Clinical Curriculum for Physicians, CHTs, and CHT-I

Goal: Establish an optimum learning environment for the course.

Objectives:  1. Define the purpose and format of the course (clinical HBO).  2. Define the resources to the participants.  3. Distribute training aids and schedules.  4. Introduce staff members and participants.

Introduction to hyperbaric chambers, multi and mono place (diving and clinical).

Calculation of pressures in HBO environment.

Mathematical formulas of the gas laws: Boyle’s law, Dalton’s law, Henry’s law, Charles’ law, and Gay Laussac as they relate to clinical HBO. Medical problems: Barotrauma of the ears, sinuses, and lungs as it relates to HBO patients. Preparing medical equipment for the hyperbaric environment. Management and treatment of extra alveolar air of clinical patients in multi place or mono place chambers.

Practical/operational use of multi and mono place hyperbaric chambers.

Physiological implications and side effects of clinical hyperbaric oxygen. Pathophysiology and management of pulmonary oxygen toxicity. Physiology and management of central nervous system O2 toxicity.

Review of approved (INSURED) FDA AMA HBO clinical indications and non-approved (NON-INSURED).

Decompression sickness of chamber attendants: types, signs and symptoms.

Treatment tables: diving and clinical. The compressing of attendants in multi place air chambers. Explain how gases under pressure act as a liquid and that the same physics and physiology applies in the chamber as in the water.

Latent hypercapnia, physiological and operational implications of carbon dioxide in multi and mono chambers includes proper ventilation; chamber masks, hoods, tents, and ventilators.

Care of medical equipment in the hyperbaric environment, and other ancillary medical equipment.

ADDITIONAL TOPICS TO BE COVERED:

Discussion of current indications for hyperbaric oxygen therapy, discussion of investigation of hyperbaric oxygen indications, hyperbaric chamber operations, screening and regulating organizations, and integument casualties. Hyperbaric emergency procedures, hyperbaric oxygen treatment tables and other treatment philosophies, evaluating the hyperbaric patient, contraindications for hyperbaric oxygen treatment, special considerations during hyperbaric oxygen treatments, hyperbaric oxygen delivery system, hemodynamic monitoring pumps and infusions, and other hyperbaric equipment. Hyperbaric staffing, hyperbaric team approach, professional societies and resources, hyperbaric care guidelines, hyperbaric oxygen care plans, psychological interventions for hyperbaric patients, transcutaneous oximetry (as requested), and physiological implications of the clinical use of oxygen in the hyperbaric environment.

Physiological implications of the clinical use of oxygen in the hyperbaric department.

Cells and their implications, and activity for wound healing.

Contraindications of hyperbaric oxygen when using respiratory depressants, chemotherapy and other forms of pain killers.

Ativan, lorazepam, and Dilantin versus other forms of respiratory depressants and pain killers.

Upper respiratory infections, and how they are contraindications for HBO treatments.

Patient care for pneumothorax, mediastinal emphysema, and embolisms in the HBO environment and otosclerosis and the hyperbaric environment.

Emphysema, bronchitis, and asthma in the hyperbaric environment for multi or mono chambers.

Hyperbaric oxygen: gas gangrene and necrotizing fasciitis recognition, treatment and implications.

Carbon monoxide, smoke inhalation, complications of cyanide poisoning, pulmonary oxygen toxicity, signs and symptoms of oxygen toxicity.

The philosophy and concept of treating spinal cord injuries, and bubble implications versus platelet plugs.

Antibiotics: (good or bad), versus DNA and fibroblasts.

Optic neuritis and progressive myopia affected by hyperbarics.

Physicians/CHT’s pre-evaluation of patients before series of clinical hyperbaric treatments to determine if their facility is capable of handling chronic or acute patients in multi place or mono place hyperbaric chambers.

Physiological implications, side effects, and contraindications of clinical hyperbaric oxygen.

Contraindications of hyperbaric oxygen.

The philosophies and management of known or unknown seizures in the hyperbaric environment, early signs and symptoms, the precautions and management.

Hyperbaric oxygen gas gangrene, fibroblast, wounds, osteoblast and angiogenesis, and their production in regard to glucose, cells, ATPs, DNA, and diet.

Pre-considerations for Physicians/CHT’s for evaluating potential patients for HBO treatments, also patient’s responsibility for preparing to go into hyperbaric oxygen environment.

Responsibility of the CHT to ensure that all other facility personnel are also aware of all the dangers that could be involved in the hyperbaric department with the use of oxygen to ensure that when the patient comes in they are showered/clean to go into the hyperbaric oxygen environment. The CHT must be aware of all oxygen safety precautions within the hyperbaric department. The CHT is responsible to the physician and all other administrators to ensure that all forms, records, waivers, and photos that are required be kept up to date.

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