PHYSICIANS RECEIVE TOP-NOTCH TRAINING IN DIVE MEDICINE AT
NOAA’s DIVING CENTER

November 21, 2002 — Commercial, scientific and recreational divers across the United States, Canada and Mexico can feel a little safer these days because a new crop of physicians just completed NOAA’s two-week advanced training course in hyperbaric medicine at the NOAA Diving Center in Seattle, Wash. The course is specifically geared to train doctors and other medical professionals to recognize and treat diving-related accidents and injuries. (Click NOAA photo for larger view of Dr. Morgan Wells demonstrating a hyperbaric chamber during October 2002 training session with physicians at the NOAA Diving Center in Seattle, Wash. Click here for high resolution version of this image, which is a large file. Please credit “NOAA.”)

This annual training is offered in conjunction with the Undersea & Hyperbaric Medical Society and Undersea Research Foundation. It was started in 1977 by Dr. Morgan Wells, now with USRF, who was the first director of the NOAA Diving Program. Though no longer with NOAA, Dr. Wells has served as director of this course ever since its inception. The course offers a depth of hyperbaric medical training only available through NOAA and the U.S. Navy.

“Medical schools devote very little time, if any, to recognizing and treating diving injuries. As a result, there weren’t many physicians around the country trained in hyperbaric medicine that could treat NOAA divers if they had a diving-related problem,” said Dave Dinsmore, director of the NOAA Diving Program and Diving Center. “Dr. Wells recognized this problem and began the training initiative to help resolve it. The physicians who take the course come from a number of different specialities, but may have a personal interest in hyperbaric medicine because many are recreational divers themselves. Many also work in hospitals that have hyperbaric chambers. Our in-depth training gives them an expertise outside their field that enables them to step in and help when injured divers are brought in. For safety reasons, we always advise NOAA divers to get the name, address and phone number of the nearest hyperbaric physician and facility in the area before diving.” (Click NOAA photo for larger view of diver entering the 30-foot high diving tower at the NOAA Diving Center in Seattle. Click here for high resolution version of this image, which is a large file. Please credit “NOAA.”)

Hyperbaric chambers, also known as decompression or recompression chambers, are used for surface decompression, omitted decompression, recompression of injured divers, training, research and pressure testing of equipment, and other clinical uses. The NOAA Diving Center has three chambers of varying sizes, and the doctors get hands-on experience in operating each of them, as well as learn the protocols for treating patients using such chambers.

Some physicians take the course not only to learn how to treat diving injuries, but to get the experience needed to use the chambers for other healing purposes. Dr. Robert Barnes is an infectious disease specialist, and also works closely with pulmonary specialists at Virginia Mason Medical Center in Seattle. “It was natural for me to take this course, particularly in the area of wound care,” Barnes said. “Some chronic wounds heal better in high pressure oxygen. Using the chamber allows the body to heal in clinical hyperbaric oxygen by forcing oxygen into the blood to form new blood vessels. It’s a new application of hyperbaric medicine.” (Click NOAA photo for larger view of divers working underwater. Click here for high resolution version of this image, which is a large file. Please credit “NOAA.”)

Barnes, who is also a recreational diver, said he will be on call to treat diving injuries now that he has had the training. He was very pleased with the course, saying, “The entire course was superb; it far exceeded in quality any other training in the subject I have previously received. One of the most interesting parts was rubbing shoulders with people like Dr. Morgan Wells. The instructors have long histories and you learn a lot from their depth of experience. Their anecdotes have given us good pointers on how to avoid problems and anticipate accidents.”

Dr. Tracy LeGros, who specializes in emergency medicine at Charity Hospital in New Orleans, La., is not a scuba diver but deals with a lot of patients who are. Although she had already completed a one-year fellowship in hyperbaric medicine in New Orleans, she took the NOAA course to get hands-on experience in the chamber as well meet the people who helped develop the diving decompression tables.

