Plenary Sessions

  • Thursday, June 27

     


    PRESIDENT'S ADDRESS

    8:00-8:30:


    Nicholas Bird, MD, FUHM

    BirdNicholas WEB NEW
    Overview
    : Provide an overview of activities, plans, and outcomes from initiatives carried out by UHMS home office, officers and committees. 

    Objectives:

    • Name two of the position statements published in the last year.
    • Describe what the UHMS has done to improve its editorial review process

    About Dr. Bird: 

    Dr. Nicholas Bird is a regional medical director for Duke Urgent Care and is board-certified in both family medicine and undersea and hyperbaric medicine. He splits his time between clinical practice and administrative responsibilities, and has a passion for improving health care delivery to optimize patient access, education and outcomes. Prior to joining the Duke medical staff, he was the chief medical officer and CEO of Divers Alert Network and an internationally recognized expert on diving injuries, accidents and medical treatment. Outside of work, he enjoy traveling, and diving the warm waters of the world. He has been a PADI SCUBA instructor for more than 25 years. He also enjoys reading Clive Cussler novels, cooking and golfing, when time permits. He lives in Durham, NC with his wife, Kim. They have three children, a grandson, and a crazy Jack Russell terrier.


    Controversies in the Hyperbaric Management of Late Radiation Injuries

     
    8:30-9:00:


    Late Radiation Tissue Injury Below the Clavicles: Considerations with IMRT and the Fibroatrophic Model
    John Feldmeier, DO

    Feldmeier Pic OfficialIn this session, Dr. Feldmeier will join with Dr. Robert Marx to address several recent articles calling into question the role of hyperbaric oxygen in treating LRTI’s (Late Radiation Tissue Injuries). While Dr. Marx will concentrate on the application of Hyperbaric Oxygen to osteoradionecrosis (ORN) of the mandible and maxilla and soft tissue injuries of the head and neck, Dr. Feldmeier will concentrate on injuries to organs and tissues below the clavicle. Special emphasis will be given to radiation cystitis and proctitis. The technique of modern radiation therapy targeting including IMRT (Intensity Modulated Radiation) will be briefly discussed. A recently proclaimed and popular model of delayed radiation injury is called the Fibroatrophic Model. It de-emphasizes vascular damage as the major contributor to LRTI. This model will be discussed from 2 perspectives: 1. Its validity and 2. Even if accepted in part or in toto, how a strong case for the use of hyperbaric oxygen can be made. At the conclusion of both Dr. Marx’s and Dr. Feldmeier’s plenary sessions, a panel discussion will occur.

    About Dr. Feldmeier: Dr. Feldmeier received his D.O. degree from The Philadelphia College of Osteopathic Medicine in 1979 with USAF sponsorship and completed residency training in Radiation Oncology at the University of Texas Health Science Center at San Antonio, Texas in 1985. He received a fellowship certificate from the USAF Hyperbaric Medicine Fellowship Training Program at Brooks Air Force Base in San Antonio, Texas and was a staff physician there from 1980 to 1982. Dr. Feldmeier was simultaneously the Chief of Radiation Oncology and Chairman of the Hyperbaric Medicine Department at Wright-Patterson Air Force Base Medical Center in Dayton, Ohio before separating from the USAF in 1985. Dr. Feldmeier has served as the Chief of Radiation Oncology at the University of Texas Health Science Center in San Antonio, Grace Hospital in Detroit, MI and the Chairman of Radiation Oncology at the University of Toledo Medical Center from which he retired in 2013 with the award of Professor Emeritus. Dr. Feldmeier has authored numerous publications in both radiation oncology and hyperbaric medicine. He has been the editor of the Undersea & Hyperbaric Medical Society (UHMS) Hyperbaric Oxygen Therapy Committee Report. He served as review editor of Undersea and Hyperbaric Medicine. He is a Fellow of Undersea and Hyperbaric Medicine and Past- President of the UHMS. He currently co-chairs the UHMS Research Committee. He is a Fellow of the American College of Radiation Oncology.   He is a medical consultant to International ATMO. He is the only physician in the U.S. board certified in both Radiation Oncology and Undersea and Hyperbaric Medicine. 

