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Undersea and Hyperbaric Medicine Section Newsletter - April 2016

 Section Update, UHM Fellowships, Case Report and more…

 

From the Chair - ACEP15 Recap

BruceDerrick_2015Thanks to everyone who participated in a great ACEP Undersea & Hyperbaric Section meeting this past fall. We had lively participation from section members and discussed a number of timely issues. Setting section goals for the upcoming year headlined the meeting and agreed objectives include: (1) updating contact information for fellowship programs on the Section microsite, (2) improving the Section microsite appearance and content, (3) more frequent newsletter publication, and (4) increasing involvement from the Section membership throughout the year.

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ACEP Clinical Policy on Carbon Monoxide Poisoning

Carbon MonoxideAs you likely already know, ACEP just released a draft of the new clinical policy on management of carbon monoxide poisoning. The draft was emailed to you for review from both the Section listserv and by ACEP. Everyone is welcomed and encouraged to submit their views to ACEP through the web based form. However, I also believe that it is important that we initiate a discussion via the UHM Section listserv and plan to draft a formal comment letter on behalf of the UHM Section membership. Additionally, we will set up a conference call or video conference once people have a chance to digest the material. This will be scheduled for April in order to ensure enough time to meet the May 7th comment deadline.

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Case Report of Iatrogenic Pneumorrhachis Treated with Hyperbaric Oxygen Therapy

Fig1-CTSpine2Stephen Hendriksen 2016Case Report
A 29 year old female experienced sudden bilateral lower extremity numbness and weakness during an attempt at a blood patch for a post lumbar puncture headache. A CT of the spine demonstrated significant spinal canal gas with mass effect. The patient was transferred from an outside hospital for consideration of hyperbaric oxygen therapy. With measurable deficits on exam, the patient was treated with a USN Treatment Table 6 with improvement of her symptoms. Repeat imaging demonstrated resolution of air in the spinal canal.

Discussion
Pneumorrhachis is a rare presentation characterized by air in the spinal canal. It can occur from a multitude of etiologies including trauma, iatrogenic, or non-traumatic causes. Common iatrogenic causes occur during surgery, anesthesia, and diagnostic tests. Non-traumatic causes include vertebral degeneration, malignancy, radiotherapy, and gas producing infections. Pneumorrhachis is classified as internal (air with the subdural or subarachnoid space) and external (intraspinal or epidural air). Internal pneumorrhachis can be concerning for a severe underlying injury.

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Diving Medicine eConference Spring 2016

This year, there have been great diving medicine eConferences. Thanks to all the fellows who have presented and to the faculty across the country for sharing your knowledge and experience.

There are just a few conferences left for this academic year. The dates for the remaining 2015-2016 academic year eConferences are:

April 5th- Hennepin
May 3rd- LSU
June 7th- TBA

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2016 is Here!! Let’s Get Started!!

There is so much to do, and so much to read!! I hope to see all of you, at one of these conferences or elsewhere. Remember, we should all do our part to promote our chosen subspecialty in any venue we can. That may be at ACEP, or a regional meeting, or another specialty conference. I surely hope to see all of you in Las Vegas in October!! It will be great fun. Thanks.

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ACEP UHM Section is coming to UHMS!

We’ve obtained approval to hold an ACEP UHM Section meeting at the upcoming UHMS Scientific Assembly this June in Las Vegas. Please plan to attend this meeting if you will be at UHMS this summer. This gives us the opportunity to get together in person one extra time during the year. We hope to continue moving the Section forward as there were a number of items we didn’t have time to discuss at the ACEP meeting. This new meeting will also promote our Section within the UHMS and help foster even more collaboration for years to come. We will email the listserv once we have a date and time for this meeting.

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ACEP16 is Rapidly Approaching

Las Vegas, NV: October 16-19, 2016
Book your travel and lodging soon! Registration for the meeting opens June 1st.

We have already begun planning for the UHM Section Meeting. Please email me if you have any items you would like added to the agenda. We will let everyone know as soon as we have a date and time for the meeting.

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Hyperbaric Fellowship Considerations

A variety of career paths can both lead to and emerge from completing a fellowship in Undersea & Hyperbaric Medicine (Hyperbaric). Hyperbaric fellowship training is regulated by two specialty boards in the United States (Emergency and Preventive Medicine), but is unique in that it draws candidates from many specialties. For example, you will find anesthesiologists, family doctors, emergency doctors, internists and surgeons pursuing this year-long training, writing the hyperbaric board exams and ultimately practicing in this field. Some are attracted because of a primary interest in Scuba diving, with the unique physiology and medical considerations it entails, while some may be drawn by other aspects of medical practice including complex wound management or critical care. Here we would like to give the reader a sense of what to expect during fellowship training in hyperbarics.

Duke Research Chamber
The Duke “golf ball” Research Chamber

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Hello From the Undersea and Hyperbaric Medicine Fellowships!!

LeGros 2016Hello everyone! I wanted to share with you a couple of important changes that have occurred with our Undersea and Hyperbaric Medicine Fellowships. We have new leaders at the helms. The Program Directors are more invested than ever in developing the most comprehensive UHM fellowships possible. This is the most up-to-date information on how you may contact the Undersea and Hyperbaric Medicine Fellowships directly.

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Hot Off the Presses!! New Articles from the World of Hyperbarics!!

These are some of the latest and greatest articles published in the last year. They represent a wide range of topics, and provoke controversy in some cases. All are worth a read. I pulled mainly from the UHMS journal, but that is simply because that is what I am reading right now. I update my jump drive of the world’s literature later in the month. I will keep you posted.

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Upcoming Events in Undersea and Hyperbaric Medicine!!

There is a lot going on. The UHMS is planning its annual meeting, and it promises to be fantastic. Additionally, there are many regional, national, and international meetings that might peak your interest. Here are just a few. I have been to almost all of them. I missed the SPUMS meeting on Reunion Island a couple of years back. However, all of them showcase the best educators on the planet in Undersea and Hyperbaric Medicine.

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Make A Difference: Write That Council Resolution!

Many College members introduce new ideas and current issues to ACEP through Council resolutions. This may sound daunting to our newer members, but the good news is that only takes two ACEP members to submit a resolution for Council consideration. In just a few months the ACEP Council will meet and consider numerous resolutions.

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