“The instructors were extremely well educated and interacted very well with the students. No question was too dumb–they were very patient,” LeGros said. “Talking one-on-one with those who deal with diving questions every day was very helpful because they were so knowledgeable.”

LeGros said she was especially interested in learning how the decompression tables were developed and how to interpret the equations. “It was a very good intro course on the physics of decompression and various gas laws and diving equations, and supplemented the physics courses I took in graduate school. It put the information into context in a useful environment.

Dinsmore said 30 physicians took the course–a maximum capacity for the classes. They were divided into four groups and rotated between the three hyperbaric chambers and the 30-foot high diving tower. As long as they were in good health, the physicians could participate in dives in the chambers and diving tower. “For those diving in the tower, a staff member was right above them, holding their air hose [air is pumped from the surface] throughout the dive. The dives are very controlled and shallow, but this gives everyone a chance to see what it is like to use typical commercial gear that they wouldn’t ordinarily have the opportunity to experience unless they were commercial divers.” (NOAA photo of 30-foot high diving tower at the NOAA Diving Center in Seattle.)

Guest lecturers—experts in their field—were flown in from various parts of the country to address the classes. One was Capt. Michael Vitch of the U.S. Public Health Service, who is director, Office of Health Services and Pastoral Care, for the NOAA Office of Marine and Aviation Operations, under which the NOAA Diving Program falls.

“Having both attended and taught at the NOAA/UHMS Hyperbaric Medicine course, I can say it’s a rather intensive and thorough course in diving medicine and physiology,” Vitch said. “Topics range from gas laws to marine life hazards, and the course also includes an opportunity for the students to do a surface-supplied dive in the controlled environment of NOAA’s diving tank, which is quite fun. Hands-on training is accomplished in operating hyperbaric chambers as well. There is much concentration on diving physiology and the relation to decompression sickness and arterial gas embolism. This includes medical treatment. A number of actual case studies from NOAA diving accidents are discussed as well.

“The course is well received by students from around the world and also gives both students and the NOAA Diving Center the invaluable opportunity to network with a variety of hyperbaric experts from all over the globe,” Vitch said.

Dinsmore emphasized that there is critical need for physicians who can determine a person’s fitness to dive. He said that people with certain medical conditions should never attempt to dive, and that physicians need to learn what those conditions are. “We had someone apply for dive certification with NOAA who had received a medical clearance from his doctor. Unfortunately, the person had recently had triple bypass surgery, and diving for this individual could have been disastrous. If the doctor had been trained in hyperbaric medicine, he probably would not have given his approval.”

According to Dinsmore, the physicians who took the course not only got the training they needed to be effective diving medical officers, they got more than they bargained for. “They were just like a bunch a kids—laughing and carrying on, and taking pictures of each other while diving in the tower. They were having the time of their life doing something completely different than their usual routine.”

The Hyperbaric Physician Training course is offered once a year at the NOAA Diving Center in Seattle, Wash. The primary mission of the NOAA Diving Program, based at the Center, is to train and certify scientists, engineers and technicians to perform the variety of tasks carried out underwater to support NOAA’s mission. With more than 300 divers, NOAA has the largest complement of divers of any civilian federal agency. The agency’s reputation as a leader in diving and medical training has also led to frequent requests from other governmental agencies to participate in NOAA diver training courses. In addition to having three hyperbaric chambers and classroom facilities, the NOAA Diving Center features a 30-foot high diving tower and an L-shaped staging pier that partially encloses a 30-foot-deep training basin in Lake Washington. Water depths exceeding 200 feet are located within one mile of the Center.

Relevant Web Sites
NOAA Diving Program

NOAA Office of Marine and Aviation Operations

Media Contact:
Jeanne Kouhestani, NOAA Marine and Aviation Operations, (301) 713-3431 ext. 220
(Photos courtesy of NOAA Corps LT Bill Cobb, operations manager of the NOAA Diving Center in Seattle, Wash.)