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Baromedical Nurses Association Update

The Baromedical Nurses Association Board of Directors met to include all BNA members.  The BNA meeting notes as presented by Dana Winn, current BNA President:

Hyperbaric Nurses Day April 6, 2024: 11am-3pm EST

The BNA invites you to join us for our annual Hyperbaric Nurses Day!  We have four speakers who specialize in hyperbaric medicine that will give a 1-hour virtual lecture.  Each lecture will have 1 CEU invitation link to follow. *** All BNA members will receive $10.00 off BNA logo items to celebrate Hyperbaric Nurses Day!

The program for Hyperbaric Nurses Day:

  • 11 am EST: Dr. Kyle DuBose of Aurora St Luke’s Medical Center HBO Indications Overview
  • 12pm EST: Dr. Claire Ellis of Duke Hyperbaric Medicine Difficult Decompression Illness Cases
  • 1pm EST: Dr. Andrew Applewhite of Baylor Scott & White Health Case review of an AGE HBO patient
  • 2pm EST Susan Baker, APRN of Nebraska Medicine ISSNHL

This is a great chance for education and to interact with the presentations. The BNA day is evolving yearly, as are many of our committees.  Registration link:

BNA logo 2024


The BNA held a vote by the BNA members to select one of 5 submissions to update the BNA logo.  Dana Winn revised the selected versionNew BNA Logo Items will be available for sale on the BNA website (hopefully in March) - Courtesy of Daphne Copeland LPN representative.


Board Members:

  • President: Dana Winn
  • Vice President: Heather Wheaton (*) is currently recruiting for this position
  • Past President: Kevin Kraft
  • VP/President/Past President – 2 years at each: The VP role is available to step in to cover for the president in their absence
  • The President – presides over the BNA board meetings and sends out newsletters periodically to the BNA.  Attends annual meeting to represent the BNA
  • The Past President – is available for assistance and support
  • Director(s) at Large: Jennifer Clough & Carol Brown (*) Currently recruiting for 1 DAL position: Director at Large – main focus is on Hyperbaric Nurses Day and other duties as assigned.  This is a 2-year commitment, and we rotate a new DAL annually.
  • Secretary: Angelina Meza-Suarez: Responsible for taking and maintaining the meeting minutes
  • UHMS Associate Nurse Rep: Jay Duchnick: UHMS Associate Nurse Representative – this is a UHMS member that liaises between the UHMS and the BNA Admin
  • Secretary & Treasurer: Robin Ortega: Maintains our money, our website, new and renewing members, CEUs
  • Historian: **Vacant** Looking for someone to gather, compile, and display our history.  **Currently recruiting for this position**

Committee Chairs:

  • Safety Committee: Anthony Johnston
  • Research Committee: Connie Hutson
  • Nominations Committee: Frank Turcotte
  • Education Committee: Eric Hexdall
  • Publications Committee: Laura Josefsen
  • Sponsorship Committee: **Vacant** This position is to assists with communicating with potential sponsors for the BNA. **Currently recruiting for this position**
  • Bylaws Committee: Monica Skarban: The Bylaws Committee maintains the BNA bylaws and policies to ensure we are functioning as a non-profit, professional organization
  • BNACB Committee: Kathy Nelson (*): The BNACB Committee has three positions and is a 3-year commitment.  Each year one position is recruited.  This committee reviews the applications for certification and re-certification
  • Awards Committee: Tina Ziemba

The BNA presents the following awards annually:

  • Rising Star Award to recognize nurses who have been working in HBO for less than 5 years who demonstrate leadership qualities
  • Circle of Excellence Award to recognize non-nurses that support hyperbaric nursing
  • Diane Norkool Awardto recognize nurses currently working in the hyperbaric field or is making a significant contribution to the field.  Must have been a BNA member for at least 2 years.
  • Laura Josefsen Lifetime Achievementto honor an individual who has been a member of the BNA for at least ten years.  The nominee will have served as a BNA Board or Committee member and is certified as a CHRN, ACHRN, or CHRNC.

