<p> U H M S D e s i g n a t e d I n t r o d u c t o r y C o u r s e i n Form CME 104 H y p e r b a r i c M e d i c i n e A p p l i c a t i o n Revised 01/03/10</p><p>Activity Title: Date Submitted: Responsible Organization: Director / Administrator: </p><p>A UHMS designated introductory course in hyperbaric medicine is expected to require a minimum of 40 hours of instruction, formal assessment upon completion, some element of practical chamber-side instruction, and must be documented by a certificate of completion.</p><p>Below is a list of elements required in a UHMS Designated Introductory Course in Hyperbaric Medicine. Please attach: a) Detailed hourly lesson objectives. Cross reference each lesson objective with the corresponding element #. Annotate on this checklist the page # at which each element can be found. b) A copy of the course certificate of completion.</p><p>ELEMENT Page # ELEMENT Page # 1. Historical Considerations 7. Side Effects and Contraindications a. Historical perspective of hyperbaric medicine a. Oxygen toxicity b. Evolution of UHMS guidelines for using HBO2 b. Other risk factors c. Other standards and guidelines c. Contraindications 2. Physics of Hyperbaric Exposure d. Management of complications a. Physical laws applicable to barotrauma and 8. Hyperbaric Chamber Systems hyperoxygenation a. Operating procedures 3. Mechanisms of Hyperbaric Oxygen b. Breathing gas systems a. Oxygen physiology, pharmacology, & c. Ancillary support equipment biochemistry d. Environmental systems and their operations 4. Air Decompression Procedures 9. Hyperbaric Safety and Emergency Procedures a. Decompression theory a. Safety codes and standards b. Air decompression tables b. Operational, electrical, and fire safety 5. UHMS Accepted Indications: Their Scientific Basis c. Emergency procedures and Treatment Protocols 10. Administrative/ Management Issues a. Decompression sickness a. Reimbursement information b. Air or gas embolism b. Management responsibilities c. Carbon monoxide poisoning & smoke inhalation c. Professional societies and resources d. Gas gangrene (Clostridial myonecrosis) 11. Clinical and Technical Practicum e. Crush injury, compartment syndrome, & other Practical experience and observations in: acute traumatic ischemias a. Patient assessment and management f. Arterial Insufficiencies Central retinal artery b. Hyperbaric chamber operations occlusion, Enhancement of healing in selected c. Ancillary hyperbaric equipment problem wounds 12. Evaluation g. Exceptional blood loss (anemia) a. Final written examination h. Necrotizing soft tissue infections b. Course critique i. Osteomyelitis, refractory j. Radiation tissue damage Those applying for a UHMS Designated Introductory Course in Hyperbaric k. Skin grafts and flaps (compromised) Medicine must submit this checklist with attachments as part of the UHMS l. Thermal burns CME Activity Application (Form CME 102) m. Intra cranial abscess UHMS USE ONLY n. Other uses of HBO2 Yes No 6. Patient Assessment and Management Instructors possess the appropriate level of training and experience a. Tissue oxygen assessment in the topic they present. b. Patient evaluation and selection for HBO2 Course is at least 40 hours duration Certificate of completion is enclosed treatment Approved as a UHMS Designated Introductory Course in Hyperbaric c. Plan of treatment (assessment of treatment, Medicine endpoints) Not Approved (Comments Attached) d. Wound care e. Care of diabetics during HBO2 Approval Date Expiration Date f. Management of the critical care patient during HBO2 g. Infection control h. Documentation (e.g., record keeping, medical photography) ______UHMS Education Committee Chairperson i. Quality assurance</p>