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EBAss NEWSLETTER Issue 1

EBAss
Newsletter

January - December
2020

EBAss is all of you! Calendar of Events

Letter from the President

by Angeliki Chandrinou, President of EBAss

Dear members, was agreed EUBS conference, postponed to
that this sys- September 2020 Prague, Czech Re-
For all of us, this year has tem should public, https://eubs2020.com/
been extraordinarily hard. I hope be concen-
that, through the pandemic, you trating on EBAss General Assembly and
and your loved ones can contin- using Eu- meeting for the Board of Directors,
ue to remain safe and protected. ropean standards and metric 14th November 2020, Online
measurements only. Also it was www.ebass.org
The EBAss community has agreed to offer the examina-
been working hard since the tion in a number of languages. UHMS Annual Scientific Meeting,
COVID-19 emergency was declared PA was tasked with this role and June 10-12, 2021, New Orleans, LA
in March to advance its mission worked with the European Col- https://www.uhms.org
and assist colleagues through these lege of Baromedicine (ECB) in
extraordinary circumstances. In order to be able to issue recog- 20th International Congress on
late May, and now in November, nized certification for success- Hyperbaric Medicine, postponed to
our 2020 BD meetings and Gener- ful personnel. PA then went on 2021, Rio de Janeiro, Brazil
al Assembly moved online, while to set up an on-line system to https://www.ichm2020.rio.br
all congresses postponed to 2021. carry out theoretical examina-
tions for hyperbaric personnel. independent system which ex-
There have also been ad- The system was launched in amines all personnel to the
ministrative changes at EBAss 2010 with a grandfathering sys- same recognized standards.
since Mr. Pete Atkey retire tem in place for existing per-
sonnel which ran for 2 years. Since its inception this
PA, a senior DDRC ex- accreditation system has at-
ecutive, has worked for Also during this time PA tracted personnel not only from
EBAss since its inception. worked with ECB to initiate European countries but also
systems to accredit schools from the Middle East, Far East,
In 2006 EBAss and ECHM had wishing to teach hyperbaric Australia and New Zealand.
established training requirements personnel in their own lan-
for hyperbaric personnel as issued guage. This system has gained Thank you Peter for all
in the Resources Manual. PA sug- a very good reputation as an you have done for all of us!
gested to Robert Houman that the
next logical step was for EBAss to
set up a system to examine and ac-
credit personnel as competent; it

The European Baromedical Association (EBAss) is a UK Registered Charity. Registered Number 1183525.

Words from the Editor baric conditions and reported
side effects of the treatment.
by Damianos Tzavellas
Unfortunately, most of
Dear reader, ic units are the hyperbaric conferences
now more have been cancelled or post-
I hope that this time of prepared to poned for next year. In say-
the year finds you all well and face chal- ing that a new era of online
safe. I believe it has been a lenges with webinars and meetings has
very challenging time for most the already emerged from countries that
of us and at all levels of person- available recommendations. have already made use of this
al, professional and social live. In other areas of interest, technology, and with very posi-
EBAss has had another success- tive feedback. It is a space that
In regards to the “Hyper- ful Safety Manager course last EBAss is looking into with great
baric” world, a lot has been dis- year in Malta and our Board of interest and would like to in-
cussed and published. Such as, Directors cannot thank enough clude in its near future proj-
the treatment’s role in fighting Dr Mario Saliba and his team ects. The start has been made
COVID-19, new infection control at the hospital of Gozo island. with the organizing of our 2020
policies or patient triage in acute Moving forward, EBAss AGM at an online platform
and elective cases. Our Associa- recommendations for Safe- and any ideas from our mem-
tion has made efforts to empow- ty Manager education are bers are more than welcomed!
er communication between hy- now available and there is
perbaric centres and to circulate an open invitation for EBAss Finally, Mr Peter Atkey
COVID-19 recommendations from accredited centres to en- has decided to step back from
the international hyperbaric soci- dorse this course to their list. his duties in the Association
eties, like the ECHM and UHMS. Our literature review and hand over his great work
An EBAss recommendation doc- for topics related to nurses, and tasks to the new gener-
ument on patient screening and chamber operators and hyper- ation. A big thank you Peter,
triage before starting HBOT was baric technicians has provided for all your passion and knowl-
also created and is available on us with some very interesting edge that you have shared
our website for anyone interest- information. Some of those with us and good luck with
ed. While writing these words, are: the UV-C disinfection all your future endeavours!
Europe is already going into a for hyperbaric facilities, glu-
second COVID-19 wave that will cose monitoring under hyper- Please send any comments
probably be stronger than the or questions you may have
first one but hopefully, hyperbar- at our email: [email protected]

Enjoy your reading!!

