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The National Fire Protection Association (NFPA), specifically NFPA 99, sets fire safety standards for hyperbaric facilities. It governs oxygen limits, approved materials, and fire suppression systems.

Type II decompression sickness involves the central nervous system, spinal cord, or cardiopulmonary system. Symptoms include weakness, numbness, paralysis, bladder dysfunction, and in severe cases, cardiopulmonary collapse (“chokes”). Type I DCS usually presents with musculoskeletal or skin symptoms. Pulmonary barotrauma relates to lung overexpansion injuries, and nitrogen narcosis is a depth-related narcotic effect. CHTs must recognize Type II DCS as a medical emergency requiring immediate recompression therapy, usually with U.S. Navy Table 6.

At oxygen partial pressures above 1.6 ATA, the risk of CNS oxygen toxicity increases significantly. Symptoms include twitching, nausea, visual changes, and seizures. Monitoring and air breaks help reduce risk.

Petroleum-based ointments are highly flammable, and in oxygen-enriched hyperbaric environments, their ignition temperature is significantly reduced. Even small amounts applied to patient skin, dressings, or equipment pose a serious fire hazard. Instead, only water-based or chamber-approved lubricants and dressings should be used. CHTs are trained to inspect patients and remove all petroleum-containing substances before treatment. This practice is part of universal precautions and NFPA fire safety protocols.

The U.S. Food and Drug Administration (FDA) regulates hyperbaric chambers as Class II medical devices. They oversee approval, marketing, and labeling of chambers for medical use. OSHA regulates workplace safety, NFPA sets fire safety standards, and CDC provides public health guidelines but does not regulate devices. CHTs must be familiar with FDA requirements to ensure compliance in their practice setting.