The British Hyperbaric Association was constituted in 1993 from the organisation called the British Isles Group of Hyperbaric Therapists. Uniquely, the membership of the association is not made up of individuals but of the 26 pressure chamber facilities providing emergency treatment for patients with decompression related illness or other indications for urgent hyperbaric oxygen therapy within the British Isles. The staff within such units are entitled to all the benefits of the Association and individuals otherwise involved in Hyperbaric Medicine can become associate members. The Association has a four-monthly newsletter and we also have a three day annual meeting which this year is on 24,25&26 October 1997 and is being organised by the Wirral chamber on Merseyside.The British Hyperbaric Association was constituted in 1993 from the organisation called the British Isles Group of Hyperbaric Therapists. Uniquely, the membership of the association is not made up of individuals but of the 26 pressure chamber facilities.

The basic aim of the Association is to promote the understanding and safe practice of hyperbaric medicine. To do this the BHA has collaborated with the Faculty of Occupational Medicine of the Royal College of Physicians to produce a code of good working practice for the operation and staffing of hyperbaric chambers for therapeutic purposes. This describes the standards to be expected and categorises therapeutic chamber facilities into one of four classes.

Category 1 Facilities capable of receiving patients, whatever is wrong with them, who may require intensive care as well as hyperbaric treatment.

Category 2 Facilities capable of receiving patients, whatever is wrong with them, who do not need intensive care but otherwise require a lot of medical and nursing support.

Category 3 Facilities capable of receiving emergency referrals of divers and compressed air tunnel workers. These facilities should also be capable of providing elective treatment of residual symptoms of decompression illness.

Category 4 Monoplace chamber facilities capable of receiving elective and emergency referrals of patients in any diagnostic category who are judged by the referring medical officer, on the advice of the hyperbaric physician, not to be likely to require access during hyperbaric treatment. Normally monoplace chambers are not suitable for the immediate treatment of acute decompression illness.

This information for each member chamber, together with their contact details, are compiled into a register of member chambers which is available to all interested parties and is circulated to government agencies and all the purchasers and providers in the UK National Health Service. The register gives referring physicians the information necessary to allow the transfer of their patient to a chamber which can deliver an appropriate level of care. With the code of practice, it also gives purchasers the information necessary to allow quality assurance procedures. At present there is a new register in press which we expect to be available in May 1997.

In the UK, hyperbaric medicine falls uneasily into an area bordered by hospital medicine, occupational medicine, industrial practice and alternative medicine. An appropriate technical standard of practice has therefore been quite difficult to identify. In order to remedy this problem BHA working parties have produced guides to fire safety and electrical safety standards for hyperbaric treatment centres in the UK. Currently, the technical working party is engaged in looking at effective methods of giving 100% oxygen to divers with decompression sickness. Similar problems relate to staff training and Health and Safety issues and the Association is addressing these problems through its Health and Safety and Education working parties. A curriculum for background training for people coming from other disciplines to work in a hyperbaric unit has been compiled and this is in press.

The British Hyperbaric Association also gathers information on hyperbaric medicine practice and over the past three years the Association has recorded the activity of its member chambers .

The bulk of the patient workload at most member chambers in the UK is still the treatment of decompression illness. The majority of these cases are, of course, sports divers but professionals are also treated and at my unit in Aberdeen about 25% of the cases we treated from 1991-5 were professional divers. Many of these divers are self-employed but commercial coastal diving and civil engineering operations which do not require an on-site recompression chamber can be supported by members of the Association who have multiplace chambers, if the availability of the chamber fits what is required by the contractor.

The information that we have gathered also indicates increasing interest in the use of hyperbaric therapy for carbon monoxide poisoning and in radiotherapy affected tissue problems. Carbon monoxide poisoning, of course, is not unknown in divers and if suspected the victim should be referred to a hyperbaric medicine unit for treatment.

The BHA is a small society but it does represent the people that treat decompression illness in the UK. As such, I am sure that our approach may be of interest to the coastal and onshore diving industry. There is also a gathering interest in hyperbaric medicine in the UK and the past two years have seen several new multiplace pressure chamber facilities installed within hospitals with support staff coming from both the health services and the commercial diving sector. As chairman of the Association I would like to extend an invitation to all to come and participate in our next annual meeting and , if possible, to submit a paper or poster or to take up an exhibition stand.

Details of associate membership, BHA publications and the Annual Meeting are available from:

Dr John A S Ross,Department of Environmental and Occupational Medicine,University of Aberdeen Medical School, Aberdeen.

AB25 2ZD. United Kingdom

Fax 44+(0)1224 662990