Evaluation of any post-dive change in the patient's condition, such as new onset of pain, shortness of breath, or a change in mentation, to determine if that symptom or sign might be due to decompression sickness or arterial gas embolism incurred during the hyperbaric treatment. If either is the cause, immediate recompression of that patient on an emergency basis is required. Re-evaluation of the condition of reimplanted digits or limbs, or skin grafts or flaps that are being treated on an emergency basis for salvage, and then communication with the attending surgeon to relate these findings so an updated treatment plan can be followed. If a patient has undergone inadequate or omitted decompression, the hyperbaric physician determines if the patient needs immediate recompression, and if so, under what treatment protocol and breathing gas mixture. This procedure must be carried out immediately, because the decision is extremely time urgent and there are multiple options for this treatment, depending upon the presence or absence of symptoms and physical findings.
Contact is made with the attending physician if any unexpected event occurs during the treatment.
Appropriate referrals for the management of any new problems, such as seizures, are made by direct contact with the appropriate specialist, by telephone or in person. Prescription of any ancillary treatment needed by the patient such as whirlpool, physical therapy, occupational therapy, or diabetes training. Preparation of the medical records of that patient, and the documentation of those findings that would need to be known by any other physicians caring for that patient. Coordination with other physicians concerning the other aspects of the patient's care, such as the scheduling of surgery, based upon any new findings. Determination of whether the patient may be converted to outpatient or skilled nursing facility status, and the facilitation of that change.