     9:00-9:30:

    Answering the criticism and challenges to HBO2 in the treatment of radiated patients
    Robert Marx, DDS

    Marx About the Lecture: Hyperbaric Oxygen Therapy (HBO2 therapy) remains a time honored scientifically proven adjunct to surgery in the head and neck radiated patient. Data will be presented identifying the proper dosage of HBO2 therapy as well as the surgeries often required in these patients.  HBO2 therapy’s improvement of late radiation effects (L9.9) reduce the complications in a variety of needed surgeries such as bone grafting the jaws, tissue flaps, and placement of dental implants. HBO2 therapy is also critical in the successful resolution of osteoradionecrosis without redo surgeries.

    About Dr. Marx:  Robert E. Marx, DDS, is Professor of Surgery and Chief of the Division of Oral and Maxillofacial Surgery at the University of Miami Miller School of Medicine as well as Chief of Surgery at Jackson South Community Hospital in Miami. He is well known as an educator, researcher, and innovative surgeon. Dr. Marx has pioneered new concepts and treatments for pathologies of the oral and maxillofacial area as well as new techniques in reconstructive surgery, including stem cell therapies. 
         His many prestigious awards, including the Harry S. Archer Award, the William J. Giles Award, the Paul Bert Award, the Donald B. Osbon Award, and the Daniel Laskin Award, attest to his accomplishments and commitment to the field of oral and maxillofacial surgery. 
          His textbook “Oral and Maxillofacial Pathology: A Rationale for Diagnosis and Treatment” has won the American Medical Writers Associations Prestigious Book of the Year Award. His other textbooks, “Platelet Rich Plasma: Dental and Craniofacial Applications,” “Tissue Engineering,” “Oral and Intravenous Bisphosphonates Induced Osteonecrosis” and an “Atlas of Bone Harvesting” have been best sellers. He is also a writer of fiction medical mystery novels. His first publication “Deadly Prescription” is currently an Amazon best seller.

    9:30-10:00: Panel discussion


    Physiology and Science in Hyperbaric Medicine


    4:00-4:
    30:


    Stem cells and hyperbaric oxygen therapy
    Stephen Thom, MD

    Thom picThe first scientific papers reporting effects of hyperbaric oxygen therapy (HBOT) on stem cell biology were published just 12 years ago and now they number over 100. This presentation will summarize the latest data on stem cell physiological responses to HBOT. Oxygen acts as a critical regulator of stem cells, and HBOT has a variety of effects on stem cell mobilization dynamics, metabolism, engraftment, and can influence paracrine roles with tissue repair. Some effects appear with the initial HBOT exposure while others develop when repeated hyperoxia-normoxia cycling occurs. Mechanisms and data on clinical utilization will be presented, as well as current questions and future directions.

    About Dr. Thom: Dr. Thom received his MD and PhD (microbial physiology) degrees from the University of Rochester in 1981. He served as professor of emergency medicine and chief of hyperbaric medicine at the University of Pennsylvania for 27 years and in July 2013 took a position at University of Maryland. He is a practicing emergency medicine physician and also carries out research in several areas. He is lead/senior author on over 130 peer reviewed papers and 40 reviews or textbook chapters on oxygen and other gas toxicities. Research interests include the role of stem cells in diabetic wound healing and cell responses to hyperoxia, pathophysiology of decompression sickness, carbon dioxide and carbon monoxide (CO). His lab group was the first to describe vasculogenic stem cell mobilization by hyperbaric oxygen therapy and he currently directs projects to assess the role of stem cells in diabetic skin wound healing. He was president of the UHMS from 1996-1998, and chair of the hyperbaric oxygen therapy committee from 1991-1993.  Dr. Thom has been the recipient of the Albert R. Behnke award of the UHMS in 1996 and 2008, the Paul Bert award from UHMS in 2007, the Edgar End award of the Gulf Coast Chapter of the UHMS in 1988, and the C. Longoni award from the Italian Undersea and Hyperbaric Medical Society in 1998.