BNA picture1     Speaking of awards, the BNA Board would like to take a moment to recognize a member who has been pivotal in the success of the BNA. 
     She has served on the board for over a decade in various roles, including stepping in and taking over the president role for multiple extra years at a time of need.
     She was the pioneer for the initiation of the Hyperbaric Nurses Day that celebrates all of us.
     She developed the Circle of Excellence award to recognize non-nurses that support hyperbaric nursing.
     She co-edited the UHMS Guidelines for Hyperbaric Facility Operations and is an RN surveyor for the UHMS accreditation program. 
     She is personally responsible for recruiting multiple BNA members to participate on committees and the BNA board, the current president included.
     She has been a wonderful mentor and resource to many nurses in the hyperbaric community.
     Please join me in thanking Annette Gwilliam for her service to the Baromedical Nurses Association and Hyperbaric Nursing.

UHMS Annual Scientific Meeting in New Orleans

  • If you are joining us for the UHMS Annual Scientific Meeting in New Orleans, please be sure to sign up for the BNA luncheon on Friday, June 14th, from 12-1 pm.
  • If you cannot join us for the meeting, please log onto the Zoom meeting to receive an update on the status of the BNA board and committees. We will also present the BNA awards, and the presidency gavel will be passed to the incoming president.

Communication challenges among healthcare professionals and the patient

As the world gets smaller and moving from country to country becomes more accessible, our challenge as a healthcare professional is to meet the needs of individuals from various cultures and ethnic backgrounds who present with a medical issue or concern. To meet their needs, we have to use our best clinical judgment and tailor how we communicate our diagnosis and propose therapies to meet their cultural needs and expectations.

Some sources have identified 7,000 languages in the world. In addition, to add to the challenge, there are over 4,000 religions, not to mention the sects of the main religions. We also have to consider unique healthcare practices and beliefs of ethnicities worldwide.

One of the critical aspects of care includes empathy.

"Empathy, i.e., the ability to understand the personal experience of the patient without bonding with them, constitutes an important communication skill for a health professional, one that includes three dimensions: the emotional, cognitive, and behavioral. It has been proven that health professionals with high levels of empathy operate more efficiently as to the fulfillment of their role in eliciting therapeutic change. The empathetic professional comprehends the needs of the health care users, as the latter feel safe to express the thoughts and problems that concern them." (Moudatsou, M. 2020)

It is essential to recognize that in addition to our fundamental commitment to meet the standard of care and provide care that is sensitive to the wishes of the patient, there are regulatory requirements such as Title VI of the Civil Rights Act of 1964, (, Section 1557 of the Affordable Care Act, (, Americans with Disabilities Act](, Title III of the Americans with Disabilities Act, (, and Joint Commission Standards, (

Various sources for guidance on cultural issues such as Cultural and Religious Sensitivity, A Pocket Guide for Health Care Professionals, Galanti, G. 2018 published by Joint Commission Resources. In addition, we have access to the Internet.

Another resource states:

Culture and health are inextricably linked. Culture influences health and illness behaviour, including how illness is perceived and experienced, what symptoms are reported, what remedies are sought, and who is consulted in the process (Srivastava, R. 2023)

No "cookbook" addresses all the permutations we may have to address. How do we effectively care for these individuals? We have the clinical knowledge, skills, and tools, but how do we apply these appropriately in today's multicultural environment?

The first step is to address the communication issue. Whether the patient is proficient in English, we must recognize that they may not be familiar with medical "lingo." Part of this first step is testing the patient's understanding of the information they were provided during the informed consent, pre-treatment education, and safety requirements specific to hyperbaric oxygen treatments. One technique is referred to as the "Teach Back Technique." After providing information, the healthcare professional asks the patient and the family to repeat what they were told in their own words. This technique will allow you to clarify any misunderstanding to assure compliance.

The next step is to ensure that cultural and ethic-based healthcare beliefs and practices are accommodated as much as possible. One technique is called the "The 4 C's of culture."

The key factor in achieving cultural competence is learning to ask the right questions to elicit an understanding of the patient's point of view. (Galanti, G. 2018, Pg 4).

