ACEP ID:

Undersea and Hyperbaric Medicine

Updates from the Outgoing Chair

Video Modules and a Sincere Thank You

I would like to thank the section for voting for me to humbly serve as your chair for these last two years. I am happy to announce that we have finished filming and are polishing the ACEP HBO Video Module series for final ACEP Undersea and Hyperbaric Medicine (UHM) Section website publication in these next few weeks. The ACEP Section Grant Program was established to assist sections in meeting member’s needs, educating the public, and furthering the advancement of emergency medicine. It is designed to help fund section projects, and it has helped to produce these videos that will be made available to the ACEP audience this year. The videos were shared at Scientific Assembly to our members and core group of attendees for feedback and final edits before publication.  I can tell you from firsthand experience that undertaking such an endeavor has been both challenging and rewarding, all at the same time. I have been able to coordinate efforts with my colleagues, as well as increase the visibility and education within the section itself. The culmination of this project serves to not only further our goal of increasing education for our section members, but also to increase our visibility to the overall ACEP membership as well. I hope it may serve as a valuable tool to reference for our members and a great visual aid that will help to satisfy the educational needs of our members for years to come.

 

Lecture Topics for Scientific Assembly

This year, we hosted Dr. Stephen Hendriksen from Hennepin County Medical Center (HCMC), who presented our key topic lecture on the HOBIT Trial for TBI (Traumatic Brain Injury). The talk titled “HOBIT Trial: Current and Clinical Experience” focused on preliminary enrollment and results of an initial few cases that have been enrolled in the multi-center study. Here is a little background and copied link on the trial (see link and website reference below):

 

HOBIT - Hyperbaric Oxygen Brain Injury Treatment Trial 

Registered with ClinicalTrials.gov: NCT02407028

NIH Project Number: 1U01NS095926-01A1

Status: Enrolling

There continues to be a high mortality and poor outcome for victims of severe traumatic brain injury (TBI). Preclinical and clinical investigations indicate that hyperbaric oxygen (HBO2) has a positive impact on reducing brain injury and improving outcomes in severe TBI. By markedly increasing oxygen (O2) delivery to the traumatized brain, HBO2 can reverse the lack of O2 that precipitates cellular energy failure and subsequent brain cell death. In past clinical investigations, HBO2, in comparison to standard care, has significantly improved energy production in the brain and improved clinical outcome. However, prior to a formal phase III definitive efficacy study, important information is required regarding optimizing the HBO2 treatment schedule to be instituted in terms of pressure and frequency and other parameters. The lungs in severe TBI patients have frequently been compromised by direct lung injury and/or acquired ventilator pneumonia and are susceptible to O2 toxicity. It is essential to determine the most effective HBO2 dose schedule without producing O2 toxicity and clinical complications.

Hyperbaric Oxygen Brain Injury Treatment Trial (HOBIT) is a proposed adaptive clinical trial designed to answer these questions and to provide important data to plan a definitive phase III efficacy trial. Primary aims of this trial are to select patients with severe TBI, the combination of HBO2 treatment parameters that are most likely to demonstrate improvement in the outcome of severe TBI patients in a subsequent phase III trial. Also, the trial will determine, in patients with severe TBI, whether there is a > 50% probability of HBO2 treatment demonstrating improvement in the outcome of severe TBI in a subsequent confirmatory phase III trial. This trial will enroll 200 subjects over 3 1/2 years and is supported and sponsored by the SIREN-NETT Network which is funded by the National Institutes of Neurologic Disease and Stroke to conduct clinical trials such as the one described. 

REFERENCE: https://nett.umich.edu/clinical-trials/hobit

 

Letter to CMS

Regarding our initiative and co-drafted letter (The Undersea and Hyperbaric Medical Society [UHMS] and Undersea and Hyperbaric Medicine Section of ACEP) to CMS (Center for Medicare/Medicaid Services), regarding the petitioning for a requirement that all facilities that plan to request federal remuneration for hyperbaric medicine services apply for accreditation by the UHMS within five years, the effort is still maintaining its focus as we continue to wait to hear back from CMS. The effort is geared toward increasing standard accreditation of all hyperbaric facilities in the United States. Both UHMS and ACEP have been concerned about the availability of quality emergency hyperbaric medicine services, including prolonged delays in receiving appropriate treatment and rising costs of lengthy transports to facilities capable of providing the necessary care for our patients. We revisited this proposal and discussed further advancement of this effort at the meeting in Denver!

 

Elections/New Position

This year, we held elections for new, incoming officers for the positions that were vacated, including: Section Chair-Elect, as well as Secretary/Newsletter Editors and Alternate Councillor. We introduced the prospect of having two ACEP members to be elected to a split position of co-Secretary/Newsletter Editors. This new position should increase productivity and ensure a joint responsibility between two section members within the section. I believe it will assist to help increase the diversity of articles for the section newsletter as well as increase productivity with regard to the publication of the section newsletter for the UHM Section.

 

Farewell and New Horizon

On that note, I would like to, once more, offer a very BIG THANK YOU to all of our members for electing me and entrusting me with the responsibility of serving as your section chair. I can humbly say that this has been an invaluable learning experience for me. I plan to continue to support and foster new ideas with the incoming leadership. As I transition back to a supportive member role within the section, I will continue to be vocal and help assist in our efforts to maintain our status as a recognized and well-established section with the College. After all, our efforts begin and culminate with the collaborative organization and combined influence that our members and their health systems bring to the table at Scientific Assembly and throughout the calendar year. 

 

All of my best to all of you and, remember, stay calm under the pressure!

 

Davut J. Savaser, MD MPH FACEP

Immediate Past Chair, Undersea and Hyperbaric Medicine (UHM) Section

The American College of Emergency Physicians (ACEP)

 

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