A plain-language guide for patients and referring providers across the Greater Toronto Area.
Hyperbaric oxygen therapy (HBOT) is often described in one simple line: “you go into a chamber and breathe oxygen.” That is true, but it is only the surface. In real medical practice, HBOT is highly organized around defined pressure levels, set session durations, safety checks, medical examination, purpose-based planning, and continuous monitoring. HBOT is not only about oxygen — it is about protocol.
At Champagne Hyperbarics, patients are cared for in a clinical environment that offers medically guided HBOT alongside wound management, serving patients across the Greater Toronto Area (GTA) who may need HBOT for non-healing wounds, delayed radiation injury, sudden sensorineural hearing loss, compromised skin grafts or flaps, and other recognized conditions. Before treatment, one question matters most: Is HBOT being delivered according to proper clinical guidelines?
This article explains what those guidelines and protocols are, why they exist, and what they mean for you.
HBOT is a medical treatment, not a wellness trend
HBOT involves breathing oxygen inside a pressurized chamber. Under pressure, more oxygen dissolves into the bloodstream and plasma, which can help oxygenate tissue that is damaged, infected, inflamed, or slow to heal. According to Health Canada, during HBOT the chamber is pressurized and the patient breathes 100% oxygen for a set period of time — compared with the roughly 21% oxygen in the air we normally breathe. We only use hyperbaric chambers which are accredited by Health Canada.
Health Canada recognizes HBOT as effective for 14 specific medical conditions, including carbon monoxide poisoning, decompression sickness, gas gangrene, diabetic foot ulcers (to enhance wound healing), delayed radiation injuries, skin grafts and flaps that are not healing well, thermal burns, idiopathic sudden sensorineural hearing loss, air or gas embolism, crush injury and related acute traumatic ischemia, exceptional blood loss, intracranial abscess, necrotizing soft tissue infections, and osteomyelitis. Fourteen recognized conditions means HBOT has defined medical uses — it is not a general “oxygen boost.”
How the oxygen is delivered is part of the treatment. The Undersea and Hyperbaric Medical Society (UHMS) notes that scientifically supported hyperbaric treatments are usually delivered at pressures between 1.9 and 3.0 ATA, depending on the disorder and the treatment regimen. Professional supervision matters because the diagnosis is what determines the dose: the pressure, the session length, and the overall plan are clinical decisions, not guesswork.
What clinical guidelines actually do
Clinical guidelines give a care team a shared framework for delivering safe, consistent treatment. In practical terms, they help answer questions such as:
- Who should be considered for HBOT, and what conditions qualify?
- What pressure should be used, and how long should each session last?
- How many sessions may be appropriate?
- What risks and contraindications should be screened for?
- How should progress be measured over time?
The UHMS describes its Clinical Practice Guidelines (CPG) program as a project to create guidelines for each HBOT indication — guidelines that are independent of reimbursement restrictions and are meant to supplement the society’s indications manual. In Canada, the Canadian Undersea and Hyperbaric Medical Association (CUHMA) promotes excellence in hyperbaric medicine through education, the promotion of best practices, and advocacy for patients. Guidelines like these are best understood as a safety net, not red tape.
Why protocols matter before treatment begins
A strong protocol starts well before the chamber. A careful review typically considers your medical history, diagnosis, current medications, imaging, wound notes, referrals, and relevant background such as diabetes, prior radiation, surgical history, hearing tests, and infection status.
Pre-treatment screening also looks for safety issues that may need attention first, such as ear or sinus problems, certain lung conditions, implanted devices, uncontrolled fever, claustrophobia, or new symptoms. This step helps ensure that HBOT is appropriate for you specifically. At Champagne Hyperbarics, patients can be referred by a provider or can self-refer for an evaluation — a helpful starting point when it is not yet clear whether a condition fits the guidelines.
Protocols are condition-specific
One of the biggest misconceptions is that every patient is treated the same way. They are not. A diabetic foot ulcer is approached differently from sudden hearing loss; delayed radiation injury is different from a weak surgical flap; and emergencies such as carbon monoxide poisoning or decompression sickness are prioritized differently from chronic wound care.
A closer look at diabetic foot ulcers
Diabetic foot ulcers are a useful example because they are complex and common. Wounds Canada is a leading Canadian authority on wound prevention and management, and the wider clinical literature consistently describes diabetic foot ulcers as a major driver of lower-limb complications. A chronic wound can affect mobility, independence, infection risk, the likelihood of hospitalization, and overall quality of life — which is exactly why structured wound-care procedures matter.