The 4 C's

    1. "The first C is for "Call," What do you call your problem? This reminds the clinician to ask, "What do you think is wrong?"
    2. "The second C is for "Cause." What do you think caused your problem?"
    3. "The third C is for "Cope." How do you cope with your condition?"
    4. "The fourth and final C is for "Concerns." What concerns do you have regarding the condition? This should address questions such as "How serious do you think this is?" "What potential complications do you fear?" "How does it interfere with your life or your ability to function?" (Galanti, G. 2018)

However, as initially identified, the multicultural, multiethnic world can be complicated and adversely affect health care delivery. Hopefully, this brief column will either confirm that you have addressed these issues in your delivery of hyperbaric oxygen therapy or provide additional information on how to improve your delivery to the ethnically and culturally diverse population that may present to your practice.


Moudatsou, M., Stavropoulou, A., Philalithis, A., & Koukouli, S. (2020). The Role of Empathy in Health and Social Care Professionals. Healthcare (Basel, Switzerland)8(1), 26.

Srivastava, Rani Hajela. (2023) The Health Care Professional's Guide to Cultural Competence - E-Book (p. 5). Elsevier Health Sciences. Kindle Edition.

Galanti, Geri-Ann. Caring for Patients from Different Cultures: Case Studies from American Hospitals, 2018. (p. 4). University of Pennsylvania Press, Inc.. Kindle Edition. 

Galanti, Geri-Ann. Caring for Patients from Different Cultures: Case Studies from American Hospitals, 2018. (p.4-8). University of Pennsylvania Press, Inc.. Kindle Edition.

Dick Clarke is the 2023 Recipient of the Prestigious DAN Lifetime Achievement Award

Dick Clarke

Richard (Dick) Clarke, a prominent leader in the hyperbaric oxygen and diving community, received the prestigious and well-deserved Lifetime Achievement Award from Divers Accident Network (DAN) in November of 2023. Dick has been making contributions to this community since enlisting in the British Navy as a very young man in 1959.  After a decade as a diver and British seaman, he moved to the civilian diving community, where he participated in numerous operational and research diving activities, including saturation dives in the subtropics and below-ice dives in the Arctic. He engaged in these exciting, physically, and intellectually challenging undertakings with enthusiasm and a voracious appetite for knowledge.  In a personal statement, Dick remembers fondly his support to such scientific and diving celebrities as George Bond (Papa Topside) and Werner Von Braun. While at UNEXSO (International Underwater Explorers Society), Dick also received 22 international underwater photography awards.

Dick transitioned to a major interest in clinical hyperbaric medicine in 1986 when he founded National Baromedical Services, where he continues as its president. He has been a successful businessman in this capacity for nearly 40 years and continues supporting several clinical facilities. Dick has always gone beyond a financial interest in diving and hyperbaric medicine. His accomplishments in education and research are not matched by many. Dick’s courses, for which he is well known, include regular offerings of the 40-hour introductory course. In the hyperbaric community at large, he is perhaps most highly regarded for his Advanced Hyperbaric Medicine Symposia.

Dick holds no advanced degree but is still a scientist of some regard. Through the HORTIS Project, he sponsored, initiated, and conducted a landmark study providing Level One evidence for the treatment of radiation proctitis. He is also the first author of its published results in the most prestigious journal in Radiation Oncology.  Through the Biomedical Research Foundation, which he founded, he is responsible for another landmark trial demonstrating that oxygen, the most potent radiation sensitizer, can be provided with hyperbaric oxygen to the tumor just before radiation with impressive increased tumor response. This approach avoids the operational barrier requiring that both be given simultaneously. Dick has been able to support this impressive research with grant awards exceeding $500,000. He has authored several additional peer-reviewed articles and book chapters. He has been a frequently invited speaker at national and international meetings and has been asked to review articles for several peer-reviewed journals on a number of occasions. I continue to be personally impressed by his deep understanding of the literature, evidenced in the articles he writes and those that he reviews.

