Monthly Briefing Archive
June 2010
May 2010
April 2010
March 2010
February 2010
January 2010
December 2009
November 2009
October 2009
September 2009
August 2009
July 2009
June 2009
May 2009
April 2009
March 2009
February 2009
January 2009
June 2010
The Board is increasingly concerned with what appears to be the practice of hyperbaric oxygen therapy without appropriate physician oversight. It is particularly disturbing to learn that, in some cases, it is the CHT’s who is operating a hyperbaric treatment facility in the absence of a physician. Disturbing, given that the process of preparing for and taking the hyperbaric certification exam offers ample evidence of wide - ranging complications and side effects that may complicate patient care. Such problems clearly require physician directed diagnosis, interpretation and management.
Please take a moment to read, or re-read, the Board’s Position Statement number 2010-01, posted in April of this year. You can locate it on the Board’s Home Page. This statement makes The Board’s expectations regarding the operational practice of hyperbaric medicine very clear. Our patients deserve nothing less.
Dick Clarke, CHT, President
National Board of Diving & Hyperbaric Medical Technology
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May 2010
As the pace of the Board’s activities continues to accelerate we want to improve the way we communicate important developments. The "Monthly Briefing" does receive some 440 visits every month. This is encouraging. However, a larger number of our diver medics, technologists and nurses do not access and benefit from this content, given that we have 4,000 of them!
To better spread the word then, we plan a monthly email blast. It will contain the current month’s briefing, along with anything else deemed informative. Examples of which will include the latest Position Statement, any significant changes to the certification and recertification processes and introduction of any new programs – the veterinary hyperbaric technologist certification is working its way to fruition.
You will have likely received our first blast, sent out during the last week of April. If not, we do not have your email address on file so send it in. The blast carried the Board’s most recent Position Statement (Physician Attendance and Supervision of Hyperbaric Oxygen Therapy). This statement was prompted by what appeared to be reports of CHT’s independently ordering and delivering hyperbaric oxygen therapy; ie, in the absence of a physician. To most of us this would be readily recognized as practicing medicine without appropriate licensure. It would further represent an obvious violation of several legal and regulatory standards and codes. However, the Board wishes to make this point very clear to its DMT, CHT and CHRN constituents.
Dick Clarke, President
National Board of Diving & Hyperbaric Medical Technology
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April 2010
I have some very good news to report regarding our diver medic colleagues serving in the U.S. Navy. In July of last year, at the invitation of Chief Petty Officer Blair Dell HMS, Special Operations Independent Duty Corpsman at the Naval Diving & Salvage Training Center and Diving Medicine for Medical Personnel lead instructor, I visited his program in Panama City. It was impressive, as was he. The diver medic training these guys undergo is both extensive and unparalleled. During my visit I was invited to speak to a DMT class about to graduate and another just getting underway. My topic was the history of the civilian DMT program and the role of today’s diver medic in the commercial diving industry.
This presentation started the wheels turning. Chief Dell and his colleagues began to research a pathway whereby naval personnel who complete DMT training could apply to the NBDHMT for civilian certification and be financially sponsored by the government. Step one was for us to review the USN DMT training course curriculum. As noted above, it was quite superb and greatly exceeded our minimum requirements. With course approval in place, these motivated individuals formally applied to the Department of the Navy for a civilian credentialing opportunity. This has recently been approved and I must say that the NBDHMT is honored to be able to certify graduates of their DMT program.
The annual meeting of the NBDHMT Board of Directors is on the horizon. As in the past, it will coincide with the annual scientific meeting of the Undersea and Hyperbaric Medical Society, in St. Pete, Florida (June 3-5). A reminder that if you are planning to be there, then don’t miss ‘Breakfast with the Board’. This year’s breakfast will be at 7:00am on Friday, June 4, 2010. Try to make it. You will have the opportunity to meet personally with the Board and learn what we have planned for the coming year. At this year’s meeting we will also have an exhibitor booth so please drop by and say hello.