COVID-19 pandemic

by Konstantina Gaitanou, President of of unnecessary human physical
contact, Information about symp-
EBAss Education Committee toms of SARS-CoV-2 / COVID-19
infection or exposure occurrence
Dear members, and Agreement that treatment
can be discontinued if the patient
The EBAss Education Com- on COVID-19 encounters a high-risk situation.
mittee almost from the begin- risk and that prevention is
ning of COVID-19 pandemic pro- an essential step prior to ac- Our Education Committee
duced a TRIAGE QUESTIONNAIRE ceptance for treatment. has the task to produce recom-
as recommendation for patients mendations that will concern
and stuff in Hyperbaric Units. Patient education should in- the staff to work safely since it
clude: Tutorials on the use of per- seems that the pandemic is not
However, it is equally import- sonal protective equipment (PPE), going to end in the near future.
ant to emphasize how necessary if required, Advice on continuation
patient education is considered of social distancing and avoidance

The European Baromedical Association (EBAss) is a UK Registered Charity. Registered Number 1183525.

General Assembly (GA) of the
9th November 2019
by EBAss
finalize a document that will thew Wormleighton from Mid-
One of the main discus- be relevant to preparedness of lands Diving Chamber (UK) who
sion topics during our last GA the new pandemic normality. was assigned the task of the
was the production of a docu- General Secretary. Mrs Chandri-
ment related to recommenda- nou took over the tasks of Com-
tions / guidelines on infection munication Committee where
control in hyperbaric facili- she was already responsible
ties. Mrs Gaitanou presented for the tasks of the website
reference publications and a and facebook sub-committee.
proposed skeleton for the doc-

ument to be produced. Ironi- Other topics of discussion For more details you
cally, not long after the GA,
infection control became the included situation of EBAss can visit the members area
big topic of discussion for all
hyperbaric facilities in Europe memberships (full individu- and download the minutes of
and around the world, due to
COVID-19. Medical Hyperbar- al, associate/corporate, etc) the GA in English and French.
ic Associations such as UHMS,
ECHM and SPUMS took the ini- and the EBAss accounts with
tiative and produced infection
control documents, specifical- a proposal for the 2020 bud- Date and place for our next
ly related to this pandemic.
That is a great opportunity for get distribution. Mr Tzavellas GA and meeting for the Board
our association to include all
these new additions/propos- stepped back from the Board of Directors is pending and an-
als from around the globe and
of Directors and his duties as a nouncements will be made soon.

General Secretary due to per-

sonal issues. He will still be

an active member of the Asso-

ciation and the editior of the

newsletter. At the same time,

the Board welcomed Mr Mat-

EBAss News

EBAss activities of the last year

 General Assembly and two meetings for the Board of Direc-  EBAss accredited cen-
tors. ters can now contact ac-
 Successful completion of the EBAss-organised 3nd Safety creditation committee if
Manager course in Gozo island, Malta. they want to run the ECHSM
 A triage questionnaire was produced to aid in the screen- course.
ing process of potential COVID patients entering the hyperbaric
chamber.
 Recommendations/guidelines on infection control in the
hyperbaric facility are in working progress.
 EBAss-organised Safety Managers course has been post-
poned until further notice.

The European Baromedical Association (EBAss) is a UK Registered Charity. Registered Number 1183525.

Welcome of new members 19. Hanson Kit Associate members

We would like to welcome 20. Richardson Lee 1. Stephen Munro

onboard and thank for their 21. Palazzolo Carmelo

support, the following person- 22. Krook JT Since then, there are anoth-

nel who joined EBAss during the 23. Guirindola Bella Mia er new members that have

last year. 24. Botond Jozan Biro joined EBAss and are awaiting

Full members 25. Chze Hsing Ho for official acceptance at the

1. Pamela Quandroy 26. Bram Jackers next GA. So, thank you again

2. Geoff Munro 27. Ellen Kop everyone for your interest and

3. Matt Ferre EBAss Accredited centres for 2020
4. Andrew Shaw
5. Charlie Elysee The following centres are EBAss accredited to run training
6. Adrian Williams courses for Chamber Operators, Nurses, ICU Nurses or Atten-
7. Phillip McConnell dants (not nurse), specialized to work under Hyperbaric con-
8. Julie Tuck ditions.
9. Oisin Conroy 1. HBO Cyprus – Cyprus
10. Stephen Stratton 2. DDRC Professional Services - UK
11. Alexander Hannam 3. Haux Life Support Germany - Germany
12. Steven Kent 4. Centro Di Medicina Iperbarica, PADOVA – Italy
13. Margarita Bertolin Solaz 5. Hyperbaric Health – Australia
14. Inneke Achten 6. University of Gdansk – Poland
15. Hedley Mark 7. National Hyperbaric Medicine Unit, Ireland
16. Ashford Clair 8. Athens Naval Hospital - Greece
17. Cook Adrienne DDRC Professional Services has recently gained EBAss accredi-
18. Dillingham John tation to run a Safety Manager course.