    4:30-5:00:

    Research that We Need to do in the Field of Hyperbaric Medicine and Some Thoughts on How to Achieve this Goal
    John Feldmeier, DO (Co-chairman of the UHMS Research Committee)

    Feldmeier Pic OfficialIt is no surprise to our membership that as a discipline, hyperbaric medicine has not achieved a consistently successful track record in accomplishing research to further advance the application of our treatment modality or even for that matter to firmly solidify those indications that we accept as “Approved.” CMS and commercial insurers are actively involved in removing re-imbursements for pharmaceuticals, devices and procedures unless their proponents can make a solid argument for their benefit based on good and adequate science. It is likely that payments for our clinical efforts are going to be put under even greater scrutiny unless new and corroborating science is done and published with a quality that is readily acceptable to payors and potential referring physicians alike. As a small field, we do not have the luxury of large sums of money available to support the conduct large research protocols involving randomized controlled trials. We can, however, learn from the major cooperative oncologic trial groups and employ registries to achieve the necessary quality of science. A number of promising new applications deserve scrutiny and some of our long-standing indications need better support. This talk will be designed to identify several areas where research must be done for the good of our patients and our discipline and will consider some methods by which these studies can be accomplished.

    About Dr. Feldmeier: Dr. Feldmeier received his D.O. degree from The Philadelphia College of Osteopathic Medicine in 1979 with USAF sponsorship and completed residency training in Radiation Oncology at the University of Texas Health Science Center at San Antonio, Texas in 1985. He received a fellowship certificate from the USAF Hyperbaric Medicine Fellowship Training Program at Brooks Air Force Base in San Antonio, Texas and was a staff physician there from 1980 to 1982. Dr. Feldmeier was simultaneously the Chief of Radiation Oncology and Chairman of the Hyperbaric Medicine Department at Wright-Patterson Air Force Base Medical Center in Dayton, Ohio before separating from the USAF in 1985. Dr. Feldmeier has served as the Chief of Radiation Oncology at the University of Texas Health Science Center in San Antonio, Grace Hospital in Detroit, MI and the Chairman of Radiation Oncology at the University of Toledo Medical Center from which he retired in 2013 with the award of Professor Emeritus. Dr. Feldmeier has authored numerous publications in both radiation oncology and hyperbaric medicine. He has been the editor of the Undersea & Hyperbaric Medical Society (UHMS) Hyperbaric Oxygen Therapy Committee Report. He served as review editor of Undersea and Hyperbaric Medicine. He is a Fellow of Undersea and Hyperbaric Medicine and Past- President of the UHMS. He currently co-chairs the UHMS Research Committee. He is a Fellow of the American College of Radiation Oncology.   He is a medical consultant to International ATMO. He is the only physician in the U.S. board certified in both Radiation Oncology and Undersea and Hyperbaric Medicine.

  • Friday, June 28


    DCI Theory & Mechanisms

     8:00-9:00:

    CNS Oxygen toxicity: Where are we now?
    Jay Dean, PhD

    Dean2Hyperbaric oxygen (HBO2) is breathed during hyperbaric oxygen therapy and during certain undersea pursuits in diving and submarine operations. What limits exposure to HBO2 in these situations is acute onset of central nervous system oxygen toxicity (CNS-OT) following a latent period of safe oxygen breathing. CNS-OT presents as various non-convulsive signs and symptoms (S/Sx), many of which appear to be of brainstem origin that involve cranial nerve nuclei, autonomic centers and cardiorespiratory centers, which ultimately spread to higher cortical centers and terminate in recurring bouts of generalized tonic-clonic seizures. The initial latent period makes breathing HBO2 practical in hyperbaric and undersea medicine; however, the safe latent period is highly variable between individuals and within the same individual on different days, making it difficult to predict onset of toxic indications. Consequently, currently accepted guidelines for safe HBO2 exposure in undersea medicine and HBO2 therapy are highly conservative. During this lecture, I will review the results of research on CNS-OT, focusing on work done during the past two decades on behalf of the Office of Naval Research (ONR) Undersea Medicine Program (one of four National Naval Responsibility Initiatives) and the Naval Sea Systems Command (NAVSEA). Topics that will be covered include the following: the pathophysiology of the S/Sx that define CNS-OT; conditions that increase the risk for developing acute toxic indications during exposure to HBO2; innovative animal (in vitro and in vivo) and human research methods adapted for use during HBO2 that have provided insight on the neural mechanisms underlying CNS-OT; brain regions that are thought to be involved in seizure genesis and propagation; and current strategies under investigation for predicting an impending seizure (“physiomarkers”) and delaying onset of CNS-OT (antiepileptic drug therapy, antiadrenergic drug therapy, ketone metabolic therapy and hyperbaric oxidative preconditioning) with the goal of longer and safer dives without impaired performance (author’s research funded by ONR Undersea Medicine).