Dick has always championed adequate initial and continuing training for technical and nursing staff. He holds the Number One CHT certificate and has served as President of the National Board of Diving and Hyperbaric Medicine since 2009. Dick is also known as an advocate for peer-reviewed and ethical practice in clinical hyperbaric medicine

Please join me in congratulating Dick. His contributions to Undersea and Hyperbaric Medicine have been many and have had a great impact. You will all be pleased to hear that Dick, in his acceptance video for the Achievement Award, indicates that he plans to continue his efforts to contribute to education, science, and clinical hyperbaric oxygen.

John J. Feldmeier, D.O.


Executive Director's Report: 1st quarter 2024

Greetings from all of us here at UHMS!

As UHMS President Dr. Pete Witucki explains in his Pressure article, the CMS payment error was corrected for G0277 in the HOPD environment (, and with that crisis behind us, we are focused on the road ahead. 

I continue to stress that it is critically important that, as the specialty society for the undersea and hyperbaric medicine field, the UHMS continue to engage with all stakeholders, especially industry, to proactively address the many challenges we face, including what I believe are the most serious threats to our field, a declining emergent/urgent provider base, lagging certification amongst our physicians, advanced providers, nurses, respiratory therapists, and technicians, and a lack of hyperbaric facility accreditation.

However, it’s also very important to note that it’s not a one-way street. The UHMS cannot change this paradigm alone, and we need your help. The physician, advanced provider, nurse, therapist, and technician must take responsibility for seeking and maintaining certification and completing 12 hours of continuing education annually. Hospitals, management providers, and chamber manufacturers are accountable for supporting and promoting hyperbaric facility accreditation and providing urgent and emergent hyperbaric medicine care for all patients.

This is a call to action for everyone involved in the specialty: to get engaged, get educated, get certified, get your facility accredited, and show that you’re doing what you claim to do, particularly around delivering optimal outcomes and treating patients of all acuities regardless of payor source.

The UHMS tent is wide open, so please come in and join us to make our specialty more vibrant and viable for generations to come!

UHMS Elections

As I mentioned in my last note, this year’s election cycle is underway, and we have numerous officer and director positions coming open, including the President-Elect, Vice President, Treasurer, 2 Members-at-Large (MAL), including our MAL military active-duty, and Associate Nurse Representative-elect.

I believe it’s every member’s duty to participate in our election process by voting for their candidates of choice, so please be alert to the announcement on March 15th that voting has started. 

UHMS Finances

I am pleased to report that UHMS’s Financial Review was completed in early February. Once again, we have demonstrated to an external accounting body that our financials are clean, and we have sufficient cash to manage unforeseen downturns. You can view our 990 and financial brochure here - About the UHMS - Undersea & Hyperbaric Medical Society.

Here are the end-of-year validated financials.

Jan-Dec 2023 PL




















Our balance sheet remains healthy, with operating, savings, and investment accounts continuing to hover at near-all-time highs.

Additionally, we are very pleased to announce the UHMS has achieved a 100% score and a Four-Star rating on Charity Navigator -Charity Navigator - Rating for Undersea & Hyperbaric Medical Society for Accountability & Finance.

Certification Matters

We continue to receive questions about technician and nursing certification. The UHMS’s position is unchanged in that we believe that all team members involved in providing care to patients in hyperbaric medicine should be certified, and our position statement - The Importance & Recognition of Hyperbaric Certification for Technicians & Nurses can be found here - UHMS POSITION STATEMENT.

Congratulations to the Q1 Associate Scholarship Award winner, Benjamin Argo. Ben has been awarded tuition-free attendance to a UHMS-approved Introductory Course in Hyperbaric Medicine. Of course, this program is required to sit for UHMS-recognized hyperbaric certification exams. 


Member Benefits

As a reminder, UHMS members receive three free CE/CME credits upon joining or renewing. This benefit represents an immediate $40 savings for Associate members and $60 for Regular members annually. 

Associate Member Town Hall

Members are invited to attend the UHMS Associate Council town hall meeting on the second Thursday of every quarter, where invited speakers present on relevant topics that apply to our specialty.