Recent Publications
articles related to Hyperbaric practices including patient management, safety
issues, testing of material and operations

keywords: Hyperbaric, oxygen

search machine: Medline

period of search: 12/2019 – 6/2020

1. Efficacy of UV-C Disinfection against C. difficile. Addition- January 2013 to December
in Hyperbaric Chambers ally, direct UV-C exposure was 2017, where 2,610 patients
Warren BG et. (JUNE 2020) more efficacious against both were selected, in the Hy-
species than indirect exposure. perbaric Medicine Centre,
Sainte- Marguerite Hospital
ABSTRACT: 2. Middle-ear Barotrauma Af- of Marseille, France.
Ultraviolet C (UV-C) light reduc- ter Hyperbaric Oxygen Thera- Results: 262 patients expe-
es contamination on high-touch py: A Five-Year Retrospective rienced MEB after HBO2,
clinical surfaces. We assessed Analysis on 2,610 Patients representing a prevalence
the efficacy of 2 UV-C devices William François Oko Pettis of 10.04% and incidence of
at eradicating important clin- Edinguele et al. (JUNE 2020) 0.587%. Their average age
was 55 ± 19 years. Women
ical pathogens in hyperbaric ABSTRACT: were more affected than
chambers. Both devices were Methods: We conducted a five- men. We have not high-
similarly efficacious against year retrospective study from
MRSA but differed significantly

The European Baromedical Association (EBAss) is a UK Registered Charity. Registered Number 1183525.

lighted a seasonality to this condition. ABSTRACT:
Risk factors were: age older than 55 years, Method: Ten non-diabetic hyperbaric staff mem-
female gender, ear, nose and throat his- bers (age 35-55 years) underwent a standard
tory (cancer, radiotherapy, infections or 243 kPa HBOT exposure for 95 minutes. Blood
allergies, malformations or benign tu- glucose levels were measured via (i) finger-prick
mors), general history (smoking, obstruc- capillary test using the FreeStyle Optium™ Neo
tive breathing disorders, thyroid disorders H glucometer and (ii) venous serum test using
and obesity), HBO2-approved indications the Cobas 6000 laboratory analyser. Samples
of sudden deafness and delayed wound were taken at (T1) 0 minutes (pre-HBOT), (T2)
healing, and altered tympanic mobility on 25 minutes, and (T3) 55 minutes into HBOT.
initial examination. Although the benign Results: All participants were euglycaemic at
stages of Haines-Harris classification were T1 (BGL 3.8-5.4 mmol·L⁻¹). The highest venous
the most encountered in our study, MEB was serum value was 5.90 mmol·L⁻¹ at T3 and the
responsible for premature discontinuation highest capillary value was 6.30 mmol·L⁻¹ at
of HBO2. T1. Post hoc tests showed a statistically signifi-
cant difference between the mean capillary re-
3. Sudden Death After Oxygen Toxicity Sei- sult pre-dive (T1) and readings at T2 (P = 0.001)
zure During Hyperbaric Oxygen Treatment: and T3 (P < 0.001) while differences between
Case Report T2 and T3 capillary results were not statisti-
Lalieu RC et al. (JUNE 2020) cally significant, illustrating the effect of HBOT
on capillary beds. Differences in venous values
ABSTRACT: across the time points were not significant.
Acute cerebral oxygen toxicity (ACOT) is
a known side effect of hyperbaric oxygen 5. Treatment of Children With Hyperbaric Oxy-
treatment (HBOT), which can cause gen- genation (HBOT): An Europe-wide Survey
eralised seizures. Fortunately, it has a low Janisch T et al. (APR2020)
incidence and is rarely harmful. Neverthe-
less, we present a case of a 37 year-old ABSTRACT:
patient with morbid obesity who died unex- Methods: We sent an internet-based question-
pectedly after an oxygen toxicity seizure in naire to HBO centers in Europe to gain information
the hyperbaric chamber. Considering possi- about their experience with children and HBOT.
ble causes, physiologic changes in obesity Results: Out of all HBO-centers who participated
and obesity hypoventilation syndrome may in the questionnaire 90 % treat children analogue
increase the risk of ACOT. Obesity, especial- to adults with regard to indication and HBOT pro-
ly in extreme cases, may hinder emergency tocol. Most treated children had life- threatening
procedures, both in- and outside of a hy- indications or the risk of organ loss. The reported
perbaric chamber. Physicians in the hyper- rate of side effects was: 6.8 % anxiety, 2.4 % baro-
baric field should be aware of the possibil- trauma, 0.9 % seizure, 0.2 % retinopathy and no
ity of a fatal outcome after ACOT through case of pulmonary barotrauma or oxygen toxicity.
the described mechanisms and take appro-
priate preventative measures. Basic airway 6. Safety of a Continuous
management skills are strongly advised for Glucose Monitoring Device
involved physicians, especially when spe- During Hyperbaric Exposure
cialised personnel and equipment are not Bliss C et al. (JAN-MAR2020)
immediately available.
ABSTRACT:
4. Evaluation of the Abbot FreeStyle Optium Materials and methods: We evaluated and test-
Neo H Blood Glucose Meter in the Hyperbaric ed commercially available Dexcom® G6 CGM
Oxygen Environment
Baines C et al (JUNE 2020)

