"Dive Medic" ???

[pocky21]

As I understand it, there are two problems with "diver medics".

In the clinical setting - 95% is wound care, CO poisoning, etc... that exclude diving emergencies. The remaining 5% is shrinking rapidly, if you read the other thread about how very few hospitals are willing to treat diving emergencies these days. This means that the "CHT" certification is preferable as it's training curriculum is much more aligned to 95%-100% of the patients a chamber will see. This is not to say that DMT certification is worthless, just that being a CHT may be preferable. Holding both would be the best, I would assume.

In the commercial setting, it would appear that you are a diver first and a medic second - the designation is little more than icing on the cake. If you weren't a diver, you would need to be at a very minimum a paramedic with two years of 911 experience, and even then the chances of you treating a dive accident are slim to none (I've read most offshore medics are little more than band-aid dispensers).

The third option is to take the class simply for informational purposes, and not to "collect the patch". I'm an EMT and have prospects of getting into hyperbaric medicine, as said before attaining CHT is preferable for the "bread and butter" treatments you'll do day in and day out - but taking the DMT course is still high on my priority list simply for information alone. BUT if you were seeking information alone, as a diver, I would recommend the EDAM class from the Catalina hyperbaric chamber, or the class from Hyperbarics International in Key Largo. The EDAM class is geared towards recreational divers seeking information, but with the chamber operations does qualify for the NBDHMT "module 16" training for DMT and CHT. On the East coast, I have read some amazing things about Dick and the program he runs out of Key Largo.

For recreational divers and DMT cert, though, two days to learn the multitude of invasive skills is completely and totally inadequate for practice in the field - and use of these invasive skills requires, at a minimum, medical direction from an off-site doc anyway. It is far from a license to run around with an airway kit and a bag of ringers trying to save lives (good way to get a major lawsuit).

 

[koozemani]

Our local club has a "dive medic". She explained it to me once over some beers. I'd explain further but it was over some beers.

 

[dive_turkey]

For recreational divers and DMT cert, though, two days to learn the multitude of invasive skills is completely and totally inadequate for practice in the field - and use of these invasive skills requires, at a minimum, medical direction from an off-site doc anyway. It is far from a license to run around with an airway kit and a bag of ringers trying to save lives (good way to get a major lawsuit).

From what I've seen of the DMT cert info from DAN, the invasive skills they use are far less than any I've already performed. Utilizing medical direction is not really the problem, finding it typically is. As for the O2 and LR, that's pretty much all I get to do now that I'm no longer on a flight crew.

Really, I was initially interested not for the idea of donning my superman cape and trolling dive sites looking for CPR opportunities. That's just not my style, I'm not the hero type. In all reality, I was interested in the Dive Medic idea as another skill I could throw into my dive bag and have handy in the event one of my buddies needed it. What I've come to realize is that I already possess the bulk of those skills and what I really need to do is some recreational reading on dive physiology and then build a "ouchy" kit to take with me, which is exactly what I plan to do.

All in all though, you make some very good points.

 

[pocky21]

I'm not trying to discourage anyone from taking the DAN class, just that there are IMO better options for recreational divers seeking training for information alone. If you're an EMT seeking to make a career out of it, finding a place that will add the invasive skills to your scope of practice is near impossible - most places require a medic like yourself, or an RN. Already having those skills as a medic makes me recommend the EDAM class or the one in Largo even more, since more class time will be dedicated to accident management, dive physiology, chamber ops, etc... It covers the module 16 requirement and you can apply directly for your DMT after that.

Didn't mean to go overboard on the ricky rescue scenario, there's a lot of EMTs out there who like to add alphabet soup, and a few who I can see donning that superman cape. The real value of the class, and the reason people should take it, is for the exact reason you stated - the class prepares you to be the best buddy ever, both as a caregiver pre EMS arrival and as a source of information after. I know I feel much better when my buddy is a fellow medical professional.