Corporate Partners

If you are a UHMS Corporate Partner, please attend our monthly Corporate Partner Town Hall meeting series. These are held on the 1st Wednesday of every month at 12 PM and are intended to be an open forum for discussing the challenges and successes your businesses and practices are experiencing and to create momentum and collaboration where appropriate.    

If your organization wants to educate the UHMS membership about the care provided or the goods and services offered, consider joining our Corporate Partnership Program. See  


The UHMS offers its version of “ask the experts.” MEDFAQs can be found at the following URL –, and is a valuable tool for our membership.

If you are familiar with MEDFAQs, check back, as new Q&As are posted regularly.


The UHMS Research Committee continues to be very active. We hope to announce some good news in the new year on the IRB front, where members of our community can come to the UHMS for the Institutional Review Board's needs.

We are soliciting donations from our members for two research initiatives. One is the Continuous Glucose Monitor study (, and the Multicenter Registry for Hyperbaric Oxygen Therapy at Dartmouth (MRHBO2) continues seeking funds for free hospital membership. The MRHBO2 is funded entirely via grants, not by the registry's participating hospitals -

Remember that donations to the UHMS Funds for Research and Policy Advancement are tax-deductible. For more information, check out the UHMS website –   


To better understand the field’s challenges, log in and visit the QUARC page – Here, you will find impending legislation and other relevant policies on the provision and limitations of HBO2 coverage and the UHMS’s responses and guidance.

The chairs of QUARC are requesting that any unusual denials or challenges with physicians gaining access to insurance panels for HBO2 services, let us know as soon as possible, please –


If you are a UHMS member, we are happy to announce a new search feature for previous issues and articles from UHM/UBR - Currently, the feature works with keywords.

If you have a suggestion or comment on how we can serve you better, please email me directly at or call me at 561-776-6110 extension 100.

It is my pleasure to serve you and our membership, and I continue to look forward to hearing from you.

John Peters

In Memoriam Dr. Dirk Jan Bakker, MD, PhD

Bakker imageOn 10th December dr Dirk Jan Bakker passed away on the age of 83.

Dr. Bakker was a general and transplant surgeon, trained by Professor Boerema and Professor Brum­melkamp and therefore he gained great interest in hyperbaric and diving medicine. His PhD thesis was “The Influence of Hyperbaric Oxygen Treatment on Aerobic and Anaerobic Soft Tissue Infections which showed up as one of the greatest patient studies in this field. He wrote several chapters on this topic in the international handbooks and guidelines for more than 30 years.

In 1990 he was the chairman of the faculty and organizing committee of the first joint UHMS/EUBS meeting in Amsterdam. Since 1996 he was the medical director of the Academic Medical Center (AMC) and after his retirement he continue to work as a member of the medical ethical committee and chairman of the animal ethics committee of the AMC.

Dr. Bakker was a member of the UHMS, the EUBS, the ICHM and was a founding member of the Europe­an Committee on Hyperbaric Medicine (ECHM). His awards included the Boerema award (1987) and the Charles Shilling Award of the UHMS (1992). He was a fellow of the UHMS and an officer in the Order of Orange Nassau in the Netherlands.

Dr. Dirk Jan Bakker will be remembered as an excellent and congenial educator with an impressive career and substantial contributions in the field of hyperbaric medicine.

Rob van Hulst, MD, PhD, FUHM
Professor Hyperbaric and Diving Medicine, dept Anesthesiology
Amsterdam University Medical Center

Is this medical device safe to be in the chamber?: An introduction to the Medical Device Approval document

Author Bio:Kevin P Gardner serves as the Hyperbaric Safety Director at Aurora St. Luke’s Medical Center in Milwaukee, WI, overseeing the maintenance and safety of a large Fink Engineering multiplace hyperbaric chamber. He also serves as a member of the NFPA 53 technical committee, the UHMS Hyperbaric Oxygen Safety Committee (SC), Advocate Aurora’s Emergency Response and Planning Committee, and is a volunteer Firefighter.


