Diving Diseases Research Centre (DDRC)

What is DDRC
What is Hyperbaric Oxygen Therapy
How does Hyperbaric Oxygen Work
What Next
‘Krug’ Multiplace Chamber
The Therapy
The Monoplace Chamber
How do I prepare for Treatment
Ear Clearing
Are there any Safety Precautions
Are there any Side Effects
For your Comfort
Accommodation
Confidentiality
Chaperones

Working in Partnership
And Finally
The Aims & Objectives of DDRC
Patient Information regarding a Complaint 

What is DDRC
The Diving Diseases Research Centre (DDRC) is a charity.
It was originally developed as a treatment centre for divers suffering from “the bends” (Decompression Illness or DCI) and as such was funded mostly by charitable donations from both amateur & professional diving organisations and other interested bodies. As more recognition has been given to the value of Hyperbaric Oxygen Therapy (HBO or HBOT) in the treatment of various other conditions, we now receive funding from the National Health Service (NHS) for the patients we treat, whose conditions have been clinically indicated to benefit from Hyperbaric Oxygen Therapy. We are situated in Plymouth in the South West of England, with a smaller satellite unit at St Joseph’s Hospital in Newport.
Most of the patients we treat are from Devon, Cornwall and South Wales. We do however also treat patients from as far afield as Birmingham and Derbyshire.
The DDRC staff comprises trained medical, clinical, chamber and administrative support staff, all of whom will be more than happy to help during your visit to the Hyperbaric Medical Centre.

What is Hyperbaric Oxygen Therapy
Hyperbaric Oxygen Therapy (HBO or HBOT) is a means of providing additional oxygen to body tissues. By intermittently increasing the amount of oxygen in the tissues the healing process is enhanced. The therapy is painless and has the potential for good results.
Breathing 100% oxygen under pressure allows the oxygen to be dissolved into plasma (the liquid part of the blood).
When this occurs, the oxygen will be beneficial to the body for a longer period of time.
HBO Therapy can be used for a range of medical problems such as difficult to heal wounds such as diabetic foot ulcers, radiotherapy damaged tissues, burns, failing skin grafts, and bone infections.
In an emergency it can be used for conditions such as gas gangrene, carbon monoxide poisoning, cyanide poisoning, air embolism and of course decompression illness (‘the bends’).

How does Hyperbaric Oxygen Work

When Hyperbaric Oxygen Therapy is given appropriately there is the potential for the following benefits in the body:

• Reduction of any gas bubbles
• Delivery of increased amounts of oxygen to injured tissues
• Promotion of blood vessel formation, especially in the micro-circulation, to increase blood flow
• Reduction of tissue swelling
• Reduction and inactivation of some infections
• Promotion of wound healing
• Preservation of compromised tissues
• Stimulation of new bone formation
• Reduction of the effects of some specific toxic substances

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What Next

Once you have been referred to us by your Doctor or Consultant and funding has been approved we will arrange your treatment dates and any accommodation for you. The number of treatments you require varies from patient to patient. For example some will require 40 consecutive treatments, others will need 30 pre operatively and then 20 post operatively. This will all be explained before you arrive. On arrival at the centre, you will meet members of staff and have a look around. The nurse will explain the therapy process to you and do some tests during you assessment, which will take about an hour. This is to ensure that you are well enough for treatment. Relatives are of course very welcome to come and use the facilities and join in with the familiarisation process.
One of the first questions we are often asked is, “Will I get wet?” No! You will not need to bring any swimwear! The term “dive” is used because the pressure is equivalent to being at a certain depth under water. The chamber is dry at all times and does not move.

 
‘Krug’ Multiplace Chamber

The multiplace chamber is like a small room with a large walk-through door. Seats are fitted to the side walls where the patients sit during the therapy. Stretchers can be wheeled into the chamber if patients need to lie down, for instance, if the doctor wishes to monitor the patient’s heart rhythm. There are several port-holes that let daylight in but there are lights as well. A trained attendant accompanies the patients inside the chamber at all times. Cameras are placed inside the chamber to allow the doctor, nursing team and the chamber staff to continuously monitor activity during the treatment session.

