PHD Hyperbaric Chamber Attracts Special Breed of Nurse, Technologist
04/03/2008

DALLAS - During the last 15 years, the hyperbaric chamber at Presbyterian Hospital of Dallas has completed more than 50,000 treatments, making it one of the busiest hyperbaric units in the country.

Every time the door of the 1,100-cubic-foot chamber has sealed shut to treat one of those patients, a certified hyperbaric nurse or technologist is along for the dive.  

Tami Poli is a certified hyperbaric technologist at Presbyterian Hospital of Dallas.

Tami Poli

"I think it's the ultimate job," said Tami Poli, a certified hyperbaric technologist who has accompanied thousands of patients "into the deep" for treatment. "We're working in an interesting, high-tech field of medicine, and we're improving the lives of the people who come here for treatment."

From all outward appearances, the patients and caregivers don't move from the chamber's first-floor perch at the Institute for Exercise and Environmental Medicine at Presbyterian Hospital of Dallas. But on the inside, the gas levels in their blood and organs undergo all the same physiological changes that people experience when deep-sea diving.

Birgitta Van Dooren is a certified hyperbaric nurse (CHRN) at Presbyterian Hospital of Dallas.

Birgitta Van Dooren

Since the unit opened in 1992, Poli's work has taken her to deep-sea depths as frequently as the most seasoned professional SCUBA divers. For Birgitta Van Dooren, a certified hyperbaric nurse (CHRN), the attraction to hyperbaric medicine was the unique environment it offered.

"It's a very specialized field of nursing," she said. "Most clinicians don't know anything about it, because it doesn't get much publicity. But I love it. I couldn't think of doing anything else."

Over the years, the hyperbaric unit's specially trained nurses and technologists have saved the lives of countless patients, from homeowners poisoned by carbon monoxide to SCUBA divers with the bends. The compression chamber, which uses compressed air at simulated depths of up to six atmospheres, also treats patients with non-healing wounds, bone infections and other injuries that can benefit from the oxygen-rich environment.

In addition to the compressed-air environment, patients breathe 100 percent oxygen from a special hood that fits over their head.

Demand for hyperbaric medicine has increased in recent years as the rate of diabetes has skyrocketed locally and around the country. Non-healing wounds are a common side-effect of the disease. Breathing 100 percent oxygen at atmospheric pressure without enclosing the patient's entire body in a pressurized chamber does not produce the same effects and is not recognized as true hyperbaric oxygen therapy.

Patients at Presbyterian Hospital of Dallas receive treatment in a large steel environmental chamber, a massive cylinder that can fit up to seven patients at a time. Each treatment, or dive, lasts about two hours. Most patients are treated at a pressure equivalent  two to three times normal atmospheric pressure, which when breathing 100 percent oxygen provides the patient with 10 times more oxygen than normal air at sea level. The chamber can reach much greater pressure for much longer periods of time for certain treatments.

The chamber has port holes or small windows and is equipped with comfortable recliner chairs and even has space for a patient bed in cases when the patient cannot stand. Many patients are able to walk into the chamber and read while sitting through the treatment, but others are in more serious condition, sometimes on ventilators or in comas from oxygen deprivation.

While constant radio communication is maintained between outside controllers and those inside the chamber, the caregiver has to be ready to treat any possible complication. The chamber can only be safely opened after slowly decompressing, which sometimes takes up to an hour.

"Once they seal the door and the dive starts, you know that you have to be ready for anything," Van Dooren said. "When you have a patient on a ventilator or with some kind of serious medical complication, it requires all your attention. That's what makes it such a challenging and rewarding job."

About Hyperbaric Medicine at Presbyterian Hospital of Dallas
The hyperbaric medicine program at Presbyterian Hospital of Dallas is a division of the hospital's Institute for Exercise and Environmental Medicine, serving as the referral center for the Divers Alert Network and Dallas County Poison Control. All nurses and technologists are specially certified in hyperbaric medicine and each R.N. is also certified in critical care medicine. It's one of only four centers in the United States that offers a hyperbaric medicine fellowship certified by the American College of Hyperbaric Medicine.

About Presbyterian Hospital of Dallas
Established in 1966, PHD is the flagship hospital of Presbyterian Healthcare System, a member of the faith-based, nonprofit Texas Health Resources system. US News and World Report ranks PHD, a recognized clinical program leader, providing technologically advanced care to patients, among the nation's best hospitals in digestive disorders, orthopedics, and neurology and neurosurgery. The 866-bed facility has approximately 4,000 employees and an active medical staff of more than 1,000 physicians. For more information about PHD, visit http://www.phscare.org/.

About Texas Health Resources
Texas Health Resources is one of the largest faith-based, nonprofit health care delivery systems in the United States and the largest in North Texas in terms of patients served. THR controls 13 affiliated hospitals and a medical research organization, and is a corporate member or partner in seven additional hospitals and surgery centers. THR's family of hospitals includes Harris Methodist Hospitals, Arlington Memorial Hospital and Presbyterian Healthcare System.  For more information about Texas Health Resources, visit http://www.texashealth.org/.

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