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Hyperbaric nursing

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Hyperbaric nursing

Hyperbaric nursing is a nursing specialty involved in the care of patients receiving hyperbaric oxygen therapy. The National Board of Diving and Hyperbaric Medical Technology offers certification in hyperbaric nursing as a Certified Hyperbaric Registered Nurse (CHRN). The professional nursing organization for hyperbaric nursing is the Baromedical Nurses Association.

Hyperbaric nurses are responsible for administering hyperbaric oxygen therapy to patients and supervising them throughout the treatment. These nurses must work under a supervising physician trained in hyperbaric medicine who is available during the treatment in case of emergency. Hyperbaric nurses either join the patient inside the multiplace hyperbaric oxygen therapy chamber or operate the equipment from outside of the monoplace hyperbaric oxygen therapy chamber, monitoring for adverse reactions to the treatment. Patients can experience adverse reactions to the hyperbaric oxygen therapy such as oxygen toxicity, hypoglycemia,[clarification needed] anxiety, barotrauma, or pneumothorax. The nurse must know how to handle each adverse event appropriately. The most common adverse effect is middle ear barotrauma, injury to the middle ear due to pressure not being equalised during compression. Since hyperbaric oxygen therapy is usually administered daily for a set number of treatments, adverse effects must be prevented for the patient to receive all scheduled treatments. The hyperbaric nurse will collaborate with the patient's physician to determine if hyperbaric oxygen therapy is appropriate. The nurse must know all approved indications that warrant hyperbaric oxygen therapy treatments, along with contraindications to the treatment.

Hyperbaric medicine developed from the treatment of divers to include treatment of other conditions not related to diving, that were found to respond to similar treatment. Hyperbaric nursing began in the 1950s in Europe, and the original process of learning on the job developed into formal training programs by the 1960s.

In 1985, the Baromedical Nurses Association (BNA) was established to promote professional standards, peer support, and continuing education for nurses working in hyperbaric environments. The BNA later partnered with the National Board of Diving and Hyperbaric Medical Technology (NBDHMT) to help develop the Certified Hyperbaric Registered Nurse (CHRN) credential, formalizing the role of the hyperbaric nurse within clinical practice.

The role of the hyperbaric nurse can vary depending on the needs and activity of the facility, and may include.

In addition to these core responsibilities, hyperbaric nurses are trained to recognize and manage hyperbaric-specific risks such as oxygen toxicity, barotrauma, and claustrophobia. They play a key role in emergency preparedness, infection control, and interdisciplinary coordination for complex wound care and critical care patients undergoing HBOT.

The Baromedical Nurses Association Certification Board was established in 1995 and the first hyperbaric nursing certification issued in the same year. As of September 2024 there are over 900 hyperbaric nurses certified by BNACB. Three levels are recognised: Certified Hyperbaric Registered Nurse (CHRN), Advanced Certified Hyperbaric Registered Nurse (ACHRN), and Certified Hyperbaric Registered Nurse Clinician (CHRNC).

In South Africa, CHRNs are registered with the Southern African Underwater and Hyperbaric Medical Association (SAUHMA).

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