For selected patients, hyperbaric oxygen may have a role. A UHMS Clinical Practice Guideline for diabetic foot ulcers found a moderate level of evidence supporting the addition of HBOT to standard care to reduce the risk of major amputation and incomplete healing in certain patients described as a conditional recommendation. This does not mean every wound is suited to HBOT. Proper screening and protocol are what help identify the patients most likely to benefit.
What an HBOT session is like
During treatment, the chamber is gradually pressurized. Patients may feel pressure in the ears, similar to the feeling on an airplane, and the team explains how to equalize. HBOT sessions commonly last around 90 to 120 minutes, and Champagne Hyperbarics monitors patients closely throughout; for most people the treatment is well tolerated and generally painless.
Behind the scenes, structured protocols guide pressurization, oxygen exposure, monitoring, communication, and decompression. The experience should feel calm for the patient and structured for the team.
Safety rules are part of the treatment
Before a session, patients are asked to avoid certain products and items. According to Health Canada, high concentrations of oxygen at elevated pressure pose a fire risk, and hyperbaric chambers are licensed medical devices. That is why preparation instructions are taken seriously.
Typical preparation guidance asks patients to avoid items such as hair products, deodorant, makeup, oils, petroleum jelly, perfume, and nail polish, and to leave behind hearing aids, Bluetooth devices, jewellery, and certain medical patches. Your clinical team will confirm the exact list that applies to you. In a pressurized oxygen environment, being strict about these details is a good thing.
HBOT works best as part of a bigger plan
Guidelines are clear that HBOT is adjunctive — it supports the main treatment plan rather than replacing it. It does not replace wound care, antibiotics, surgery, diabetes or vascular care, oncology follow-up, or ENT care. Chronic wounds, for instance, also need appropriate dressings, offloading, infection prevention, blood-sugar management, nutrition, and circulation assessment. Champagne Hyperbarics offers wound-care services alongside HBOT, which can help make the overall journey feel more connected.
How progress is tracked
Protocol does not end after the first appointment. The team monitors how a patient responds over time. For wounds, that may include size, tissue quality, drainage, pain, signs of infection, and photographs or measurements. For hearing loss, it may include hearing tests and symptom tracking. For radiation injury, it may include symptom tracking with specialist input.
Sometimes treatment continues as planned, sometimes the plan is adjusted, and sometimes another provider becomes involved. Ongoing review is part of responsible HBOT care.
The bottom line
Clinical guidelines and protocols are what make HBOT safe, structured, and medically meaningful. They help ensure the right patient receives the right treatment, at the right pressure, for the right amount of time, with the right monitoring. At Champagne Hyperbarics, HBOT is approached as a considered clinical process, with patient safety, wound care, and evidence-based decision-making at the centre. In hyperbaric medicine, oxygen matters — but how it is delivered matters just as much.
Frequently asked questions
- Are the protocols the same for every patient?
No. Protocols vary based on your diagnosis, your safety considerations, your treatment goals, and how you respond. A plan for a diabetic foot ulcer is not the same as a plan for sudden hearing loss. - How long is an HBOT session?
Sessions commonly last around 90 to 120 minutes, and patients are monitored throughout. Your care team will confirm the schedule that applies to your treatment. - Why do I need to be assessed before HBOT?
An assessment helps determine whether HBOT is medically suitable and safe for you, and it allows the team to build a plan around your specific condition and history. - Is HBOT used for all conditions?
No. Health Canada recognizes HBOT for 14 specific conditions. Whether HBOT is appropriate — and whether it may be covered — depends on your diagnosis, supporting documentation, and clinical assessment.
Medical disclaimer
This article is for general educational purposes only and is not medical advice. It does not establish a doctor–patient relationship and should not replace consultation with a qualified healthcare professional. Hyperbaric oxygen therapy is an adjunctive, evidence-based treatment for specific recognized conditions; it is not a guaranteed cure, and individual results vary. Always consult a physician about your own diagnosis, treatment options, and whether HBOT is appropriate for you.
References
- Health Canada. Hyperbaric oxygen therapy. canada.ca — Hyperbaric oxygen therapy
- Undersea and Hyperbaric Medical Society (UHMS). HBO Indications (including scientific definition and pressure range). uhms.org — HBO Indications
- Undersea and Hyperbaric Medical Society (UHMS). Clinical Practice Guidelines program. uhms.org — Clinical Practice Guidelines
- Undersea and Hyperbaric Medical Society (UHMS). Clinical Practice Guideline for Diabetic Foot Ulcers (UHM 42-3). uhms.org — CPG for DFU (PDF)
- Wounds Canada. Wound prevention and management resources. woundscanada.ca
- Canadian Undersea and Hyperbaric Medical Association (CUHMA). Promoting excellence in hyperbaric and diving medicine. cuhma.ca
- Champagne Hyperbarics. Clinic services and patient information. champagnecentre.com