Dick Clarke, President
National Board of Diving & Hyperbaric Medical Technology
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March 2010
Our efforts to provide advance notification of recertification deadlines by regular mail are frequently thwarted by incorrect postal addresses we have on file. It would be preferable, of course, to have everyone’s email contact. It is more likely to be up-to-date and avoids postal costs. We are in pretty good shape with all of you who have certified in the last several years. However, our records are less impressive for many who have been around a lot longer. Please ensure that the corporate office (nbdhmt@aol.com) has your email address when you have a moment.
Look our for us at the Undersea and Hyperbaric Medical Society Annual Scientific Meeting, June 3-5, in St. Petersburg, Florida, and Hyperbaric Medicine 2010, Columbia, South Carolina. We will have exhibitor booths at both of these meetings. Stop by and meet our administrative staff and Board Members. At the UHMS meeting we will again host a ‘Breakfast with the Board’. The Board’s certification activities will be updated as you enjoy a complimentary breakfast. This proved very popular last year, with some 70 in attendance. This is another good opportunity to get your questions addressed and represents a useful forum for comments and discussion.
Recent visitors to the Board’s website will have recognized a new logo. Nurses now have clear representation on the Home Page via very nicely designed imagery. With the development of a CHRN specific logo we have been able to introduce merchandise specific to the certified hyperbaric nurse. Check out these and several other additions to the Online Store link using the link provided on the Home Page.
Dick Clarke, President
National Board of Diving & Hyperbaric Medical Technology
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February 2010
With the elimination of the Basic level DMT. There exists a need to access invasive skills training. A survey of DMT instructors indicates that such opportunities do exist. The following facilities/instructors have indicated interest in a 'bridging' course that will provide the necessary training to permit Basic DMT's to re-certify.
Hyperbaric Training Associates/Ron Ellerman
rellerman@wi.rr.com
Oxyheal Health Group/Kevan Corson
kcorson@oxyheal.com
Divers Alert Network/USC Catalina Hyperbaric Chambers
huggins@usc.edu
National Polytechnic College of Science
jspelich@natpoly.edu
Contact those instructors if you need additional information. Effective January 1 of this year invasive skills are a mandatory component of the DMT certification training curriculum.
The Board recently decided to eliminate two of the long established CHT Qualifying Vocations. One was 'Researcher'. This was rather a vague term. It had very rarely been employed during certification requests and it did represent a potential for abuse of the spirit and intent of the Qualifying Vocation. The second was 'Medical Services Specialist'. This is a title and position specific to military personnel. Again it has very rarely been employed. Should medical services specialist wish to apply for CHT status, alternative Qualifying Vocation pathways exist (EMT or application to the 'Others' subsequently appeal to the Board).
A reminder that the 480 hours of preceptorship that follows hyperbaric training must include 40 hours of direct oversight. Established CHT's and CHRN's are expected to serve in this capacity. Specific preceptor guidelines will appear in the March Briefing. Hyperbaric physicians would represent an alternative, should there be a program lacking experienced technologist and nurses. If difficulties persist please contact Board headquarters.
Dick Clarke, President
National Board of Diving & Hyperbaric Medical Technology
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January 2010
Adding to NBDHMT recognition by the Health on the Net Foundation as promoting useful and reliable information, the NBDHMT is now a proud member of the Institute of Credentialing Excellence. Formerly the National Organization for Competency Assurance, ICE is dedicated to providing education, networking and advocacy resources for the credentialing community. We will be submitting applications for our DMT®, CHT® and CHRN® credentialing programs to ICE’s accrediting body, the National Commission for Certifying Agencies, in the coming months.
We are going to delay the restructuring of the DMT® certification examination. You may recall that the Board had intended to align DMT® certification testing with its CHT® and CHRN® processes. This was to have occurred on January 1 of this year. Unanticipated delays in the reconfiguring of the exam question bank have necessitated this change in plan. All of the Board’s approve DMT® instructors and DMT® training facilities have been advised to maintain their current testing procedures until further advised.
Progress continues with the development of a certification examination in veterinary hyperbaric technology. Under the able leadership of Dr. Dennis Geiser, DVM, University of Tennessee, College of Veterinary Medicine, a committee is fine-tuning the process where those seeking such certification will be trained, tested and credentialed. It is anticipated that Board approved training will commence before the end of this year.