The European Baromedical Association (EBAss) is a UK Registered Charity. Registered Number 1183525.

transmitters under hyperbaric conditions. Each transmitter contains a 3V, 130-mAh (0.39 Wh)
lithium manganese dioxide battery (IEC CR1632) and circuit board that are fully encapsulated
in epoxy. Each transmitter is pressurized to 90 pounds per square inch (psi) in an autoclave
at 40°C for up to 72 hours during manufacturing to ensure that all enclosed air spaces are
eliminated from the epoxy. We compared the CGM components against section 14.2.9.3.17.5 of
the 2018 National Fire Protection Association 99 (NFPA 99) Health Care Facilities Code require-
ments. Six CGM transmitters attached to estimated glucose value generators (EGVGs) underwent
11 pressurization cycles to 45 feet of seawater (fsw). All transmitters were returned to the
manufacturer to assess post-exposure structural integrity. G6 sensors, which contain no electri-
cal components or compressible air spaces, do not pose a risk in the hyperbaric environment.
Results: There was no observed change in preset EGVG readings during hyperbaric exposures.
Post-exposure testing revealed no structural compromise after repeated hyperbaric exposures.

7. The Myopic Shift Associated With Hyperbaric Oxygen Administration Is Reduced When Using a
Mask Delivery System Compared to a Hood - A Randomised Controlled Trial
Bennett MH et al. (DEC 2019)

ABSTRACT:
TMethods: We conducted a randomised trial of oxygen delivery via hood versus orona-
sal mask during a course of 20 and 30 HBOT sessions. Subjective refraction was per-
formed at baseline and after 20 and 30 sessions. We repeated these measurements at
four and 12 weeks after completion of the course in those available for assessment.
Results: We enrolled 120 patients (mean age 57.6 (SD 11.2) years; 81% male). The my-
opic shift was significantly greater after both 20 and 30 sessions in those patients us-
ing the hood. At 20 treatments: refractory change was -0.92 D with hood versus -0.52
D with mask, difference 0.40 D (95% CI 0.22 to 0.57, P < 0.0001); at 30 treatments: -1.25 D
with hood versus -0.63 with mask, difference 0.62 D (95% CI 0.39 to 0.84, P < 0.0001). Re-
covery was slower and less complete in the hood group at both four and 12 weeks.

SAFETY MANAGER COURSE
FOR HYPERBARIC PERSONNEL

3rd Safety Manager Course in Gozo Island - Malta

The 3rd Safety Manager Dr M. Saliba, Dr S. Bigeni
Course was successfully com- and Mrs M. Cassar for their
pleted last year at the Hyper- exceptional hospitality and
baric Unit of Gozo General organization of the event.
Hospital, on the island of Gozo,
Malta. Our participants where From now on any ac-
from the UK, Italy, the Nether- credited training center can
lands and of course Malta. include the Safety Manager
education in the list of their
We would like to thank courses.
the Executive Director, Dr. Jo-
seph Fenech, and local hosts,

The European Baromedical Association (EBAss) is a UK Registered Charity. Registered Number 1183525.

Attention!!

The registration form for becoming a new EBAss member or renew your ex-

isting membership you can find online at http://ebass.org/registration-form/

The process for members to join the Board of Directors can be found in part IV

of the EBAss statutes at http://ebass.org/statutes/

We would like to thank our corporate members for their ongoing support to
our Association.

Corporate members

EBAss
Newsletter

ebass.org Work Better Under Pressure

Accreditation Education Safety Communication

The European Baromedical Association (EBAss) is a UK Registered
Charity. Registered Number 1183525.