 

[dive_turkey]

Ha! Rescue Ricky, haven't heard that in a while. I figured him and his keystone cop buddies had gone for beer.

As for being the best buddy: My bow hunting buddies always get annoyed when I hand out field dressings and CAT tourniquets at base camp. Then another friend of ours told us a story and showed us a scar from where he had driven a razor sharp broad head into his thigh and lost enough blood to be dizzy by the time he got to the truck to call for help. I always tell my friends it's be real embarrassing for me to have a preventable death occur on a hunting trip. Now I just tell them that if I find them unconscious, they're getting an "Aussie" IV, nasopharyngeal airway, ammonia inhalants, and possibly a good shaving.... Needless to say, now they carry the kits I made for them.

My hockey team has a ton of med personnel, too. At one point we had two surgeons, a pediatrist, an ER PA, myself, an Air Force flight nurse, and I think there was one other medic. We were pretty stacked for a while there.

I'd love to find an ENT doc to dive with. My sinuses are all jacked up.

 

[tc]

Both the Dive Medic (DMT) and Certified Hyperbaric Technlogist (CHT) certifications are granted through the National Board of Diving and Hyperbaric Medical Technology (NBDHMT) Their website is here- National Board of Diving and Hyperbaric Medical Technology

The basic intent of the DMT certification is to provide Dive Medics for commercial dive ops that are located in areas that are remote or don't have immediate access to medical care. (Think offshore oil rigs) and the CHT is intended more for clinical environments. If you look through the scope of practice however the only CHT skill that is not in the scope of training/practice for DMT's is TCOM- Transcutaneous Oxygen Monitoring, so a DMT's scope of practice is actually greater than a CHT's with that exception.

The invasive skills module was added a few years back, there used to be DMT basic and advanced certifications and apparently the folks that were doing the hiring couldn't figure out the difference so the ADC pushed for eliminating the basic cert since it didn't meet their needs for DMT's working in the commercial diving field. The invasive skills module was added to bridge the knowledge/skills gap of the folks with the basic cert (usually EMT- Basics) so that they could continue to work in the field. And no, it's probably not enough just by itself to produce someone competent to use those skills. (No disrespect to the folks teaching the module- you just need more clinical time than the class affords to get good at it.)

Most DMT courses require that you have an EMT-Basic cert or better as a prerequisite. There are some that include the EMT training as part of their course, you just need to make sure you get into the right course for your needs.

 

[muddiver]

Well done TC, most of the previous posts were so miss-informed. DMT do have a place in the commercial diving industry because insurance carriers have requirement like every shift has to have one. So the big diving companies pay an incentive wage for DMTs vs welders or NDT techs.

 

[Sam Miller III]

Well done TC!

I had planned on chatting with number one son who is an ER & Scrips trained Hyperbaric Doc for his defintion. Ya beat me to it!

SDM

 

[pocky21]

Interesting - my reading from about a year ago seemed to point to the following two applications for a DMT:

1. A commercial diver with EMT/DMT certs who's primary focus is diving (with the mentioned pay incentive).
or
2. An experienced paramedic who does not dive, but rather is the medical authority for that particular facility

And were an accident to happen where (2) is applicable, then a DMT in position (1) would not have the authority to render care.

I am not a commercial diver and am only going off what I have read/heard from internet searches and a few non-practicing DMTs. Have I been misinformed?

 

[tc]

The person with the highest medical cert/license will be the one in charge (and responsible) when medical care is performed.

But in general we actually try to work together to produce the best outcome for the patient.

A Paramedic also needs to go through the Module 16 (the hyperbaric stuff) training in order to be certified as a DMT, they wouldn't need to go through the invasive skills training since they've already had that. Most DMT's are divers but I don't recall it being a requirement.

Here's a link to a history of DMT's written by Dick Clarke- President of the NBDHMT-
http://www.nbdhmt.org/forms/Diver_Medic_Training_and_Certification102010.pdf