oxygen therapy. What is the most appropriate action?

Accepted Answer

Proceed with treatment as the perforation acts as a natural pressure equalizer

Answer

A tympanic membrane perforation actually eliminates the risk of middle ear barotrauma since pressure equalizes freely through the opening.

Question 2

Which of the following best describes the oxygen window concept as it applies to hyperbaric treatment of decompression sickness?

Accepted Answer

The partial pressure gradient created when oxygen replaces inert gas, facilitating bubble reabsorption

Answer

The oxygen window refers to the unsaturation created when metabolically consumed oxygen is not replaced by inert gas, enhancing inert gas elimination from bubbles.

Question 3

A diabetic patient with a non-healing wound has an ankle-brachial index (ABI) of 0.45. Before proceeding with HBO therapy, what intervention is most critical?

Accepted Answer

Vascular surgery consultation to address arterial insufficiency

Answer

An ABI of 0.45 indicates severe peripheral arterial disease; revascularization must be considered before HBO therapy can be effective.

Question 4

When evaluating a patient for HBOT, a transcutaneous oxygen measurement (TcPO2) of what value at the wound site best predicts a favorable response to therapy?

Accepted Answer

20–40 mmHg on room air with a rise to above 100 mmHg during HBO

Answer

A periwound TcPO2 of 20–40 mmHg on room air that rises above 100 mmHg during HBO (the 'challenge test') predicts a favorable wound healing response.

Question 5

A patient receiving HBO for a diabetic foot ulcer suddenly reports visual changes and facial twitching after 40 minutes at 2.4 ATA. What is the immediate priority?

Accepted Answer

Remove the oxygen mask and switch to air breathing

Answer

These are prodromal signs of central nervous system oxygen toxicity; immediately switching to air breathing typically aborts the progression to seizure.

(CHS) Certified Hyperbaric Specialist Practice Test

(CHS) Certified Hyperbaric Specialist Practice Test

CHS Patient Evaluation & Treatment Protocols 2