As the Board enters it 25th year I am reminded of its formative period. Having first attempted, unsuccessfully, to align certification of diver medics with the National Registry of Emergency Medical Technicians, the Board was formed in 1985. We were advised by some at that time that an upstart organization such as ours would fail to gain necessary credibility and respect. Time has proven otherwise. And all of those who have benefited therapeutically from your care, be they the commercial oilfield saturation diver off Brasil’s Atlantic coast, the teenage female scuba diver in the Florida Keys, the carbon monoxide poisoned warehouse worker in Salt Lake City or the retiree in Philadelphia who avoided losing her radiation damaged bladder, represent the ultimate validation of a certification body dedicated to the safe and effective application of undersea medicine and hyperbaric oxygen therapy.
Dick Clarke, President
National Board of Diving & Hyperbaric Medical Technology
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December 2009
Take a moment to check out the Board’s all new Online Store. It was completely revamped and upgraded in November. Merchandise is of the highest quality and the store’s payment process has finally entered the modern era -- credit cards are accepted! Consider these items as a great way of displaying and promoting your certification status as a Diver Medic or Hyperbaric Technologist. Hyperbaric Nurse merchandise will be offered once a suitable logo has been designed and approved by the Baromedical Nurses Association Certification Board. Let us know if there are other items you would like to see offered. Sweat shirts and ball caps are in the works.
A new NBDHMT Position Statement was posted on the website home page several weeks ago. It relates to the disturbing practice of hyperbaric oxygen chambers and related supportive infrastructure being sold to the lay public and used in the in-home setting. To the informed, this practice will immediately raise several red flags. Given the Board’s leadership position on all things hyperbaric safety, it would be remiss if we did not offer public comment against this practice.
This month’s ‘Briefing’ represents a full calendar year of what we hope have been helpful insights. We will continue to use this communication vehicle to keep you apprised of what we have in the planning stages and what is being contemplated. Those of you who have written to us about the Monthly Briefings have been uniformly pleased. We hope this sentiment extends more broadly.
Some reminders: The decompression table’s examination questions on both the CHT and CHRN examinations will change effective January 1. From this point, these questions will be based upon the most recent version of the U.S. Navy Diving Manual (Revision 6). All DMT training must incorporate invasive skills training in the new year. Fees will increase for CHRN certification on January 1st, 2010.
DMT certificates will be issued only at the time of the initial certification. A new card will be issued upon re-certification. In the past, certificates were issued for both certification and re-certification. We have updated the certificates so they no longer have an expiration date. Therefore, your certificate will always show your original certification date.
On a final note, Board Administrators Jeannie McLamb and Nancy Martinich join me and the entire Board of Directors in wishing you and your families an enjoyable and safe holiday season.
Dick Clarke, President
National Board of Diving & Hyperbaric Medical Technology
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November 2009
Many of you will have noticed the HON icon that now features prominently on the Board’s website. The Health on the Net Foundation (HON) promotes and guides the deployment of useful and reliable health information. Created in 1995, HON is a non-profit, non-governmental organization. It is accredited to the Economic and Social Council of the United Nations.
The NBDHMT received HON certification in October of this year. This important distinction was the result of a HON review committee determination that the information contained within the NBDHMT website meets HON’s eight ethical principals. HON will regularly monitor the website to ensure ongoing compliance. Visitors to the site are assured of the quality and trustworthiness of its medical and health content.
You may also have noticed improved navigation within the DMT, CHT and CHRN linked sections. The ability to locate and download certification application materials has been enhanced. Please don’t hesitate to contact Board headquarters if you feel that we can further enhance the value of our website content.
As noted in previous ‘Monthly Briefings’, the Board has been researching the possibility of incorporating national testing centers into the certification examination process. Having completed the review process it is apparent that we will not be able to offer testing center examination options. Principally, it came down to cost. Clearly, these testing centers commonly deal with larger organizations than the NBDHMT. Unfortunately, there is no way that the Board can absorb associated annual costs (as high as $60,000 in two instances) nor realistically pass on these costs to those who sit the certification examinations. We will continue to coordinate on-site proctorship testing opportunities, to the widest geographic scope possible. A quick review of the current testing locations will indicate just how wide spread and how frequent the Board is able to schedule testing sites. For 2009 alone, some 30 locations will have been used by the end of the year.
