CARSON CITY — Over the past few weeks, the Nevada Division of Public and Behavioral Health (DPBH) has collaborated with other state and local agencies and licensing boards to review public health and safety concerns of cryogenic chamber machines, also called a cryosauna. DPBH has conducted site visits to the known open facilities that have the machines and consulted with a major distributer of the machines in the United States, CryoUSA, located in Dallas, Texas.
Based on these findings, DPBH has developed the following guidelines approved by the Chief Medical Officer that outlines the expected standards related to the use of cryogenic chamber machines in the state. These guidelines set standards expected in Nevada and provide information on the use of these machines for consumers so they can make an informed decision about using the machine. Guidelines are not considered law; however, they should guide practice. The guidelines are as follows:
Age: The cryogenic chamber should not be used by minors. Industry standards reflect it should not be used by youth under the age of 14 or 16 years; however, DPBH would not recommend use by minors under the age of 18 years.
Height: The client must be above the level of gas/fog produced in the machine to use. This is often a height of at least 5 feet.
OHSA Requirements: The facility must meet all OSHA requirements. This includes, but is not limited to, posting necessary signage, hazard communication training, and handling of the nitrogen tanks. They also must operate with the current liability and workers compensation coverage.
Usage: The facility should always adhere to the manufacturer’s recommendations on usage of the machine. A client should not be allowed to use the cryogenic chamber for more than three minutes a session and one session per day as a general standard. Some providers allow a client to use it twice per day. Between sessions, the employee must ensure the client’s temperature has reached a normal range prior to the next session. The machine should never be operated by a person on themselves. It should have a well-trained employee operating the machine for the client. The client should not have any jewelry, moisture, or products on their body before entering the machine (perspiration, cosmetics, lotion, perfume, etc.). The client must wear socks or slippers, gloves, and briefs for men each session, ideally made of cotton and wool.
Screening: Any person considering using a cryogenic chamber should consult their medical provider prior to use. The blood pressure should be taken on each client before and after session to ensure it is within normal range. A client should not use the machine if they currently have, or have recently had, any of the previous health conditions:
Heart attack or stroke, high blood pressure, pregnancy, seizure disorder, Reynaud’s Syndrome, cold allergies, vein thrombosis or clotting issues, an infection or fever, pacemaker and other implanted medical devices, certain medications, claustrophobia and serious medical condition not already mentioned.
Training: Employees operating the machine should receive comprehensive training on how the machine operates, how to identify an issue with the machine, how to maintain and clean the machine, what to do if the machine is malfunctioning, and employee and client safety. Some distributers require training and testing for all operators and issue a certificate of completion prior to operating the machine for a client.
Waiver and Client Education: The facility should provide a waiver to clients that clearly outlines what the procedure can provide, the risks of using the machine, the safety instructions, and contraindications. It should also note that it is not a medical procedure and cannot be used to treat a medical illness or condition. The facility should not promote outcomes of the procedure that have not been scientifically evaluated, as this is confusing and misleading to the client.
Signage: It is recommended that beyond the required signage for OSHA, there is signage that notes the machine is not a medical device and should be used at the risk of the client. It should note that exposure to liquid nitrogen by the employee or client can cause severe burns to the skin, light-headedness, fainting, and asphyxiation.
Other: The facility should have a defibrillator and emergency kit onsite and provide regular employee training for use.
Employees should also have CPR training. There should be a nitrogen monitor in the room to ensure levels are within a safe range.
Chief Medical Officer Dr. Tracey Green reminds Nevadans that, “You should always consult with a licensed medical provider before engaging in any procedure that may affect your health.”
For more information about the Division of Public and Behavioral Health, go to http://dpbh.nv.gov/.