Pressure critical for hyperbaric oxygen treatments

court order that will direct that the report may be "discovered" for the purpose of its review by legal counsel for the plaintiff or "admitted in evidence" for the evaluation and information of a jury in malpractice litigation. Courts are generally reluctant to allow such inspection or use of incident reports and a majority of the courts that have addressed this problem are still in general opposition to any request for "discovery" or "admission into evidence" of incident reports. There is a trend, however, developing that warrants the concern of surgeons expressed in your question above. The complication related to incident reports lies in the fact that the preparation of such reports is not altogether optional as a practice. Casualty insurance companies that provide professional liability (malpractice) insurance for hospitals insist upon being promptly notified regarding the happening of any untoward accidents. Hence the mandatory requirement for incident reports and the corresponding care that must be exercised because of the possibility that a particular incident report may be subject to the inspection and scrutiny of adversary parties. As to the refusal of some physicians to participate in the preparation of the incident report, your hospital may have a disciplinary problem as it relates to such physician's responsibility to conform to the rules and regulations of the hospital. Aside from that, the incident report that does not contain a surgeon's note andlor signature may be nevertheless completely adequate for the primary purpose intended, that is providing information to the hospital's insurance company. The incident report would meet the usual test of legal sufficiency without the participating note and signature of the physician of record.

William, A Regan, JD Managing partner Regan, Carberry, Flynn, and Gelineau Providence. RI If you have questions on OR nursing law you would like answered, please send them to William A Regan, JD, c/o AORN Journal, 10170 E Mississippi Ave, Denver, Colo 8023 1. Questions of general interest will be selected for replies in this column. Other questions will not be answered. Questions will not be acknowledged or returned.

Pressure critical for hyperbaric oxygen treatments I have received several positive responses to the article in the October Journal on how hyperbaric oxygen (HBO) treatments affected my symptoms of multiple sclerosis. However, I do want to correct what I told you on the pressure in the chamber. Many people and even baromedical physicians share confusion over the pressures. In the article, I mentioned pressure goes up to 70 feet under water. This is in error. ATA (atmospheres absolute) in hyperbaric medicine is preferred to feet or other terms. One must not abbreviate this to "atmospheres" as it might cause further confusion. (Editor's note: one atmosphere absolute = sea level pressure; two atmospheres absolute = 33 feet of sea water pressure; three atmospheres = 66 feet of sea water pressure.) The pressure used in hyperbaric oxygen for multiple sclerosis patients is critical; if too much pressure is used, their condition may deteriorate. At 1.5 ATA to 2.0 ATA, none of the more than 400 MS patients treated at the Ocean HBO Center in Lauderdale-by-the-Sea (Fla) suffered deterioration in conditon. Richard A Neubauer, MD, at the center, has offered to send a protocol to any interested professionals. His address is Ocean HBO Center, 4001 Ocean Dr, Lauderdale-by-theSea, Fla 33308. Gloria S Rogers, RN Marlboro, Mass The AORN Journal welcomes letters from its readers on subjects of interest to OR nurses. Letters should be typed and should include the writer's name, full title, and address The Journal reserves the right to edit all letters.

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