On a final note, a new CHT certification level has been introduced. It serves to recognize those who have advanced professionally from their technical and clinical duties to management and administrative responsibilities. Until now, these individuals have frequently been unable to complete the necessary technical and clinical hours to meet CHT recertification requirements. By applying for CHT-Admin, they will now be able to maintain their CHT ‘identity’ and continue to be recognized as a hyperbaric professional.
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October 2009
‘Primary Source Verification’ is now live on our website for all categories of certification. Prospective employers can now directly search our CHRN, CHT and DMT databases. Upon entering an individual’s last name in the appropriate box, via the ‘Confirm Certification’ link on the Home Page, one will see that individual’s full name, certification number (for CHRN’s and CHT’s) and expiration date, if they are indeed certified. Each of the three databases is updated weekly. If the name of a particular individual does not appear, those searching are prompted to a link to the Board headquarters email address to request a more updated search.
Animal chambers have long been a part of hyperbaric medicine’s research efforts. More recently, animal chambers have been employed in a clinical/treatment setting. This practice is growing considerable, and on an international scale. Some of the conditions suffered by our hyperbaric patients are also suffered by animals. One would expect, therefore, that these animals would derive benefits similar to those our patients enjoy. Already, however, there have been several fatal equine hyperbaric chamber fires. In order to enhance the practice safety and clinical effectiveness of these animal chambers, the NBDHMT is in the process of developing a hyperbaric certification standard for veterinary technologists. A working group made up of NBDHMT Board members and veterinary specialists has been formed. Their remit is to create a training course and certification examination that will result in the awarding of a Certification in Hyperbaric Veterinary Technology (CHVT). It is intended that this new NBDHMT certification will be available in the latter part of 2010.
On a final note, certification and recertification fees for CHRN’s will increase on January 1, 2010. The Board will accept payment at the current rates for 2010 certifications if payments are received by December 31 of this year. For those of you due to recertify in the early part of 2010, payment in December will represent a saving of approximately 20% on next year’s fees.
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September 2009
Certification examination schedules are at an all time high. From January through July of this year, testing was scheduled at 12 different locations, involving 105 nurses and technologists. For the remainder of the current year 16 additional examinations are scheduled, with 111 CHT/CHRN applicants registered to date. Independent of these impressive numbers is a steady volume of diver medics being certified.
Given the above, I thought that you might be interested to learn of the total number of those who have been certified since the inception of the NBDHMT. These numbers will provide some idea of the growing interest in the practice of undersea and hyperbaric medicine. The first CHT examination was offered in San Diego, in 1991. From that point, through 2005, 687 became certified. From 2006 to August 2009 another 702 have certified. The last four years, therefore, has seen more certification activity than in the previous fifteen years. On the nursing side, the CHRN exam was first offered in 1995. Through 2005, 292 nurses became certified. From 2006, an additional 326 have certified. Again, the last several years has produced more CHRN’s than the previous 11 years. The DMT certification program is equally impressive. While DMT training began in 1975, it was not until 1989 that formal certification was introduced. From 1989, through 2005, the Board certified 774 diver medics. In the last 3 ½ years another 839 have been added to the rolls.
I think that we can take comfort in this growth, and the increasing professional recognition and credibility that formal certification offers.
Work continues to restructure the DMT certification program into a single standard. As noted in previous briefings, the DMT testing process will be brought in-house in the coming year. The ‘Module 16’ training curriculum is being fine-tuned and the question bank finalized. The same applies to the adoption of national testing centers for three certification programs, which we hope to introduce in the not too distant future.
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August 2009
The annual Board of Directors meeting was held in Las Vegas, in June, in conjunction with the 2009 annual scientific meeting of the Undersea and Hyperbaric Medical Society. An extensive agenda was tackled, much of it designed to enhance the operations and quality of the Board’s various certification processes.
Sub-committees were formed in order to upgrade the DMT training course outline (commonly referred to as Module 16) and to create the DMT examination database. As noted in early ‘Briefings’, the DMT certification examination process will be undertaken by the NBDHMT, in the same manner as the CHT and CHRN programs, beginning in 2010. Invasive skills training will become a standard component of all DMT training at that time.