    About Dr. Dean: Dr. Jay B. Dean is a professor of Molecular Pharmacology & Physiology at the University of South Florida in Tampa. He currently teaches respiratory physiology in the Morsani College of Medicine and directs the USF Hyperbaric Biomedical Research Laboratory, which is funded by the ONR’s Undersea Medicine Program to study the pathophysiology of CNS oxygen toxicity. Dean is a devoted historian of aeromedical research during World War II, a topic he has researched extensively since his days as a PhD graduate student at Ohio State. Dean hails from Mason, Michigan, and received his training from Central Michigan University (BS 1979, Biology), Michigan Technological University (MS 1981, Biol. Sci.), The Ohio State University (PhD 1986, Physiology), and did his postdoctoral training in neurophysiology and respiratory control at the University of North Carolina-Chapel Hill (1986-91). Jay lives in Land O’Lakes, Florida with his wife, Janet, who teaches biology and oceanography at Pasco Hernando State College.

    9:00-9:30: US Navy Diving: DCS Lessons Learned
    Pete Witucki, MD

    PeteWitucki pic

    This lecture will be a discussion of the past, present and future of decompression illness mitigation within the United States Navy.


    About Dr. Witucki: Dr. Witucki is board certified in Undersea and Hyperbaric Medicine as well as Emergency Medicine. He practices both specialties at the University of California San Diego. He served as an Undersea Medical Officer in the United States Navy and retired in 2017 after 26 years of service.

    9:30-10:00:

    Wearable diving technology
    Ki Chon, MD

    New Ki Chon 228x300 228x300 1About the Lecture: There has been an emergence over the past several years of novel wearable devices that can potentially be applied to underwater physiological monitoring.  This lecture will present an overview of various wearable sensors that have been developed for dry conditions that can potentially be used for underwater applications. Moreover, various signal processing and machine learning algorithms will also be discussed that have been developed for accurate detection of vital signs and for combating motion artifacts from wearable devices. 

    About Dr. Chon: Ki H. Chon received the B.S. degree in electrical engineering from the University of Connecticut, Storrs; the M.S. degree in biomedical engineering from the University of Iowa, Iowa City; and the M.S. degree in electrical engineering and the Ph.D. degree in biomedical engineering from the University of Southern California, Los Angeles. He spent three years as an NIH Post-Doctoral fellow at the Harvard-MIT Division of Health Science and Technology, one year as a Research Assistant Professor in the Department of Molecular Pharmacology, Physiology, and Biotechnology at Brown University, Providence, Rhode Island, and four years as an Assistant and Associate Professor in the Department of Electrical Engineering at the City College of the City University of New York. He then moved to the Department of Biomedical Engineering at SUNY Stony Brook as an Associate Professor and was promoted to a full professor. Most recently, he was a Professor and Chair of Biomedical Engineering at Worcester Polytechnic Institute, Worcester, MA. He is currently the John and Donna Krenicki Professor and Head of Biomedical Engineering at University of Connecticut, Storrs, CT. His current research interests include medical instrumentation, biomedical signal processing, wearable sensors and devices including use of smart phones for vital signs and monitoring cardiac arrhythmias, development of hydrophobic vital sign sensors and identification and modeling of physiological systems.