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The Therapy
The Chamber Operator controls the chamber from outside at all times and is able to maintain constant audio and visual contact with the attendant inside the chamber. When patients are comfortably settled the door is closed and the Chamber Operator checks communications with the attendant. When all is ready, compressed air will be blown into the chamber, temporarily increasing noise levels. At this point, you may feel fullness in your ears much like the feeling when travelling in the mountains or flying in an airplane. You will already have been taught how to ‘clear your ears’ (equalise the pressure change), so as soon as you hear the noise in the chamber, ear clearing should begin. You may need to repeat ear clearing throughout the time it takes to reach the treatment depth – approximately 10 minutes. If you feel discomfort or pain in your ears, let the attendant know immediately so that we can help you. As soon as the required pressure is reached, you will be helped to put on a clear hood or a face mask which supply 100% oxygen. You will breathe oxygen for up to 90 minutes but will have ‘air breaks’ of approximately 5 minutes when you will be able to have a drink, etc.
During the compression stage the chamber will become quite warm. At the end of the therapy the chamber is decompressed and it will then become quite cold. (There are blankets provided to keep you warm, if required). Both stages are fairly noisy but it will be much quieter in between. You are advised to wear ear defenders throughout the compression stage to protect your ears from the noise. The treatments at the centre from Monday to Friday usually consist of either once or twice-daily therapies, as prescribed by the medical team. Each treatment session lasts approximately 21/4 hours.

The Monoplace Chamber
The monoplace chamber is designed for single person occupancy and will be pressurised with 100 per cent oxygen which is breathed directly. Patients being treated in the Newport Hyperbaric Centre will be treated in a monoplace unit only.

How do I prepare for treatment

It is important to arrive half an hour before your scheduled treatment. For morning treatments, arrive not later than 8.45am and for afternoon treatments, no later than 1.45pm. Local patients attending for lunch time dives should arrive no later than 11.30am. Cotton clothing provided at the centre must be worn inside the chamber. Please get changed on arrival. Ladies please note – no make up is to be worn inside the chamber; therefore no lipstick, foundation, mascara, nail varnish or hairspray etc.
No alcohol should be drunk for at least 12 hours prior to treatment.
No smoking for at least 2 hours before and after your oxygen treatment. We would prefer, if you are able, that you stop smoking completely during your course of treatment.
Eat a meal before treatment, especially if you are diabetic.
Take normal necessary medications (if any) as usual. Pain medication can be taken during your treatment.
We ask that cash and valuables are not brought to our centre. However, if this is not possible, please use the lockers provided or ask one of the administration staff for assistance. Your valuables will then be locked away and you will be issued with a receipt.

Ear Clearing
This is a question that many patients are concerned about, but please don’t worry, we will ensure that you are able to do this before you begin your treatment; if not then we will take necessary steps to assist you.
As soon as the air flows into the chamber you need to start making your ears ‘pop’.

Here are several ways to effectively do this:

• The easiest method of clearing your ears is to try to very gently blow through your nose while holding your nose and lips tightly closed
• You can try moving your lower jaw from side to side or an in or out motion
• Sometimes just swallowing alone or swallowing some water may work especially with your mouth and nose held closed
• It is just a matter of finding what works for you!

If you cannot effectively clear or pop your ears by the above methods you will feel pain/discomfort in your ears. It is important that you let the attendant know immediately so that they can help you and stop any further increase in pressure in the chamber. If you are still unable to clear your ears then grommets (pressure equalizing tubes) can be inserted into your ears.
These tiny tubes placed in your ear drum will equalise the pressure for you. These would be fitted by your local hospital or Derriford Hospital ENT Department after discussion with a doctor.

Are there any Safety Precautions

There are some things that MUST NOT be taken or worn inside the chamber these include:

• Lighters/matches Cigarettes
• Newspapers Perfume/aftershave
• Hairspray/oil Nylon clothing
• Ointments/liniments Make-up/nail varnish
• Wigs/hairpieces Watches
• Petroleum/Vaseline products Hearing aids
• Fountain Pens Hard Contact lenses
• Heat Pads Hand Warmers
• Metal-Framed Spectacles Cosmetics

If you are aware of a patient having any of the above on their person, please tell someone immediately. The following items CAN be taken into the Krug (multiplace) chamber, but NOT into the monoplace chamber:

• A book or magazine
• A biro pen
• Plastic Frame Spectacles

In the multiplace chamber you can watch a DVD on one of the screens or listen to music via a headset. In the monoplace you are able to watch TV or a DVD through the wall of the chamber & listen on speakers behind your head.

Are there any Side Effects
Some side effects are possible and the most common are listed below:

• Light-headedness; if this happens it lasts approximately 5 minutes and occurs after treatment is over
• Some people may feel some tingling or a dull ache in the area of an injury, generally this is a temporary effect
• Changes in vision, this can occur as a result of multiple treatments, although it is generally temporary. It may last for a few months after treatment. If necessary we can assist in the cost of temporary glasses. Please ask at Reception for more details

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For your Comfort

Our Centre has a kitchen where you can make tea and coffee, and is equipped with a microwave oven and fridge. There is a relaxing patient lounge where you can sit and watch television or read, with south facing gardens where weather permitting, you can sit out and enjoy the sunshine. Relatives are of course very welcome to come and use the above facilities and are encouraged to help us help you.

