Introduction

National Board of Diving and Hyperbaric Medical Technology (NBDHMT)
By Paul C. Baker, CHT

The National Board of Diving and Hyperbaric Medical Technology (NBDHMT) was formed in 1991 and introduced a certification program for all technologists working in the field as well as an “approved” introductory training course for those desiring to enter the field. It was not the intention of the NBDHMT to provide an “entry level” pathway for certification in hyperbaric technology (CHT). Certification was offered as an “added qualification”. It was anticipated that this broad cross section of health care providers would include licensed registered and vocational nurses, therapists, chamber technicians, physician assistants, diving medical technicians, corpsmen, physiologists, emergency medical technicians, paramedics, life support technicians, researchers and physicians involved in the delivery of undersea, hyperbaric and aviation medicine and related research activities.

In 1995 the Baromedical Nursing Association Certification Board (BNACB) was founded. This board provided an avenue for registered nurses to obtain certification in hyperbaric medicine (CHRN) separate from the CHT program. Again, this is not an entry-level program. The NBDHMT validates and administers the certification examination on behalf of the BNACB.

Staffing and Training
In the international hyperbaric community, staffing and training standards differ from country to country.  Examples of the standards from some of the countries presently active in the hyperbaric field follow. These examples include The United States of America, Australia, Latin America, New Zealand, Singapore, South Africa, South East Asia and the United Kingdom.

Historical Perspective of Hyperbaric Staffing and Training
During the last decade the field of clinical hyperbaric medicine has witnessed an extraordinary growth of interest and activity. No longer limited to military settings and isolated clinical institutions hyperbaric chambers have been and will likely continue to be installed across the spectrum of the health care industry. This has occurred, in part, due to important progress made in better defining the mechanisms of action of hyperbaric oxygen therapy as well as a growing awareness of it’s place in the medical treatment of various aspects of hypoxic related illness. A growing realization of the significant problems facing patients suffering from chronic and problem wounds in our aging society and the opportunity to improve patient’s outcomes has further stimulated the growth of this specialty.

During the 1970’s, most hyperbaric chambers were operated by the United States Armed Services with the US Navy and the US Air Force being the primary operators. The Navy chambers were used to support the US Navy’s dive program and were used primarily to treat diving related decompression illness. The US Air Force chambers were used primarily to treat altitude related decompression illness.  Decompression Illness, once the only condition for which hyperbaric therapy was indicated, now represents less than 3% of the typical hyperbaric medicine case load. At this time all chamber personnel were trained by the Armed Services. This training included chamber operations, dive tables and decompression procedures. Personnel selected for this advanced training were primarily divers and medical corpsman. As time and mission evolved clinical medical skills were added to the curriculum. Graduates of these courses were designated as “Diver Medics”.

As the exploration for oil and gas grew, oil companies hired former armed services diver medics to provide chamber support at the dive sites. The National Association of Diving Technicians was formed in 1981 to meet the training and certification needs of these remote duty diver medics. It was felt that the esoteric nature of undersea medicine and it’s geographically and medically remote applications were considered too complex for conventional first responders. As a result a standardized curriculum was developed and courses, approved by the Association, were begun. Today, the certified diving medical technician is a respected undersea first responder, whose skills and training have done much to enhance the timeliness and quality of accident management at the dive site.