Undersea and Hyperbaric Medicine Content Outline

1.0 Fundamentals

• 1.1 Physics of Diving
  • 1.1.1 Units
  • 1.1.2 Gas law, buoyancy
  • 1.1.3 Vision and acoustics
  • 1.1.4 Phys properties of gases (density, solubility, etc.)
• 1.2 Rec/trtmnt of phys/pharm effects/tox of gases
  • 1.2.1 Oxygen
    • 1.2.1.1 CNS
    • 1.2.1.2 Pulmonary
    • 1.2.1.3 Ocular
    • 1.2.1.4 Blood
  • 1.2.2 Carbon dioxide
  • 1.2.3 Other gases
• 1.3 Equipment
  • 1.3.1 Chamber systems design, construction and maintenance
  • 1.3.2 ASME and NFPA regulations
• 1.4 Decompression theory
  • 1.4.1 Decompression tables
  • 1.4.2 Decompressing chamber attendants
  • 1.4.3 Altitude effects of decompression
  • 1.4.4 Saturation
  • 1.4.5 Repetitive
  • 1.4.6 Bubble detection
• 1.5 Pathophysiology, clinical manifestations, and management of dysbarism
  • 1.5.1 Barotrauma
  • 1.5.2 Signs and symptoms of DCS
  • 1.5.3 Signs and symptoms of AGE
  • 1.5.4 Signs and symptoms of venous gas embolism
  • 1.5.5 Long-term diving effects (dysbaric osteonecrosis, etc.)
  • 1.5.6 Management of pressure-related diving accidents
  • 1.5.7 Effects of bubbles
  • 1.5.8 Mechanism of gas entry and distribution
  • 1.5.9 Diving casualties

2.0 Diving Medicine

• 2.1 Physiologic effects of diving
  • 2.1.1 High pressure nervous syndrome
  • 2.1.2 Breath-hold diving
  • 2.1.3 Physiology of immersion
  • 2.1.4 Surface decompression
  • 2.1.5 Mixed-gas diving
• 2.2 Diving operations
  • 2.2.1 Bounce diving
  • 2.2.2 Saturation diving and fire safety
  • 2.2.3 Caisson and tunnel work
  • 2.2.4 Surface decompression
  • 2.2.5 Flying after diving
  • 2.2.6 Mixed-gas diving
• 2.3 Medical and technical support of diving
  • 2.3.1 Medical standards
  • 2.3.2 Hazardous marine life
  • 2.3.3 Other medical disorders
  • 2.3.4 Psychology of closed spaces
  • 2.3.5 Chambers, bells, habitats, and sat systems
  • 2.3.6 Underwater breathing apparatus
  • 2.3.7 Thermal

3.0 Clinical Hyperbaric Medicine

• 3.1 Indications for hyperbaric oxygen therapy
  • 3.1.1 Carbon monoxide poisoning – carbon monoxide complicated by cyanide poisoning
  • 3.1.2 Clostridial myositis and myonecrosis (gas gangrene)
  • 3.1.3 Crush injury, comp synd, and other acute traumatic ischemias
  • 3.1.4 Enhancement of healing in selected problem wounds
  • 3.1.5 Exceptional anemia
  • 3.1.6 Intracranial abscess
  • 3.1.7 Necrotizing soft-tissue infections
  • 3.1.8 Osteomyelitis (refractory)
  • 3.1.9 Delayed radiation injury (soft tissue and bony necrosis)
  • 3.1.10 Skin grafts and flaps (compromised)
  • 3.1.11 Thermal burns
  • 3.1.12 Other
• 3.2 Patient management
  • 3.2.1 Patient selection and care
  • 3.2.2 Treatment protocols
  • 3.2.3 The physiological effects of hyperbaric oxygen
  • 3.2.4 Pharmacological effects of HBO
  • 3.2.5 Management of O2 toxicity
  • 3.2.6 Patient monitoring and equipment
  • 3.2.7 Complications of HBO therapy