• Osteomyelitis (Refractory) • Delayed Radiation Injury (Soft tissue and Bony Necrosis) • Skin Grafts and Flaps (Compromised) • Thermal Burns


The basis components required to start a program. Feasibility: What is the need for HBOT in your institution


and community? Do you have a wound care center? If not, you will need to have this function performed within the HBOT de- partment. Remember the treatment of wounds is your bread and butter. A feasibility study can be performed by reviewing ICD 9 codes and payer types for your institution over the past year. Is there a competitive hyperbaric service in neighboring hospitals? This service requires a sufficient number of referable patients to be profitable. Most importantly you need a physi- cian champion to lead the charge and get other physicians, as well, to support the program. This lead physician could be from various specialties. We have a total of 7 trained physicians in HBOT with various backgrounds, i.e.; anesthesiology, pul- monary, vascular surgery, critical care, general practitioner spe- cializing in diabetes and wound care. You could have emergency medicine physicians, podiatrists and so on. Lastly, you will need administrative approval and support for the ex- penses you will be incurring. Expenses: You will be asking for one or two monoplace


chambers which cost about $130,000.00 each. You will need a source of oxygen with high flow and a room with adequate space (for two chambers, work area, dressing room, bath- room, etc. Our physical renovation to make the area suitable cost us approximately $80,000. There will be initial training costs and then ongoing operating costs, but these are nearly all salary related. Education: Our staff, physicians and therapists, completed


a training program approved by the UHMS. The chamber op- erators are all registered respiratory therapists and certified hy- perbaric technologists (CHT), a credential given by the National Board of Diving and Hyperbaric Medical Technology (NBDHMT). Marketing: Regional physicians need to be knowledgeable


about the benefits of HBOT, therefore, an educational and mar- keting plan will be necessary for success. Lectures and news- paper articles are an informative way to educate physicians. Risks: Risks are present in every new venture, lack of pa-


tients or insurance denials can hurt any service but can be min- imized if managed well. Clinically, our most common problem is the equalization of ear pressure when initiating treatment but there are many ways to remedy this. Oxygen toxicity is a concern but manageable and fortunately rare. A COPD patient with air trapping requires a benefit / risk analysis and standby chest tube. Finally, it is important to research the various resources in


the field and speak to programs that are in existence. There are turnkey companies that will start your program or other com- panies that will even operate your entire program for you. That pathway might be best if you're short on financial and/or human capital. For more information and one of the most valu- able resources about HBOT, pick up a copy of; "Hyperbaric Medicine Practice", Eric P. Kindwall, MD and Harry T. Whelan, MD, available through Best Publishing Company. So dive in, the water’s fine.


The 12th Annual FOCUS ON RESPIRATORY CARE & SLEEP MEDICINE CONFERENCE (FOCUS Spring)


The Gaylord Opryland Hotel Nashville, TN


May 10-12, 2011 The Focus Conference is the largest, most


comprehensive meeting for Respiratory Care and Sleep Medicine in the world. No other


group or association presents a better value to its attendees/exhibitors as the Focus


Conference does. 30,000+ people have called the FOCUS Conference the "greatest conference of their careers" and an "outstanding value".


We've secured beautiful rooms at the incredible Gaylord Opryland Hotel for only $149 per night - a bargain, since this hotel usually commands


rates of $200 per night. We also negotiated with the hotel to allow up to quad occupancy for that same $149 rate and we were able to obtain this rate for up to 3 nights before the conference starts and for 3 days after the conference


concludes, allowing you to plan a true family vacation around the conference, if you wish. Just one mile from the Grand Ole Opry Music


Hall in Nashville, this luxurious resort features six restaurants, four bars and multiple retail stores. Under glass atriums and surrounded by


nine acres of indoor gardens, winding rivers and beautiful waterfalls, Gaylord Opryland is a relaxing getaway that thousands of previous


Focus Conference attendees have enjoyed. Grab your significant other (who will be admitted to the conference at no charge) and join us.


800-661-5690


www.foocus.com Focus Journal Fall 2011 25


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