Aurora St. Luke’s Medical Center in Milwaukee has a long, storied history of contributions to the hyperbaric industry. You might even say that we were pioneers of engineering and testing medical devices to ensure their safety in the hyperbaric environment. Of note, The Kindwall HBO Handbook, “Hyperbaric Medicine Procedures,” states the following:

“There are not enough clinical hyperbaric chambers to make it financially rewarding for equipment manufacturers to make devices approved for use in or with the hyperbaric environment. As the number of facilities continues to rise there will be an increased financial incentive for equipment manufacturers to meet the demands of this neglected market. Manufacturers should be encouraged to engineer hyperbaric specific devices or design chamber compatibility into their product line. Until this happens we must continue to evaluate and modify existing medical devices to meet our needs for safely caring for patients during their hyperbaric oxygen therapy.” EP Kindwall, 1971

As you probably know, this situation has largely remained unchanged since Dr. Kindwall wrote these comments. Today, the UHMS Hyperbaric Oxygen Safety Committee regularly receives requests for advice on what can and cannot go into a hyperbaric environment. The UHMS Equipment Subcommittee spent several years developing a medical device approval form in response to the community's needs. In late 2023, the UHMS Equipment Subcommittee approved and published the medical device approval form. This document was passed to the larger Safety Committee for approval and finally was accepted by the UHMS Board for publishing. The form can be found on the UHMS website Medical Device Approval Form - Multiplace (FINAL 9-14-23).docx ( This article aims to introduce you to the approval form and describe the sections of the approval process.


The introduction of the Medical Device Approval Process – Class ‘A’ Multiplace Chambers states the following:

“The following Medical Device Approval Process is a generic process that has been endorsed by the Hyperbaric Oxygen Safety Committee of the Undersea and Hyperbaric Medical Society as a method that may be used to systematically document the evaluation and risk mitigation of medical devices to be connected to or used inside a Class ‘A’ Multiplace Chamber. This approval process was formatted using the current edition of the National Fire Protection Association (NFPA) 99 Health Care Facilities Code, 2021 Edition, Chapter 14, and other codes invoked by this chapter. This process is intended to serve as an aid in the selection, testing, modification, documentation, and approval of medical devices for use in the Class ‘A’ Multiplace chamber environment. The user of this document may choose to add other testing as deemed appropriate by their institution.”

It is important to note that while this process does not certify any device for global use, it does assure a measure of safety regarding flammability, pressure intolerance, oxygen incompatibility, and explosiveness. The process may allow a facility to use existing medical devices off-label after they have passed rigorous examination and testing.

The FDA’s Use of “Off-Label" and Investigational Use of Medical Devices

As Dr. Kindwall stated, few medical devices are intended to be used in the Multiplace hyperbaric environment. Thankfully, the FDA has acknowledged that there are instances where medical devices not cleared for a particular use may be deemed appropriate by the Physician delivering care.

“Good medical practice and the best interests of the patient require that physicians use legally available drugs, biologics and devices according to their best knowledge and judgement. If physicians use a product for an indication not in the approved labeling, they have the responsibility to be well informed about the product, to base its use on firm scientific rationale and on sound medical evidence, and to maintain records of the product's use and effects. Use of a marketed product in this manner when the intent is the "practice of medicine" does not require the submission of an Investigational New Drug Application (IND), Investigational Device Exemption (IDE) or review by an Institutional Review Board (IRB). However, the institution at which the product will be used may, under its own authority, require IRB review or other institutional oversight.”

Source: "Off-Label" and Investigational Use Of Marketed Drugs, Biologics, and Medical Devices.“

(for more information on this topic, you may also wish to review this site: Frequently Asked Questions about Medical Devices.)

“The process starts by identifying the equipment/device to be reviewed for approval."

