You don’t know what you don’t know...
Most of us have had an instance in our life where we’ve wanted a ‘do-over.' Maybe it has been something simple like filling up your car with gas one day, only for it to drop 20 cents a litre the next. Or something more serious, with much bigger consequences. In hyperbaric medicine, we have training programs for our staff to make sure we operate with the highest standard of safety. We have learned from past mistakes, and with practice hopefully we will never find ourselves not knowing what we didn’t know until it was too late.
We know that risk management is one of the top priorities in hyperbaric oxygen therapy (HBOT). This has prompted associations like CUHMA to produce a standard of practice, along with the development of safety standards from agencies like the CSA, and training standards from organizations like the National Board of Diving and Hyperbaric Medical Technology (NBDHMT). Here at the Environmental Medicine and Physiology Unit (EMPU) at Simon Fraser University we have contributed to this standard by developing training for Hyperbaric Medical Technologists in 2017. This certificate program includes the same content included in the Clinical Hyperbaric Technologist (CHT) program required by the NBDHMT with the addition of training as a Hyperbaric Chamber Operator certified through the Diver Certificaton Board of Canada (DCBC). We have catered it to our laws and standards within the Canadian system of hyperbaric medicine, while ensuring it meets requirements for hyperbaric technologists to obtain work worldwide.
Historically, the use of hyperbaric technology came out of necessity, and so it’s full applications and the safety around pressurized vessels was learned along the way. By the late 1800s caisson workers were using compressed air while working in tunnels to hold out the water around them. Workers soon noticed body pain after long hours in these environments, which was dubbed “Caisson Disease”. From research done since then, we now know this as decompression sickness – we know its causes, treatments, and how to reduce the risk of getting it. It was also discovered that high percentages of oxygen has a therapeutic effect when given under pressure. Therefore, we cover the fundamentals of diving physics, physiology, and dive tables, as well as the current medical usage of HBOT in our course giving students a baseline in which HBOT is used and understood around the world.
The best way to get students to understand these fundamentals and put them into use is through practice. Because we are a research chamber, we interact with the medical, academic and commercial diving communities. For a Medical Technologist course, this gives the students a look at hyperbaric therapy from a variety of different disciplines. Whether it’s a commercial diver learning to use a TCOM machine, or a nurse donning SCBA gear for a fire drill, people benefit by learning several aspects of HBOT and chamber safety.
One of the major themes that runs throughout most Hyperbaric Technologist courses is the team-based approach of any well-functioning hyperbaric facility. This was reiterated from all of our faculty who, like our students, come from a variety of backgrounds. From the physicians, to the operators, tenders, facility staff, and patients – everyone needs to be on the same page. Having trained staff with a good fundamental base in hyperbaric treatment and chamber operations makes sure that everyone is aware of the risks. If we are trying to avoid past mistakes and advance past knowing what we didn’t know before, an intense and interactive course on Hyperbaric Medical Technology is a good place to start.