PURPOSE:
The purpose of Hendrick Woundcare Center is to provide patient evaluation and wound care, which includes hyperbaric oxygen treatments for a wide variety of approved indications including both chronic and acute conditions. The staff is committed to providing care in a personal, yet professional, manner, educating patients in terms of their condition and treatment plan. They also provides emotional support to enhance patient compliance in this stressful and sometimes lengthy course of therapy, and coordinates the patients' schedules with other departments, and community services as related to HBO (hyperbaric oxygen) and woundcare treatments.
PROGRAM DESIGN:
Patients are referred to the Woundcare Center by either their personal physician. Patient evaluations take place within the unit, and transcutaneous oximetry is performed in HBO (if indicated) to assess tissue oxygenation or ischemia. A qualified technician explains the purpose of the treatment with its risks and benefits. A physician examines the patient, answers questions, and determines whether treatment will be beneficial.
Outpatients are scheduled for daily treatment Monday through Friday. The HBO unit schedules inpatients' daily treatments Monday through Friday. Additional treatments (e.g. BID) are done as necessary and as time allows. Should the need be present, patient treatments will be carried out through the weekend, at the physician's discretion.
TREATMENTS & THERAPIES:
HBO therapy is a treatment in which the patient breathes 100% oxygen while at greater than ambient atmospheric pressure. The following conditions are approved indications for HBO therapy:
Chronic Conditions:
- Enhancement of healing in selected problem wounds
- Chronic refractory osteomyelitis
- Preservation of compromised skin grafts or flaps
- Sternal wound infections
- Soft tissue infections with necrosis
- Radiation necrosis – Osteoradionecrosis and soft tissue radiation damage
- Selected refractory myosis – Mucormycosis or Actinomycosis
Acute Conditions:
- Carbon monoxide poisoning
- Gas gangrene
- Acute cyanide poisoning
- Arterial gas embolism
- Decompression sickness
- Crush injuries with acute traumatic ischemia
Special Considerations:
- Acute blood loss anemia
- Thermal burns
- Brown recluse spider bite
Depending upon the diagnosis and the physician order, HBO therapy will be administered at a pressure of 2.0 ATA, 2.5 ATA with air breaks, or 3.0 ATA with air breaks.
Woundcare therapy is provided by woundcare specialists using multiple modalities in conjunction with, or without HBO. Sharp debridement, skilled dressing choices and compassionate care is provided for patients with wounds such as arterial/venous stasis ulcers, burns, pressure sores, surgical wounds, snakebites, open abscesses, traumatic injuries, diabetic wounds, and any open wound that doesn't heal within a timely manner.
CRITERIA FOR CARE AND DISCHARGE:
To qualify for HBO therapy or woundcare, a patient';s condition must fall under one of the above listed approved indications. Transuctaneous oximetry on room air will be performed in all applicable situations and repeated in chamber at the wound site to evaluate response. An in-chamber response indicates that HBO therapy will be beneficial for the patient and should, therefore, be continued.
During HBO therapy, a woundcare physician is at the chamber-side at all times for emergency, as well as routine, patient care. Patient progress is continually assessed by a Woundcare physician for further need and appropriateness of therapy. Woundcare patients are also seen on a daily basis by woundcare physicians. Any progress is monitored by the woundcare staff and relayed to the primary care physician.
When the physician feels that HBO therapy can be discontinued, patients are instructed as to the care of their wounds and signs and symptoms of infection. If needed, outpatient woundcare is arranged, as well as being followed by the hyperbaric physician. The patient is made aware that they should call the Woundcare Center if, at any time, the wound appears to be red, hot, or worsening quickly . In some instances it is necessary to reinitiate hyperbaric treatments.
GOALS:
The goals of the Hyperbaric unit and the Wound Center are to provide excellence and service in healing patients, reducing the length of their hospital stay, and improving their quality of life, with education, innovation, and cost containment .
RESPONSIBILITES:
It is the responsibility of the Woundcare Center to maintain, at all times, the same quality and level of care that the patient is receiving on the nursing floor or in critical care. That is, if the patient is on telemetry, EKG monitoring will be continued through the hyperbaric treatment. IV infusions and mechanical ventilation will also be maintained as ordered.
The Woundcare Center staff is responsible for gaining and maintaining the trust of the patient. The patients are very aware that when they are inside of the chamber, their safety is in the hands of the hyperbaric technician. The operating technician is responsible for the patient's safety. The patient's safety depends upon the technician strictly adhering to the guidelines set forth in the policies and procedures of the Hyperbaric Medicine unit.
Patient information and confidentiality, and privacy, will be maintained at all times.
The Woundcare Center team will work together with ancillary departments to ensure that the patient received the best possible care while, at the same time, conserving time and hospital resources.
CONTACT:
Woundcare: 670-4369
HBO: 670-4185
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