Could your Chamber Exhaust Termination Points be blocked?
April, May and June are the peak months for tornadoes in the United States. We have heard from colleagues about severe storms hitting their facilities. In tornadoes and other harsh weather conditions, the chamber exhaust termination point can become buried in snowdrifts or draped with material resulting from heavy winds.
To illustrate this point, a center in the heart of tornado alley narrowly escaped a touchdown that may have caused considerable and noticeable damage to the building. The mindful hyperbaric technician thought to inspect the roof after the winds, despite the fact that the roof had been inspected weeks before.
Below is a picture of plastic sheeting that blew onto their roof and completely covered all three termination points of the chamber exhaust. Should this debris have completely occluded their lines, the ability for the chamber to exhaust oxygen would have malfunctioned.
Routine chamber inspections are very important but thinking outside the box when scenarios like inclement weather is absolutely necessary to maintain a safe chamber operation for you and your patient.
As part of routine chamber inspections, it’s important to consider all aspects that impact chamber operation, from the bulk liquid oxygen site located outside the building and plumbed all the way to the chamber suite, to the chamber exhaust line that exits the suite via the headwall and runs to either the building rooftop or exterior side wall. Ensuring the chamber lines that are coming and going remain free of occlusions is imperative.
The termination point of the chamber exhaust line
can easily be overlooked
Perhaps because of the location or challenges with obtaining access to visualize, we know there can be problems with the termination point of the chamber exhaust. We recommend inspection by someone with knowledge of safe chamber operation on a monthly basis and after any significant weather event such as high winds, heavy rain, or ice and snow.
The NFPA 99 chapter 14 (2012 edition) offers several standards that aid us in awareness and maintenance of safety. We've highlighted the most important for you:
- 14.2.9.2 - Exhaust from all classes of chambers shall be piped outside of the building. (Each chamber shall have its own exhaust line)
- 14.2.9.2.1 - Each Class B chamber shall have an independent exhaust line.
- 14.2.9.2.2 - The point of exhaust shall not create a hazard.
- 14.2.9.2.3 - The point of exhaust shall not allow reentry of gases into the building.
- 14.2.9.2.4 - The point of exhaust shall be protected by the provision of a minimum of 0.3 cm mesh screen and situated to prevent intrusion of rain, snow or airborne debris.
- 14.2.9.2.5 - The point of exhaust shall be identified as an oxygen exhaust by a sign prohibiting smoking or open flame. With a roof top exhaust at least 18 inches tall terminating with an elbow turn facing downward to prevent rain entry and one that has a screen cover to prevent debris entry and signage to warn others.
Resources
The WoundReference Hyberbaric Oxygen Therapy Knowledge Base features guidelines to promote high standards of patient care and operational safety within the hyperbaric program and other important tools.
For customized safety programs and other wound care and hyperbaric medicine consultation services, visit MidWest Hyperbaric.
Acknowledgement
We thank Julie Rhee ScM, for style editing
About the Authors
Jeff Mize, RRT, CHT, UHMSADS
With over four decades of healthcare experience, Jeff currently holds the position of Principal Partner at Midwest Hyperbaric LLC and the Co-founder and Chief Clinical Officer of Wound Reference.
Jeff has excelled in critical care throughout his career, devoting almost a decade as a Flight Respiratory Therapist/Paramedic for the Spirit of Kansas City Life Flight. In 1993, Jeff transitioned into the field of Hyperbaric Medicine and Wound Care, where he committed 21 years of his career to serving as the Program Director for a 24/7 Level 1 UHMS Accredited facility with Distinction. In this role, he continued to provide patient care while overseeing all administrative, clinical, and daily operations within the Wound Care and Hyperbaric Facility.
Jeff is a Registered Respiratory Therapist and a Certified Hyperbaric Technologist (CHT). He has also undergone training as a UHMS Safety Director and a UHMS Facility Accreditation Surveyor.
Jeff currently serves as a member of the UHMS Accreditation Council, the UHMS Accreditation Forum Expert Panel, and the UHMS Safety Committee. Additionally, he is an esteemed member of the NFPA 99 Hyperbaric and Hypobaric Facilities Technical Standards Committee.
Jeff's dedication to the field has earned him numerous prestigious awards. In 2010, he received the Gurnee Award, which honored his outstanding contributions to undersea and hyperbaric medicine. Three years later, in 2013, he was awarded the Paul C. Baker Award for his commitment to Hyperbaric Oxygen Safety Excellence. Most recently, in 2020, Jeff was honored with "The Associates Distinguished Service Award (UHMSADS)," a recognition reserved for exceptional Associate members of the Society who have demonstrated exceptional professionalism and contributions deserving of the highest accolades.
Tiffany Hamm, BSN, RN, CWS, ACHRN, UHMSADS
An Advanced Certified Hyperbaric Registered Nurse and Certified Wound Specialist with expertise in billing, coding and reimbursement specific to hyperbaric medicine and wound care services. UHMS Accreditation Surveyor and Safety Director. Principal partner of Midwest Hyperbaric LLC, a hyperbaric and wound consultative service. Tiffany received her primary and advanced hyperbaric training through National Baromedical Services in Columbia South Carolina. In 2021, Tiffany received the UHMS Associate Distinguished Service Award. "This award is presented to individual Associate member of the Society whose professional activities and standing are deemed to be exceptional and deserving of the highest recognition we can bestow upon them . . . who have demonstrated devotion and significant time and effort to the administrative, clinical, mechanical, physiological, safety, technical practice, and/or advancement of the hyperbaric community while achieving the highest level of expertise in their respective field. . . demonstrating the professionalism and ethical standards embodied in this recognition and in the UHMS mission.”
