Commercial, professional and scientific divers often find themselves at work in medical and geographic isolation. Medical evacuation of injured divers can be complicated by long distances and large bodies of water. This process may be further complicated by access difficulties, such as no runway and limited helicopter landing capabilities. Further, decompression accidents require immediate recompression. Delays in definitive treatment can result in fatal outcome, permanent neurological injury, or other career-ending complications.
It is common, therefore, to find hyperbaric recompression chambers located at the working diver’s site of operation. Chambers can be aboard off-shore drilling rigs, on oil and gas production platform support vessels, on research vessels and at shore-based island marine science facilities. Treatment guidance will be directed medically by a contracted physician trained in diving medicine. However, it is uncommon for this physician to be in close proximity of the chamber and ready to evaluate the diver and accompany them during treatment. Rather, they may be many hundred to several thousand miles away. To be therapeutically effective, therefore, an on-scene specialized medial presence is essential. A certified DMT, essentially a ‘diving’ paramedic, represents the best option. Specialized training is necessary for these medics to function effectively as the eyes, hands and ears of the diving medicine physician. Training is extended to invasive skills in order to administer physician ordered adjunctive interventions and manage complications related to decompression insults and barotrauma. The DMT training program was introduced to address this unique need.
DMT training programs provide focused didactic and practical training that addresses recognition, stabilization and treatment of decompression and other diving-related injuries. These topics represent core curriculum, as does the necessary invasive skills that permit optimal medical management. Additional course content includes decompression procedures, chamber operations, and marine life injuries. Region-specific topics such as cold water diving and tropical diving issues, altitude diving, represent optional material.
Instructors and facilities who wish to offer DMT training apply to the NBDHMT for course approval. Approval is based upon review of the proposed curriculum, knowledge and expertise of faculty members and suitability of the educational setting. Promising applicants are granted provisional approval. Upon NBDHMT review of instructor and program post-course critiques for two consecutive courses, approval becomes either unconditional, extended as provisional status, or withdrawn. The purpose of all of this oversight is to ensure that quality training is provided and graduating DMTs will be likely to offer optimal care to the injured diver.
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Updated January 20, 2020