Who is not allowed to accompany patients during hyperbaric oxygen therapy?

Hyperbaric oxygen therapy (HBOT) can improve prognosis following traumatic brain injury (TBI), increase cure rates, and reduce disability rates. It is a therapeutic intervention involving breathing pure oxygen in an environment pressurized to more than one atmosphere absolute (ATA). HBOT is commonly used for various types of brain injury—including TBI and post-craniotomy recovery—and serves as an effective adjunctive treatment. So, who should not accompany patients during HBOT? Below, we address this question.

Individuals Prohibited from Accompanying Patients in the Hyperbaric Oxygen Chamber

1. Absolute contraindications include untreated pneumothorax; concurrent administration of disulfiram; concurrent use of antineoplastic agents such as bleomycin, doxorubicin, or cisplatin; and preterm or extremely low birth weight infants. Additionally, conditions requiring special clinical attention—such as severe emphysema, pulmonary bullae, uncontrolled hypertension, heart rate below 50 bpm, second-degree atrioventricular block, retinal detachment, or active bleeding—must be carefully evaluated by a specialist in hyperbaric medicine before HBOT is considered.

2. Relative contraindications (i.e., factors increasing risk but not absolutely prohibiting HBOT) include the perioperative period following thoracic or middle-ear surgery; active respiratory viral infections; uncontrolled epilepsy; fever; claustrophobia; basilar skull fracture with cerebrospinal fluid leakage; hereditary spherocytosis; and uncontrolled hypertension. Notably, HBOT is generally not recommended for pregnant women during the first trimester unless medically essential. However, individualized assessment remains critical—blanket restrictions are inappropriate.

Knowledge Extension: Nursing Care During Hyperbaric Oxygen Therapy

1. Emphasis on Fundamental Nursing Care

Monitor peripheral perfusion of neurologically impaired limbs—including skin color, temperature, and turgor—to prevent pressure injury or limb torsion. Maintain appropriate warmth for affected limbs and promptly report any abnormalities to the physician for timely intervention. Patients with reduced or absent capacity for self-care are at increased risk for complications such as urinary tract infection, pressure ulcers, and pulmonary infection.

2. Psychological Nursing Interventions

A positive nurse–patient relationship forms the foundation for effective psychological support. Greet patients with kindness and empathy, using warm, reassuring language to foster trust and emotional security. Arrange a guided tour of the hyperbaric chamber, and clearly explain the principles, procedures, potential side effects, and coping strategies associated with HBOT to alleviate anxiety and enhance cooperation.

3. Reinforcement of Safety-Centered Nursing

Chamber safety encompasses optimal equipment functionality, hemodynamic stability during treatment, preparedness for emergency situations, and secure patient transport. Ensure orderly and safe entry into the chamber; strictly prohibit unauthorized items to prevent adverse events and eliminate safety hazards.

The above outlines individuals who should not accompany patients during hyperbaric oxygen therapy. We hope this information proves helpful.