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Hyperbaric oxygen therapy (HBOT) involves exposing the body to a pressurized environment at a minimum of 1.4 atmospheres absolute (ATA) with 100% oxygen inspiration.[1] Selecting an appropriate treatment plan requires considering both the potential risks and benefits.[2] Although HBOT is generally well tolerated, candidates, especially those with chronic medical conditions, should undergo thorough evaluation before initiating treatment.

HBOT indications should be carefully evaluated against potential contraindications to ensure that the expected benefits outweigh the associated risks.[33] Interprofessional collaboration is crucial for assessing contraindications and determining whether HBOT is appropriately indicated. HBOT is used in both emergent and elective settings. The roles of healthcare professionals can vary significantly. In emergencies, earlier initiation is associated with improved outcomes.[34] Although emergency physicians typically make the final decision regarding emergent HBOT, nurses, radiologists, emergency medical personnel, and pharmacists play vital roles in identifying contraindications. Emergency medical personnel are responsible for obtaining the initial history, which may reveal indications for emergent HBOT, such as diving injuries or carbon monoxide toxicity. Radiology staff must review prior imaging for abnormalities, such as pulmonary nodules, that may contraindicate elective HBOT. In emergent situations, radiologists are vital in ruling out tension pneumothorax, the only absolute contraindication to HBOT. Pharmacists and pharmacy staff are vital in reviewing a patient’s medication regimen to ensure the safe administration of HBOT in conjunction with other medical interventions, such as cancer chemotherapy. Nurses play a crucial role in monitoring patients for adverse reactions and ensuring their safety and well-being throughout the HBOT treatment process. For elective HBOT, primary care providers must evaluate medical conditions that could serve as relative contraindications, including claustrophobia, upper respiratory infections, diabetes, eustachian tube malformations, and chronic respiratory diseases. Continuous monitoring of comorbidities is necessary to mitigate potential risks associated with HBOT. The Oxford Centre for Evidence-Based Medicine (CEBM) has established evidence levels for HBOT based on specific conditions, including gas embolism, radiation injury, and refractory osteomyelitis.[35][36][37] This framework allows clinicians to make informed decisions about the use of HBOT, ensuring its appropriate use based on the quality of evidence available for each condition.