Program Curriculum Goals
At the completion of the fellowship, the hyperbaric fellow will:
Develop the knowledge base and clinical skills necessary to:
Discuss investigational indications for the use of HBO and areas of future research.Develop requisite academic skills to be an effective researcher and teacher in diving and hyperbaric oxygen therapy.
- Evaluate and prescribe appropriate HBO therapy for all the medical conditions currently accepted by the UHMS as amenable to hyperbaric oxygenation.
- Manage patients during hyperbaric treatments.
- Evaluate and treat diving related illnesses.
The HBO fellowship will provide the following experiences to achieve curriculum goals:
HBO clinical service
- HBO clinic
- Supervision of daily chamber operation and treatments
- HBO emergency call
- HBO consultation service
- Participation in diving medicine clinic once per week
- Didactic curriculum and HBO core lecture series.
- Development of HBO lectures for core curriculum, community hospitals
- Monthly HBO journal club
- Monthly HBO case conference
- Required HBO research project to be completed within the one year term
- Participation in UHMS
- Submission of research for presentation at the annual UHMS meeting
- Participation in the San Diego Diver Death Committee for the investigation of diving fatalities.
- Participation in the Scripps Institute of Oceanography Diving Program.
- Rotation at UCSD Hillcrest and Encinitas Wound Centers
- Opportunities for clinical elective experience with the US Navy, NOAA Aquarius Habitat, UCSD Center for Diving Excellence, etc
- Participation in UHMS Physician Training in Diving Medicine
Instructional Objectives for Fellowship Training
- List the approved indications for hyperbaric oxygen therapy
- Cite the contraindications and side effects of HBO
- Describe the physiologic effects of HBO by providing a one hour lecture for students/residents
- Provide a brief description of the history of hyperbaric medicine
- Evaluate patients and decide whether HBO therapy is appropriate
- Prescribe the correct HBO treatment protocol for a given indication
- Perform noninvasive measurements of tissue oxygenation and use the results to predict which patients might respond to HBO
- Obtain informed consent following discussion with patients regarding risks and benefits associated with HBO therapy.
- Demonstrate operation of all equipment commonly used in the multiplace HBO chamber
- Discuss monoplace operation and emergency procedures
- Describe the care of critically ill and injured patients in the chamber, and perform appropriate management including patient monitoring, use of medications under pressure, airway, ventilatory, and cardiovascular support
- Discuss factors that will enhance outcome of chamber resuscitations
- Cite methods of psychological preparation and support for pediatric and adults undergoing HBO treatments
- Discuss investigational areas for the use of hyperbaric medicine
- Design a research project that can be completed within the one year fellowship in one of the investigational areas for HBO
- Identify potential health hazards in recreational divers by performing dive physicals in weekly dive clinics.
- Describe the physiologic effects of pressure and immersion
- Discuss decompression theory
- Describe the pathophysiology and treatment of decompression illness
- Demonstrate knowledge of diving tables and historical features of dive history
- Demonstrate proficiency in a comprehensive neurologic exam
- Demonstrate proficiency in myringotomy and chest tube placement
- Demonstrate appropriate professional conduct, humanistic qualities, and teamwork .
- Surface decompression
Pathophysiology and Treatment of Decompression Illnesses. Signs and symptoms of decompression sickness and AGE
- Bubble detection
- Mixed gas diving
- Altitude diving, flying after diving
Health hazards in divers
- Mechanisms of gas entry and distribution
- Effects of bubbles
- Dysbaric osteonecrosis
- Treatment of decompression illnesses
- Medical examination and standards for hyperbaric exposure: military, commercial, recreational, scientific, hyperbaric personnel.
- Recognition and treatment of hazardous marine life injuries