Guide for Parents with Children Undergoing HBOT
Hyperbaric oxygen therapy can make a great contribution to your child’s development and health if he or she is the right candidate for therapy. For children under the age of 8, despite the obvious benefits, there are challenges to administering the therapy and fulfilling the requirements in a way that the child has optimal results. Some points will be discussed to inform you how with a mutual cooperation, we can make your child’s experience in the hyperbaric chamber a good one.
- Preparing your child for this experience – Just like adults, it is easier if you first explain and attempt to ensure cooperation from your child. Children, regardless of age or maturity level, act a little differently when you get them in the hyperbaric facility. They either freeze or are all over the place and hard to keep still. It is important for them to understand what they will be going through, and you must explain to them the whole procedure to make them comfortable. You can encourage participation with games, or choices of videos/toys that the child is comfortable with.
- Preparing for the initial consultation – Please bring a list of:
- All your child’s medical conditions;
- All your child’s medications (whether prescribed, naturopathic, homeopathic, or food supplementation, IV (such as chemotherapy);
- All medical devices attached to his body (including but not limited to NGT, PICC lines, porta-cathethers, foley catheters, insulin pumps, pace makers);
- Medical procedures within the past 6 months (including surgery, a biopsy, injections in the eye, radiotherapy, etc.);
- Results of any laboratory exams or medical imaging/diagnostics done within the past 6 weeks relevant to his case.
- Preferred clothing and materials – You may bring your own set of 100% cotton clothing, socks, and a small blanket for your child for improved comfort. These may be left in his cubby to ensure accessibility during the therapy session. For children that are toilet-trained, pure cotton underwear is necessary. For children who are not toilet-trained, disposable diapers may be allowed inside the chamber, provided that they do not have any velcro attachments. Pull-up diapers are preferred. If only diapers with velcro are available, the technician may cut out the Velcro, and replace it with medical tape. A cloth is allowed inside the chamber but no paper or tissue.
- Putting your child more at ease - Having an adult (preferably a parent) inside the chamber with the child is a big help. We will make him feel more involved by allowing him to first observe pre-therapy examination on his accompanying adult. Certain types of soft toys and feeding bottles/pacifiers can be allowed inside the chamber, but no hard shell (might damage the acrylic window), battery-operated or velcro. Preferred music or videos can be played over the media player to facilitate the comfort in the new environment. These are most especially important for the child’s first dive, because this session sets the tone for all succeeding sessions.
- Preparing for the actual therapy sessions – Do not give carbonated beverages to your child within 1 hour of HBOT to avoid stomach gas and pain. Avoid giving foods and beverages with caffeine. Tell the therapist if your child did not sleep through the night before. Electronic devices (like iPods, toys with batteries, tablets); Velcro (like those in disposable diapers); or papers (including toilet paper/tissue or wet wipes) are NOT allowed inside the chamber. Water wetted cloth is allowed but no other evaporating solution. Have your child eat a meal or feed within 2 hours before therapy. Decongestant may be given prior to HBO if needed, to reduce problems when equalizing.
- Physical or Chemical Restraints – Some cases will need a form of restraint appropriate for your child’s development to be applied. These restraints may either be physical (like a papoose board), chemical (such as diphenhydramine syrup) or both. For chemical restraints, the child’s family doctor or pediatrician must prescribe this; and the baby’s parent/ caregiver must administer it prior to therapy. Hyperbaric staff does not administer chemical restraints. It is important that you pay attention to your child’s breathing during the therapy, as a restrained child cannot guard his airway.
- Observing your child’s health prior to and during the treatment period – Watch out for complications of therapy and other “minor” medical conditions that potentially may complicate the therapy sessions or course of therapy. Is your child irritable? Does he have a cough? Does he have a runny nose? Does he tug his ear a lot? Does he sneeze often? Does he complain of pain in any part of his body? Will he be having any procedure during therapy (like surgery, a biopsy, injections in the eye, radiotherapy)? Will there be any changes in his medication (especially medications like steroids, insulin, hormone supplements, or blood thinners)? If any medication is changed/added, procedures are performed, or any medical concerns arise during therapy, please inform the therapist immediately so that the proper evaluations and adjustments of the protocol can be made prior to proceeding.
- Scheduling therapy sessions – Therapy has best results when taken in successive days. Ideally therapy is given daily on weekdays, with weekends to rest. It is recommended to schedule the therapy sessions at the same time every day to facilitate adaptation of the child to his new routine and environment. If coming from outside Metro-Vancouver, therapy cycle may be shortened by scheduling sessions twice a day and during the weekends. This is done by appointment only and is subject to availability of the hyperbaric team (though most requests are easily accommodated). Protocols for certain medical conditions may call for twice a day dosing. Twice daily sessions may also be scheduled, and the latter session should be at least 4 hours after the end of the first session.
- Required number of sessions, Rescheduling and Cancellations – Therapy for most children will require somewhere between 40 and 80 sessions, depending on the medical condition and on the ability of the child to respond to therapy. Rescheduling and cancellations must be done at least 24 hours before the scheduled therapy. The facility reserves the right to charge the full amount of the therapy for cancellations done on the same day or if no notice is given for an absence from therapy.
- Positive Reinforcement – You may encourage your child to complete his sessions by giving him some form of incentive for good behavior such as: giving a high five, offering praise, giving a hug or pat on the back, giving a thumbs-up, clapping and cheering, telling another adult how proud you are of your child’s behavior while your child is listening.
- Accompanying adult – One of the child’s parents is the most preferred accompanying adult. The adult needs to likewise undergo the clearance consultation and will need to prepare the same information about his medical state as the child being taken into therapy. It is recommended that the same adult accompany the child throughout the therapy if possible. This is to ensure consistency and better ability for the child to adapt to the new routine and environment. It is preferred that an adult, who is well known by the child, with a calm demeanor, knows how to care for the child, and who has minimal risk of claustrophobia or nasal congestion be the accompanying adult. This is also to ensure the comfort and safety of the adult, as he is also considered a patient.
