Tobago's Hyperbaric or Recompression Facility - Roxborough Hyperbaric Facility (RHF)

Tobago's Hyperbaric or Recompression Facility is housed at the Roxborough Medical Clinic, which is a drive of about 20 minutes from Speyside and about 40 minutes from Scarborough. The Facility is operated jointly by A.T.D.O., the Tobago House of Assembly and T.D.C. (the Tourism Development Company).

The Roxborough Hyperbaric Facility (RHF) is the only recompression chamber in Tobago. The chamber at the facility is used to treat mainly decompression illness/ sickness from diving, however in the rare case, treatment for other medical conditions such as gas gangrene have been performed using Hyperbaric Oxygen Therapy (HBOT).

The Roxborough Hyperbaric Facility seeks to improve the service offered to the local and international community in all medically approved hyperbaric oxygen therapy. The chamber at the facility is used to treat mainly decompression illness/ sickness and indeed more than 90% of the cases have been this type of ailment; however, in the rare case, treatment for other approved ailments such as gas gangrene have been performed.

Although its primary function is to treat diving emergencies, the facility is also used by the medical community in the treatment of certain medical conditions that benefit from Hyperbaric therapy.

• 
  

  INFORMATION FOR THE PATIENT - FREQUENTLY ASKED QUESTIONS (FAQs)

  • What is HBOT?

    HBOT: Hyperbaric (‘hyper’ – high; ‘baric’ – pressure) Oxygen Therapy as the name suggests, uses high pressure oxygen to treat various ailments. The approved ailments include:

    • Air embolism
    • Decompression sickness (‘the Bends’)
    • Carbon monoxide poisoning
    • Clostridial myonecrosis (‘gas gangrene’)
    • Severe necrotizing infections/combined synergistic infections
    • Crush injury
    • Burns
    • Severe Haemorrhagic anaemia

  • What is BENDS or Decompression Sickness (DCS)

    Bends, as it is known locally, is also called Decompression Sickness (DCS) and it occurs after a rapid decrease in pressure, normally caused by an uncontrolled or emergency ascent while diving. During deep or long dives, inert gases become absorbed into the body's tissues at higher than normal concentrations. As the diver ascends to the surface, these gases leave the solution and form "micro-bubbles" in the bloodstream which can be exhaled safely through the lungs if the ascent is slow enough. If the ascent is uncontrolled or too fast these micro-bubbles can occur within tissues and organs and can be fatal.

  • The Treatment

    The Chamber Operator describes the treatment to the patient including the length of the treatment and possible discomfort that may be experienced. The patient is then introduced to the inside tender. Certain things are not allowed into the chamber as they may present a fire hazard and these are removed before treatment. These include:

    • All jewelry
    • Alcohol
    • Petroleum Grease
    • Greasy foods
    • Lighters

    During the treatment the Chamber Operator and the doctor monitor the patient’s condition for signs of improvement. After the treatment the patient is monitored and is not allowed to leave the facility until at least 30 minutes have passed. The staff of the facility continues the monitoring the day after the treatment.

  • How long does a typical treatment last?

    The length of a treatment depends on the patient’s complaint as this would determine the amount of time on oxygen and “air breaks” the patient needs. The most typical treatment done at the Roxborough Hyperbaric Facility is for TYPE 2 Decompression Sickness using the United States Navy Dive Table 6. This lasts for approximately 4 hours and 45 minutes.

  • What happens if I need to use the bathroom?

    The chamber at the Roxborough Hyperbaric Facility is a double lock chamber. If you need to use the bathroom a portable potty is passed into the outer lock. You are asked to go into the outer lock and door between the inner and outer lock are closed. In this way you are given some measure of privacy while you use the “bathroom”.

  • Can I have something to eat or drink while undergoing treatment?

    Yes. Food is passed into the chamber for you to eat. The inside tenders carry water into the chamber with them at the start of the treatment.

  • Am I allowed to read or sleep while in the chamber?

    The RHF Manager prefers that you remain awake and that patients do not read during treatment.

  • What are the side effects of the treatment?

    One of the main side effects is the feeling of pressure on your ear, much like when you are traveling in a plane or diving. To relieve this you can do the following:

    • Swallow
    • Work your jaw back and forth or side to side
    • Simulate chewing

    You should feel your ear “pop” and in this way the pressure is relieved. (Sometimes all three at the same time helps). Other side effects include lung irritations from the amounts of oxygen inhaled.

  • Examination

    Upon arrival a report on the incident is taken. The patient is given a simple neurological examination if necessary by the facility manager and is examined by the doctor. The doctor determines the type of illness and recommends the appropriate table to be followed.

  • Payment

    The patient or designate is asked about method of payment. If paying by insurance, the information is taken and verified before the start of the treatment. If paying with cash, a receipt is given after payment is received.

Diving Emergency Protocol

Courses offered at the Roxborough Hyperbaric Facility include:

• Inside attendant courses (minimum of 6 participants for the course to be run)
• Diver’s Alert Network On- Site Neurological Examination
• Emergency First Response Primary and Secondary Care
• Emergency First Response Care for Children
• Basic Chamber Operation

Contact Details

Roxborough Hyperbaric Facility
c/o Department of Marine Resources and Fisheries
Ground Floor, TLH Building, Milford Road, Scarborough, Tobago
Tel: (1-868) 639-4354/4446/1382 or 660-4000
Fax: (1-868) 639-1382
Email: kirw...@hotmail.com or divi...@yahoo.com