Another important update is the decision to conduct all future certification examinations through a national chain of testing centers. This is now commonplace for medical, legal, accounting and other professions. The use of testing centers will make it much easier for individuals to schedule their exams, by not having to wait for the required minimum number of applicants before a test date can be scheduled in a specific area. It will also serve to enhance the security and confidentiality of the examination process. We expect to have this process in place by early 2010.
The Board has been approached by members of the veterinary medicine community. They are interested in the development of a training and certification standard for those who operate equine and other animal hyperbaric chambers. An initial approach occurred two years ago; interest is now renewed. I met with a representative of this group in July and the Board will look closely at this possible extension of its certification activities in the coming months.
The Board wishes to emphasize that, going forward, the 480 hours of preceptorship necessary to complete eligibility prior to taking the CHT examination must occur following formal Board approved hyperbaric training. Work experience that has been accumulated prior to the formal training is not considered part of the 480 hours of preceptorship. Preceptorships are expected to be undertaken via an experienced CHT or CHRN wherever possible. If you are thinking of becoming certified in hyperbaric technology, please have your preceptor contact the Board for a guidance document.
On another topic, the Board wishes to clarify the procedure for those who fail their certification examination. They may re-take the examination following a six month waiting/study period. If an examinee fails a second time, they are then required to repeat formal NBDHMT approved hyperbaric training, at which point they become eligible to take the examination a third and final time. Those who fail their third attempt (and this has not occurred to date) would not be eligible to make any further attempts.
One final point is to remind those who apply for certification as CHT’s and CHRN’s that they must submit evidence of completion of three transcutaneous oxygen studies, which represents completion of the TCM Module training process. This evidence can be in the form of a statement within the letter that confirms completion of the preceptorship process.
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July 2009
The new Board headquarters team continues to get a good grasp on the day-to-day aspects of the various certification processes. This has been enhanced by improved office automation capabilities and access to upgraded information technology. Your patience during the past several months has been greatly appreciated. We are now in a much better position to serve you more efficiently.
Both the upgraded CHT and CHRN examinations have literally been put to the test. It appears that our efforts to improve the respective testing banks have been successful. This observation is based upon the very few comments received with completed tests, which typically raise concerns regarding question clarity, appropriateness or intent. We will continue to monitor test results closely and make adjustments as they appear necessary.
If you are a certified DMT, CHT or CHRN and have not done so already, please take a moment to email the Board with your date of birth. We are in urgent need of this in order to introduce Primary Source Verification (see May 2009 Monthly Briefing).
A reminder that those DMT’s certified as ‘Basic” will need to provide evidence of invasive skills training upon application for re-certification on or after January 2010. In the coming months the Board will provide information on where such invasive skills training is being offered.
The NBDHMT Board of Directors held their annual meeting in Las Vegas, on June 24. This meeting coincided with the annual scientific meeting of the Undersea and Hyperbaric Medical Society. I will provide a summary of the Board meeting in the next edition of Monthly Briefing.
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June 2009
Many of you will be aware of the fatal hyperbaric chamber fire that occurred in a free-standing facility in South Florida, on May 1st.
The fire appeared to involve an early model Vickers monoplace. While details of the resulting investigation have not yet been made public, early indications suggest that this facility’s normal course of operations involved marked violations from what would be considered standard hyperbaric safety. This tragic event has prompted the NBDHMT to move forward its planned publication of a series of Position Statements. The first two such Statements are now published on the Board’s Home Page. More will follow and any comments you may have are welcomed.
The Board’s headquarters are now operating from their new location, in Columbia, South Carolina. Please be patient as our team comes to grips with a huge amount of documentation. Note the new Board contact details at the foot of each page of the website. On a particularly sad note, I also want to let you know that the Board’s long serving office manager, Pauline Poletti, is seriously ill and unable to continue her employment. Pauline has a tough time ahead of her, yet she remains in good spirits. Not the least of her difficulties is mounting and uncovered health care costs. A fund has been established by her co-workers, family and friends to help offset these costs. If you would like to make a contribution to Pauline’s financial burden please send it to:
The Pauline Poletti Donation Account,
# 207 81 1600 8 at Capital One Bank.
Payments can be made directly to any Capital One Bank or sent to the attention of Mandy Wise, 1816 Industrial Blvd. Harvey, LA 70058-2314. I know that Pauline, who served the Board and all those who certified for almost 20 years, will be very grateful.