     


    Altitude Decompression Sickness

    4:00-4:30: Combating flier’s “bends” during unpressurized flight and explosive decompression in World War II
    Jay Dean. PhD

    Dean2The air war of 1939-45 was a “physiological war” because the Allies sought extreme altitudes in unpressurized warplanes to gain the tactical advantage in aerial combat. How high? In 1940, the Allies predicted the air war; thus WWII would be won by the side that waged combat operations at 40,000 feet. Altitude flying and fighting at 40,000 feet became the goal that would inspire America’s aeromedical research program for the war’s duration.

    Accordingly, reducing the risk of decompression sickness (DCS) at altitudes above 30,000-35,000 feet in unpressurized aircraft became a major research challenge for the physiologists of the U.S. Army Air Forces (USAAF) and U.S. Navy (USN). In April 1944, America deployed its first pressurized bomber (Boeing B-29 Superfortress) in the Pacific theater of operations to alleviate the physiological problems caused by hypobaric pressure, anoxia and cold. Pressurized flight, however, created a new problem: Namely, it was unknown how aircrews would respond to explosive decompression at high altitude following structural failure of their ship’s pressure cabin (6.5 psig). Would the incidence of DCS increase compared to slower rates of decompression in unpressurized airplanes?

    In this lecture, Dr. Dean will revisit the research and mitigation strategies for dealing with “flier’s bends” or “aeroembolism” during unpressurized flight and following explosive decompression during pressurized flight. Topics covered include the following:

    • discovery of flier’s bends during altitude chamber “flights” by Dr. Harry G. Armstrong at Wright Field, Dayton, Ohio (1934-1938);
    • development of oxygen prebreathing (OPB) to “denitrogenate” prior to altitude flying above 30,000 feet in altitude chambers and aircraft (1938-1945: Wright Field Aero Medical Lab and Mayo Aero Medical Unit with Boeing and Lockheed Aircraft Companies);
    • Dr. Fred A. Hitchcock’s pioneering research on the physiology of explosive decompression (1941-45: The Ohio State University Laboratory of Aviation Physiology); and more.

    Ultimately, the air war of 1939-1945 would be mostly fought and won below 40,000 feet; however, the equipment and procedures developed during the war years were immediately available for higher altitude flight during the post-war jet era.

    About Dr. Dean: Dr. Jay B. Dean is a professor of Molecular Pharmacology & Physiology at the University of South Florida in Tampa. He currently teaches respiratory physiology in the Morsani College of Medicine and directs the USF Hyperbaric Biomedical Research Laboratory, which is funded by the ONR’s Undersea Medicine Program to study the pathophysiology of CNS oxygen toxicity. Dean is a devoted historian of aeromedical research during World War II, a topic he has researched extensively since his days as a PhD graduate student at Ohio State. Dean hails from Mason, Michigan, and received his training from Central Michigan University (BS 1979, Biology), Michigan Technological University (MS 1981, Biol. Sci.), The Ohio State University (PhD 1986, Physiology), and did his postdoctoral training in neurophysiology and respiratory control at the University of North Carolina-Chapel Hill (1986-91). Jay lives in Land O’Lakes, Florida with his wife, Janet, who teaches biology and oceanography at Pasco Hernando State College.

    4:30-5:00: USAF hypobaric exposures experience
    Marc Robins, DO

    RobinsDr. Robins will speak on DCS altitude problems faced and a history of U2 case reports. (Nothing recent has really been collected)

    About Dr. Robins: Dr. Robins started his career in medicine working for the Ski Patrol in Southern Oregon at age 19 which soon led to employment as a nurses aide then as a Registered Nurse. Prior to medical school he worked as an RN in the Emergency Department at a level 1 Trauma Center, graduating with his Doctorate in Osteopathy in 1988. Receiving a Health Professions Scholarship to pay for Medical School he did his first Residency in Family Practice at the David Grant USAF Regional Medical Center at Travis AFB, California, and then a second Residency in Aerospace Medicine with Fellowship in Occupational Medicine and a Masters in Public Health from Harvard University School of Public Health. He was awarded the Malcom Grow Air Force Outstanding Flight Surgeon of the Year Award in 1995, and completed a 20-year career as an Air Force Flight Surgeon. His assignments included European Aeromedical Evacuation Squadron, and command positions for Fighter Base Aeromedical Squadrons and the High Altitude U2 program in Beale, California, commanding medical services in six major deployments and one Humanitarian Mission. Dr. Robins culminated his career as the US Aerospace Medicine Consultant to the Australian Defence Force Medical Chief (US Surgeon General equivalent), retiring as a Colonel. He attended the NOAA Dive Medical course in 2010 and maintains an avid interest in recreational scuba diving, certifying in 2003. He is a pilot, enjoys skiing, mountain biking, motorcycle riding and rock climbing.