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Accommodation
HeartSWell Lodge is within 200 metres of DDRC and can provide accommodation for relatives and friends of patients who are receiving treatment. Their telephone number is 01752 315900. The rooms are twin bedded and there are self-catering facilities available. Food is not provided by HeartSWell Lodge, therefore patients will receive a small amount of subsistence for each night’s accommodation to assist with the purchase of an evening meal. The nearest shop is within 1 mile of the Centre and an Asda store is within 2.5 miles. Other accommodation nearby is the Jack Rabbit Vintage Inn, Innkeepers Lodge, Derriford, Plymouth PL6 8BD - Room reservations 0845 112 6088.
It is important to remember that all additional costs must be paid by you and not charged to DDRC. DDRC can only pay for the accommodation of the patient being treated.

Confidentiality

Whilst you are with us you might learn some information about a patient, who may or may not be known to you. Whether you are a friend, family member or stranger to that patient, we ask you to respect their right to confidentiality by not repeating the information to anyone else. If we all treat any information we may learn about others in the way we would like information about ourselves to be treated, we believe that we will have created an appropriate environment for all our patients and visitors.

Chaperones
All patients may request the presence of a chaperone during any consultation, examination or procedure. If you feel you would like a chaperone to be present during a consultation or examination please mention this at any time during your treatment at DDRC.
In the interests of both patients and clinicians it is the policy of DDRC to provide female patients with a chaperone when undergoing an examination or procedure of an intimate nature by a male clinician (doctor, nurse or other healthcare practitioner). Following the examination a separate opportunity can be provided for private conversation between the patient and doctor.
Patients are advised that they may decline the presence of a chaperone but they will be asked to sign a DDRC disclaimer to this effect. Chaperones will either be qualified nurses or other healthcare staff who have received training for this role.

And Finally..
We look forward to welcoming you to our centre and the treatment you will be receiving. We hope that the information on this page has answered your questions about our centre and the treatment you, your relative or friend will be receiving.
However please do not hesitate to ask any member of staff any questions that you may have and they will be pleased to help you where they can.
Patients, their friends and relatives are at liberty to read any of DDRC’s policies and procedures. If you wish to do so at any time please ask at the DDRC Reception.
Please remember that it is the policy of the NHS and DDRC to treat every patient’s condition and any information regarding a patient in a confidential manner. As you will associate with fellow patients and their families, please remember to treat any information you may gain in the same confidential manner. If you have any concerns, please speak to any member of staff.
If you would like to comment on the usefulness of this web page, or suggest further topics for inclusion please email This e-mail address is being protected from spam bots, you need JavaScript enabled to view it or let a member of staff know while you are at DDRC - Thank you

The Aims and Objectives of the Diving Diseases Research Centre
To work within the charity’s Memorandum and Articles and as a provider of health care to comply with the following ideals:

• To provide high quality care for patients referred to the centre for hyperbaric oxygen therapy (HBOT) and/or wound care in the clinical areas recommended by the Undersea and Hyperbaric Medical Society
• To undertake research into the effects of altered pressure environments on the human condition; and with ethical approval and in collaboration with NHS and non-NHS professionals, through Evidence Based research provide HBO therapy for patients with medical conditions that may improve through HBO treatment
• Provide an environment of education and learning for all patients and staff, students and visitors, in order to enhance each person’s experience and advance the role of HBO therapy in UK medicine
• As a charity to undertake appropriate fundraising activities to fund further research
• The charity aims to work in a collaborative fashion with partners and tenants to improve the scientific and medical environment both locally and nationally. To that end they will choose tenants with this in mind

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Patient Information regarding a Complaint
We hope that the situation never arises, but if you do find yourself in the position where you feel that you wish to make a complaint about anything to do with your treatment or stay here at DDRC, we would like to help and hopefully resolve the situation as quickly as possible.
In the first instance please share your concern with either your doctor, nurse or a chamber team member, who will do their best to help you. If this is inappropriate or fails to get the result you desire, please ask to speak to one of the management team, who will speak to you as soon as possible, and make every effort to deal satisfactorily with your complaint. If you are not satisfied with the results please put your complaint in writing to the Chief Executive, or ask a friend or relative to speak or write on your behalf. Your complaint will be treated in confidence and dealt with under our Complaints Procedure which is available for you to see from the Administration Office.
If all the above fail to satisfy you please contact the Healthcare Commission, with whom we are registered and by whom we are inspected. They can be contacted at the address below:

Healthcare Commission
Dominion House
Lime Kiln Close
Stoke Gifford
Bristol BS34 8SR
Tel: 020 7448 9200
Fax: 020 7448 9222
Helpline: 0845 6013012
http://www.healthcarecommission.org.uk

The services provided at the Hyperbaric Medical Centre are usually paid for by the NHS, and if you prefer to complain to the commissioner of the services please contact:

The Complaints and Litigation Office

Plymouth PCT
Nuffield Clinic
Lipson Road
Plymouth
PL4 8NQ
Telephone: 01752 314167
Email: This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

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