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May 2009
Plans are underway to introduce ‘Primary Source Verification’ to the Board’s website. This is an increasingly common verification aspect of modern healthcare. It is now mandated by the Joint Commission on Accreditation of Healthcare Organizations for all clinical staff required by an employing organization, or the state, to have licensure, registration or certification. The purpose of this verification is to ensure that a person’s qualifications are consistent with their job responsibilities. In the past, such verification was a somewhat lengthy, convoluted and not always successful process. It commonly entailed hard copy communication with numerous related entities. Today the process can be greatly enhanced via access to information links within single website sources.
We plan to get the CHT verification process up and running first. Those seeking to confirm that a staff member or potential employee is currently certified in hyperbaric technology through the NBDHMT will be able to access the ‘Primary Source Verification’ link on the Board’s Home Page. By entering an individual’s name and date of birth, current certification status can be confirmed. We plan to have CHT verification in place by July of this year. Verification will be extended to DMTs and CHRNs in due course.
Another important news item is that the Board’s headquarters is being relocated to Columbia, South Carolina in the coming weeks. We anticipate a seamless transition and no interruption in certification and related support services. Look out for new contact details on the website. On behalf of the Board, I would like to extend my sincere thanks and deep appreciation to Dr. Keith Van Meter. He has generously provided an administrative home for the NBDHMT in his company’s offices in New Orleans for almost 20 years.
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April 2009
An important milestone was reached during March of this year. The first major revision of the CHT examination in the 20 years since it was first introduced was completed. Questions have been added and deleted during this period. However, the exam was in need of a top to bottom overhaul and upgrading. What we have now better reflects today’s operational, technical and safety practice standards. The examination more effectively tests each prospective hyperbaric technologist’s core knowledge. Gone are the questions most relevant to nursing practice and hyperbaric physician decision-making. The examination has also been carefully weighted between key subject categories, in order to further improve balance specific to the roles and responsibilities of the hyperbaric technologist.
All subsequent CHT examinations will use this new question bank. We have elected to maintain the decompression tables’ questions based on the 1999 version of the U.S. Navy Manual’s Standard Air Decompression Tables for the time being. Many of you will be aware that these tables underwent a significant change in 2008. Theses new tables are now incorporated as Revision 6 of the U.S. Navy Diving Manual. We have elected to maintain the 1999 version as not all training centers have switched their teaching materials. We anticipate that the CHT examination will incorporate the 2008 decompression tables for all examinations that are scheduled after January 1, 2010. The principles of table computation remain the same. However, time frames have changed to reflect more conservative exposures and depths are now broken down into 5 instead of 10 fsw increments.
The Baromedical Nurses Association Certification Board is likewise undertaking a updating of the CHRN examination question bank. We expect that their new questions will be incorporated within the coming weeks and be reflected in all scheduled CHRN examinations after June 1, 2009.
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March 2009
A recent visit to Board headquarters in February allowed me to reacquaint myself with Pauline and meet for the first time with Melissa. These two individuals are truly dedicated to the success of the Board’s mission and all those who certify. I also spent time with past president Paul Baker and executive committee member Dr. Keith Van Meter during my time at the office. We discussed a number of initiatives, one of which involves modernizing all of the present office technology. Another will see the Board being able to finally accept credit card payments.
I have a meeting scheduled with the diving medical officers and safety directors from the Gulf of Mexico’s commercial diving industry, in the early part of this month. The purpose of this meeting is to determine from these important ‘end users’ of the DMT certification program if we are continuing to meet their needs. Much has transpired in both the diving industry and the provision of emergency medical care since the inception of the DMT program, in 1975. The Board is presently undertaking a comprehensive review of the DMT certification program. We must ensure that it remains current, pertinent and responsive to the needs of the industry and its injured divers.
I am in communication with all of the current DMT training programs. They have provided valuable service over the years and we want to ensure that they have the necessary tools and guidance to continue to effectively address this important aspect of diving safety. Some changes are likely. The basis for any change will be enhanced education and training and the optimizing of care rendered on behalf of the injured diver.