     

  • Saturday, June 29


    The Regulatory And Reimbursement Challenges Facing Nations And How These Have Been Addressed

    8:00-8:25:

    Canada 
    Ken LeDez, MD

    LeDezAbout the Lecture: The lecture will give an overview of the hyperbaric medicine in Canada, covering a broad range of topics including:

    • Healthcare organization, insurance coverage, physician remuneration and audits
    • Approved conditions for hyperbaric oxygen treatment
    • Accreditation of hyperbaric facilities
    • Physician licensing, certification, credentialing and medical organizations
    • The Diploma in Hyperbaric Medicine from Royal College of Physicians and Surgeons of Canada
    • Medical liability coverage and technical fees
    • Continuing medical education requirements
    • Clinical hyperbaric facilities and 24-hour coverage issues

    About Dr. LeDez:  Dr. Ken LeDez established and is Medical Director of the Hyperbaric Medicine Service in St. John’s, Newfoundland and Labrador, Canada and Associate Professor in the Faculty of Medicine at Memorial University and former Chair of the Discipline of Anesthesia.  He is a staff anesthesiologist at the Health Sciences Centre in St. John’s.  Dr. LeDez has provided medical coverage for offshore saturation diving since 1992.  After graduating from medical school at the University of Dundee, Scotland, Dr. LeDez undertook further training in anesthesia in the UK and Canada, completed research and clinical fellowships in Anesthesiology and Hyperbaric Medicine at the University of Toronto and later at Dalhousie University.  He was a founder of the Canadian Chapter of the UHMS and its first President (now called the Canadian Undersea and Hyperbaric Medical Association – CUHMA).  Ken LeDez is a former Vice-President of the UHMS, has authored multiple scientific publications in anesthesiology and hyperbaric medicine and was co-author of book chapters and the book “Gas bubble dynamics in the human body” published in 2017.  In addition, Dr. LeDez is the Chair of the Hyperbaric Medicine Specialty Committee of the Royal College of Physicians and Surgeons of Canada and the editor and principle author of CUHMA’s “Guidelines to the practice of hyperbaric medicine and provision of hyperbaric oxygen treatment in Canada”.  He has been involved in multiple national and international committees related to clinical standards of care and is Chair of Sub-Committee 4 of the ISO Technical Committee 121 on anesthesia, respiratory and critical care equipment.

     

    8:25-8:50:

    United Kingdom
    Pieter Bothma, MD

    Pieter BothmaAbout the Lecture: The infamous postcode lottery of obtaining funding for HBO depending on where you live, has been criticized widely. It also apply to other specialties including oncology where the most expensive medication was available in some areas and in many areas it was not.  While negotiating a new commissioning policy for HBO as a specialized service, NHS England agreed a block contract to treat the majority of the conditions that we prefer to treat. The policy was due to be completed in 1 to 2 years, but took seven years. This has now been replaced by the new commissioning policy which is a lot more restrictive.

    About Dr. Bothma: Dr. Bothma is a Consultant in Anaesthesia, Critical-care and Hyperbaric medicine. He is Medical director of the London hyperbaric unit operating at 2 sites: in London(Whipps Cross University Hospital) and in Great Yarmouth (James Paget University hospital). He has been involved with the clinical reference group negotiating with NHS England for the last 7 years about a new commissioning policy. He regards this  as the biggest investment of his time for the least benefit to anyone. He is currently chairman of the British Hyperbaric Association.