  • Page one, “The Medical Device Approval Team” establishes the guidelines for who should be involved in the evaluation process. It is the expectation that all team members become familiar with the Medical Device Approval Form used by your facility.
  • Page two calls out the resources the team needs to complete and verify code requirements successfully. It is important to remember that the document references the current code at the time of authorship. As code language is subject to change, subsequent document versions will be edited accordingly.
    1. NFPA 99: Health Care Facilities Code (2021)
    2. NFPA 70E: National Electrical Code
    3. ANSI Z136.3 American National Standard for Safe Use of Lasers in Health Care
    4. NFPA 101: Life Safety Code
    5. NFPA 53: Recommended Practice on Materials, Equipment, and Systems Used in Oxygen-Enriched Atmospheres
    6. CGA Compressed Gas Safety Guidelines
    7. ASME PVHO -1 and -2 NOTE: Other electrical engineering Codes and Standards may be required by your institution.
  • Pages three and four are for equipment information (medical device being evaluated).
  • Pages five through thirteen include the biomedical engineering visual exam & schematic review. These pages must be completed by the Bio-Medical Engineering department alongside the Hyperbaric Safety Director (HSD). Code information is necessary to complete this section.
  • Pages fourteen and fifteen, “Hyperbaric Function Testing,” provide steps to guide you through functional testing of your new equipment.
  • Pages sixteen and seventeen, “LETTER OF MEDICAL DEVICE APPROVAL,” contain a declaration for the HSD to fill out after the medical device is either approved or not approved.

As technology advances, hyperbaric programs will continue to face many new medical products available to our patients. Therefore, it is imperative that we remain aware of these emerging risks and continue to develop mitigation strategies to improve safety. It is also vitally important to have a consistent and thorough process to evaluate these products.

We are currently using the Medical Device Approval Form here at St Luke’s to investigate a ventilator for critical care in the multiplace.

To serve as a reminder,

***The UHMS HBO2 Safety Committee can provide information to aid you in answering your question. Still, the ultimate responsibility for these questions rests with your facility's Hyperbaric Medical Director (HMD) and Hyperbaric Safety Director/Coordinator (HSD/C).

***This assessment is the opinion of the Hyperbaric Safety Committee and does not constitute product approval. We suggest that the HMD and HSD/C of your facility perform a risk assessment and document your conclusions before treating the patient.

President's Column: First Quarter 2024

In July 2023, the Center for Medicare and Medicaid Services (CMS) released their 2024 Outpatient Prospective Patient System (OPPS) Proposed Rule, which included a 7% increase for G0277 hyperbaric oxygen treatment (per 30-minute segment) from $125.07 to $134.51 to go into effect Jan 1, 2024.

On Nov 7, 2023, it was called to the attention of UHMS leadership that CMS had released their 2024 OPPS FinalRule, which now reflected a 41.5% decrease in G0277 from $125.07 to $73.64. This difference between the Proposed and Final Rule was unexpected and without explanation.

UHMS leadership was very concerned and recognized that a cut of this magnitude would likely result in the closing of many HBO2 facilities across the US, depriving patients of necessary medical services and potentially closing many 24/7 facilities, further exacerbating the shortage of such facilities. Time was critical as this OPPS Final Rule was set to go into effect in just seven weeks.

We suspected this drastic change between the Proposed and Final Rule of the OPPS was due to a clerical error in data entry. UHMS immediately notified CMS, asking them to please review their data. We also engaged our membership in a letter-writing campaign, met regularly with our corporate stakeholders (Alliance of Wound Care Stakeholders), and engaged Dobson Davanzo & Associates LLC, a healthcare economic and policy consulting firm with expertise in CMS data sets.

Dobson Davanzo’s analysis concluded this was an error, and their final report was submitted to CMS via the Alliance of Wound Care Stakeholders on Dec 8, 2023. On Dec 21, 2023, CMS acknowledged this error and corrected the G0277 reimbursement rate to $132.21, a 5.4% increase from 2023. Crisis averted.

I want to thank Dr. Helen Gelly, John Peters, the representatives from the Alliance of Wound Care Stakeholders, Dobson Davanzo, UHMS Corporate Partners, and all of the UHMS members who supported this effort through letter writing, phone calls to political representatives, etc. 

I am very proud of our specialty for coming together on short notice during a crisis.

I hope to see you all in New Orleans for the UHMS Annual Scientific Meeting in June.