Dick Clarke, President
National Board of Diving & Hyperbaric Medical Technology
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February 2009
From its independent beginnings, almost three decades ago, the NBDHMT has carved an indelible nitch within the mainstream of undersea and hyperbaric medicine's safety and patient care consciousness. Early attempts to affiliate with existing certification bodies proved unsuccessful. The principal stumbling block was the operational, geographic and medical remoteness of the DMT. These diving first responders were, at times, far beyond the conventional time frames of traditional land-based EMT's/Paramedics in terms of reaching medical facilities and transferring direct care to a physician. This perceived risk was considered too great a hurdle for pre-hospital certifying agencies to assume responsibility for the DMT.
Lacking any alternative and with a firm desire to standardize and enhance the DMT program, an independent non-profit organization was formed. Critic's charged that such an organization would not gain the necessary credibility and acceptance. The board persisted. Time and events have proven our critics wrong. Today, the NBDHMT is an increasingly measured standard, in the U.S. and elsewhere. Oil and gas production companies, oil field diving support companies, hospitals, health insurance companies, training agencies, geographically remote recompression facilities and accreditation programs recognize and promote the personnel and standards that are a product of Board's certification processes.
One recent and particularly important validation of the NBDHMT's credibility and good standing in medical practice comes from Medicare, the U.S. government’s health insurance giant. Several of Medicare's regional intermediaries are now mandating certification in hyperbaric technology or hyperbaric nursing in order to conduct reimbursable transcutaneous oxygen assessments outside of traditional vascular diagnostic setting. One such intermediary, Trailblazer's Health Enterprises *, in a 2008 update, noted:
'Additionally, transcutaneous oxygen measurements may be performed by persons possessing the following credential's obtained by the National Board of Diving and Hyperbaric Medical Technology (NBDHMT):
Certified Hyperbaric Technologist (CHT) or,
Certified Hyperbaric Registered Nurse (CHRN)
* Trailblazer's Health Enterprises, LLC
LCD Non-Invasive Peripheral Arterial Studies U-17B-R6; 10/01/2008
The board intends to build on all of this momentum. Stay tuned to the Monthly Briefing column to find out more specifically where we are heading.
Dick Clarke, President
National Board of Diving & Hyperbaric Medical Technology
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January 2009
A note to say how pleased I am to return to the Board as its president and to advise you of some of the initiatives planned for the coming year.
It has been 13 years since I handed over the leadership reins to Paul Baker. Since then, and ably assisted by his fellow Board members, Paul has undertaken his duties and responsibilities to good effect. Now comes a well earned retirement – well, not entirely. I intend to appoint him to a Director-at-Large position. This will ensure continuity, as well as maintain the availability of a valuable resource.
Through a series of ‘Monthly Briefings’ posted on the website, I will keep you, the DMT, CHT and CHRN, in touch with the Board’s activities, initiatives and progress. In addition, you are invited to contact me at any time should there be other issues you would like to raise, or questions you may have. This first briefing will lay out what I have I mind as a starting point for my tenure.
I intend to initiate a detailed review of the DMT program. It has been in place for some 30 years and its graduates have played an important role, sometimes life-saving and often central nervous system sparing, in the practice diving medicine. This has particularly been the case in the medical and geographic remoteness of the commercial offshore diving industry. At this point in time I feel it important to ensure that the training and certification aspects envisioned and applied back in 1976 remain consistent with the evolving needs of the diving/undersea medicine communities.
To this end I plan to meet with safety officers and managers of the various commercial diving companies and diver treatment facilities in order to get their perspectives on the DMT program. It may also be preferable that we evolve to a ‘national’ DMT certification examination, as we have in place for the CHT program. Feedback from those who employ DMT’s will allow us to refine and upgrade related training standards and the certification process.
A second initiative will be to evaluate the potential ‘globalization’ of the Board’s certification activities through the teaming with similar organizations elsewhere in the world. Several opportunities already exist and others may be out there. Given our extensive certification experience, the Board is in a position to assume a leadership role as it relates to international diving and hyperbaric medicine safety, technology and practice excellence.
I will stay in touch with you through regular briefings that will be posted on the Board’s website. Best wishes for 2009!
Dick Clarke, President
National Board of Diving & Hyperbaric Medical Technology
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