    8:50-9:15:

    United States
    Caroline Fife, MD

    Caroline Fife1716About the Lecture: The advent of the Quality Payment System changes the focus of the conversation about the effectiveness of hyperbaric oxygen therapy.  The goal of the QPP is to decrease Medicare Spending per Beneficiary. Although the current regulatory and reimbursement pressure on HBOT is focused on decreasing utilization (both improper use but overall use), the cost component of the QPP puts hyperbaric practitioners and hospital centers at a different kind of risk. If practitioners do not engage in the Merit Based Incentive Payment System, they could experience unanticipated consequences such as being removed from provider lists by private payers. This topic will explain the confusing "cost" component of MIPS and its implications for the future of the field.

    About Dr. Fife:  Dr. Fife completed a family medicine residency at the University of Texas, Southwestern in Dallas followed by a two-year fellowship in undersea and hyperbaric medicine at Duke University. Until 2013 she was a Professor of Medicine at the University of Texas Health Science Center, Houston, where she initiated the Memorial Hermann Center for Wound Healing and Hyperbaric Medicine. She is now a Professor of Geriatrics at Baylor College of Medicine in Houston, and the Medical Director of the CHI St. Luke's Wound Clinic in The Woodlands, Texas. Fife is also the Chief Medical Officer of Intellicure, Inc., a health information technology company, and the Executive Director of the U.S. Wound Registry, a non-profit organization recognized by CMS as a qualified clinical data registry. The USWR develops hyperbaric and wound care-relevant quality measures which help hyperbaric practitioners meet the requirements of Medicare’s Quality Payment Program.
          She is a past president of the Undersea and Hyperbaric Medical Society. Past and present board activities include the Alliance of Wound Care Stakeholders (current co-chair), the American Academy of Wound Management, the Association for the Advancement of Wound Care and the American Professional Wound Care Association. She is the clinical editor of Today’s Wound Clinic, and has authored more than 100 peer-reviewed articles and book chapters as well as editing three textbooks (the Textbook of Chronic Wound Care, Wound Care Practice, and Women and Pressure: Diving and Flying). Her research contributions include altitude decompression studies that enabled the construction of the International Space Station by decreasing the time needed for oxygen pre-breathe as part of a NASA-led research consortium, the development of real-time lymphatic imaging with Dr. Eva Sevick using near infrared technology, and more recently, the use of real-world data for comparative effectiveness studies to understand what works best for patients with chronic wounds and ulcers.

    9:15-9:40:

    Australia
    Michael Bennett, MD

    MbennettAbout the Lecture: As for most jurisdictions, Australia has faced serious challenges in this area. HBO has been under constant review for 17 years by the national Medicare system. This presentation will outline the course and outcome of these reviews.

    About Professor Bennett:  Professor Bennett is the Academic Head of the Department of Anaesthesia, a Senior Staff Specialist in diving and hyperbaric medicine at Prince of Wales Hospital and Conjoint Professor in the faculty of Medicine, University of New South Wales in Sydney, Australia. He graduated from the University of New South Wales in 1979 and spent his early post-graduate training at the Prince Henry/Prince of Wales Hospitals before undertaking training in Anaesthesia in the UK. He returned to Sydney in 1990 as a retrieval specialist on the Lifesaver Helicopter and here developed an interest in both diving and hyperbaric medicine. He was medical director of the Department of Diving and Hyperbaric Medicine at POWH from 1993 to 2007. He also has a strong interest in clinical epidemiology and is an experienced clinician and researcher. In 2002 he was the recipient of the Behnke Award for outstanding scientific achievement from the Undersea and Hyperbaric Medical Society. Since 2004 he has been highly involved in the teaching of Evidence-based Medicine within the Medical faculty at UNSW and in 2005 was appointed co-director of the Quality Medical Practice Program there. He is the author of over 140 peer-reviewed publications including 15 Cochrane reviews of the evidence in Diving and Hyperbaric Medicine. Prof. Bennett was the convener of the Australia and New Zealand Hyperbaric Medicine Group Introductory Course in Diving and Hyperbaric Medicine from its inception in 1999 to 2014. He is an executive member of the Australia and New Zealand College of Anaesthetists (ANZCA) special interest group in diving and hyperbaric medicine and chair of the ANZCA DHM subcommittee responsible for the ANZCA Diploma of Advanced DHM. He is a past Vice-President of the UHMS and currently the Past President of SPUMS.

