Hyperbaric Oxygen Therapy (HBOT) – Minor Consent & Overview
Introduction / Purpose
Hyperbaric Oxygen Therapy (HBOT) for minors is intended to:
- Promote tissue repair and healing
- Increase oxygen delivery to blood and tissues
- Support recovery from injury, inflammation, or chronic conditions
- Enhance overall wellness and performance
Treatment Overview / How It Works
- Patient enters a pressurized chamber to breathe 100% oxygen
- Session length is typically 60–90 minutes
- Treatment frequency is determined by medical evaluation (commonly 2–5 times per week)
Contraindications & Warnings
HBOT may not be suitable for minors with:
- Untreated pneumothorax (collapsed lung)
- Certain respiratory illnesses (e.g., severe asthma, COPD)
- Severe congestive heart failure
- Claustrophobia (unless managed appropriately)
- Pregnancy (if applicable for older minors)
Precautions:
- Ear barotrauma may occur
- Proper monitoring is required for patients with seizure disorders, sinus infections, or respiratory illness
Possible Risks / Side Effects
- Mild: Ear pain, sinus discomfort, temporary vision changes, fatigue
- Moderate: Claustrophobia, temporary lightheadedness, chest discomfort
- Rare/Serious: Oxygen toxicity (lung or CNS effects), seizures, barotrauma (ear, sinus, lung injury)
Pre-Treatment Instructions
- Avoid alcohol and caffeine 24 hours prior (if applicable by age)
- Avoid smoking or second-hand smoke exposure
- No oils, lotions, or flammable substances on skin
- Eat a light meal; avoid heavy meals immediately before session
During Treatment
- Patient will be continuously monitored
- Communication maintained via intercom
- Pressure and oxygen levels adjusted gradually
Post-Treatment / Aftercare
- Gradual decompression to avoid adverse effects
- Hydrate and rest as needed
- Report any unusual symptoms immediately
Guardian Responsibilities
- Provide accurate health information for the minor
- Ensure pre- and post-treatment instructions are followed
- Report any side effects or concerns immediately
Acknowledgment & Consent
- I, the guardian, understand the purpose, risks, benefits, alternatives, and potential side effects of HBOT for my minor.
- I voluntarily consent to HBOT for my child at AI Wellness Center of Excellence.
- I acknowledge that results may vary and no guarantees are made.
- I release AI Wellness Center of Excellence, its providers, staff, and affiliates from any liability, except in cases of gross negligence or willful misconduct.
- I consent to photographs or recordings of my child for medical documentation, education, or promotional purposes if applicable.