     

    9:40-10:00:

    Panel discussion

     

     

     

    1:00-1:30:

    HBO2 and Inflammatory Bowel Disease Update
    Jay Buckey, MD

    Buckey

    About the Lecture: This talk will cover new developments in the treatment of inflammatory bowel disease with hyperbaric oxygen. Inflammatory bowel disease involves both hypoxia and inflammation, and hyperbaric oxygen can have effects on both of those factors. Also, hyperbaric oxygen can affect the microbiome, which is another potential mechanism for HBO2’s effects in IBD.

    About Dr. Buckey:  Jay C. Buckey, MD is a Professor of Medicine at the Geisel School of Medicine at Dartmouth and the medical director of the Center for Hyperbaric Medicine at Dartmouth-Hitchcock Medical Center. 

    1:30-2:00:

    Diving, operational & environmental physiology of the Thai cave rescue
    Richard Walker, MD

    About the Lecture: This lecture looks at the physiological concerns for the Thai cave rescue, both the soccer team members and the rescuers, as well as some of the operational concerns of the divers themselves. We examine the nature of specialty dive environments and how these environments drive the needed skills, equipment and experience required for successful expeditions as well as how this differs from normal dive operations. In addition, we examine the unique hazards to the rescuers and the psychological stresses and preparation needed for conducting dive operations in this environment. 

    About Dr. Walker: Dr. Walker is an experienced diver and instructor with over 33 years diving, including over 20 years as a cave, wreck, mixed gas and rebreather instructor and has participated in numerous expedition dives. In addition, Dr. Walker is boarded in both Emergency Medicine and Undersea/Hyperbaric Medicine with experience teaching military and civilian personnel to work in austere environments. He has experience working on projects for NASA where he worked on DCS mitigation during EVA for the Constellation project, for the Air Force where he was on the committee working to address the U2 High Flight DCS problem and on numerous underwater projects and expeditions both for research and exploration. He currently is the chair of the department of emergency medicine at UT and teaches emergency medicine and hyperbaric medicine in Memphis TN.


    Topics in Undersea and Hyperbaric Medicine

    4:00-4:30:

    Top articles in HBO2
    Justin Allen, DO
    Fellow, Duke, Durham, NC

    allenAbout the Lecture:

    • Review recent literature published since July 2018 to present.
    • Perform a critical analysis of the articles, including implications on future practice of hyperbaric medicine.

    About Dr. Allen: Dr. Allen is originally from Hobart, Indiana. He graduated from Wabash College (BA, biology) in 2011 and completed medical school at the Lake Erie College of Osteopathic Medicine (Doctor of Osteopathic Medicine) in 2015. He completed an internal medicine residency at Lakeland Health in Saint Joseph, Michigan, in 2018 and is currently a fellow in undersea and hyperbaric medicine at Duke University Medical Center in Durham, N.C.  He will be pursuing a career as a full-time nocturnist at Duke Raleigh Hospital and will practice clinical hyperbaric medicine part-time. Outside of medicine, he is a competitive runner, part-time triathlete, and occasional snowboarder. Most recently, he finished 10th at the 2019 U.S. Duathlon national championships and qualified for team USA for the 2020 Duathlon World Championships.  He also enjoys traveling with his fiancée, Kaitlyn, who he will marry this December in Cancun.

    4:30-5:00:

    Top articles in Undersea Medicine
    Aurel Mihai, MD
    Fellow, SUNY, Syracuse, NY

    Mihai photoAbout the Lecture:

    • DCS models and frameworks
    • Oxygen toxicity
    • Reviews and guidelines
    • Noteworthy short articles

    About Dr. Mihai:  Aurel Mihai (pronounced uh-REL ME-high) is current fellow of undersea and hyperbaric medicine at SUNY Upstate Medical University in Syracuse, NY. His primary training is in family medicine. His interest in undersea medicine is mainly in recreational and public safety diving, primarily in mitigating risk for aging divers and divers with comorbidities.