Unlocking the Potential of the Hyperbaric Accreditation Support Forum and Instagram for UHMS Hyperbaric Facility Accreditation Communication

In the field of hyperbaric healthcare, Hyperbaric Facility Accreditation serves as a symbol of quality, safety, and excellence. For hyperbaric facilities, achieving and maintaining accreditation is not only a matter of pride but also a commitment to providing optimal care to patients undergoing hyperbaric oxygen therapy. Effective communication is crucial to uphold transparency and instill confidence in facilities undergoing accreditation surveys. Utilizing platforms such as the Accreditation Support Forum and Instagram can significantly enhance the sharing of accreditation-related information, creating a stronger connection with the community of hyperbaric medicine.

The role of Accreditation Support Forums is communication

Accreditation Support Forum is an online platform where experienced surveyors provide valuable information on accreditation probes monthly. This forum offers a plethora of communication opportunities for hyperbaric facility accreditation.

  • Educational: Initiate discussions dedicated to accreditation, clarifying its significance, the accreditation process, and its impact on patient care. Engage forum members to cultivate a deeper understanding of the topics covered.
  • Expert Insights: Host Q&A sessions featuring expert hyperbaric accreditation representatives. This interactive format allows forum members to pose questions directly and receive expert insights, addressing any concerns or misconceptions surrounding accreditation.
  • Updates and Announcements: Keeping forum members abreast of accreditation-related developments, such as procedures, compliance requirements, or changes in accreditation standards. Timely communication fosters transparency and accountability within the community of hyperbaric medicine.
  • Peer Support: Foster a supportive environment where members can offer guidance, share experiences, and provide support to those seeking more information or better understanding. Peer-to-peer interaction enhances solidarity and promotes a sense of community among the hyperbaric forum members.

Instagram: A Visual Medium for Hyperbaric Facility Accreditation Awareness

Instagram, with its visually oriented platform, offers a dynamic canvas allowing us to share information through storytelling and engagement. UHMS Hyperbaric Facilities Accreditation can leverage Instagram to communicate accreditation information effectively.

  • Visual Storytelling: Create visually captivating posts and stories that highlight the Hyperbaric Facility Accreditation journey, showcasing the facility's unwavering commitment to excellence in healthcare. Utilize multimedia elements such as infographics, videos, and images to convey key messages in an engaging manner.
  • Behind-the-Scenes Content: Offer followers an exclusive peek into the inner workings of the Hyperbaric Facility Accreditation, including findings during surveys, the latest information related to codes and standards, safety protocols, and training ideals related to hyperbaric standards. Creating this natural content can relay the importance of the Hyperbaric Facility Accreditation process and help to build trust and respect with the facilities seeking accreditation.
  • Interactive Features: Harness Instagram's interactive features to actively engage followers in hyperbaric accreditation-related discussions. Encourage participation by soliciting feedback or posing thought-provoking questions on topics related to quality assurance and patient safety.

I hope to use Instagram to grow the hyperbaric medicine community

  • User-Generated Advocacy: Encourage patients, caregivers, and staff members to share their hyperbaric accreditation experiences using designated hashtags. Repost user-generated content to amplify their voices and showcase the positive impact of hyperbaric accreditation on patient care.
  • Collaborations and Partnerships: Collaborate with reputable figures, such as industry influencers, healthcare professionals, or code and standard organizations, to co-create content aimed at raising awareness about Hyperbaric Facility Accreditation. This will enhance credibility and reinforce the facility's commitment to delivering exceptional healthcare services.

Effective communication of UHMS Hyperbaric Facility Accreditation information is important for transparency, community engagement, and building confidence among facilities. The Accreditation Support Forum and Instagram are excellent platforms for achieving this. By embracing these platforms, hyperbaric facilities can create stronger connections with their understanding the industry of hyperbaric medicine, ultimately improving the quality of care and advancing the standards of hyperbaric medicine.

To join the Accreditation Support Form, sign up at:

forum qrTo follow us on Instagram: @hyperbaric_accreditation
Accreditation Instagram QR


Congratulations to these Facilities!


November 2023


UMass Memorial Health Harrington
Charlton, MA      


Claxton-Hepburn Medical Center
Ogdensburg, NY

Holy Cross Hospital-Davis
Layton, UT

Long Island Community Hospital-Hauppauge
Hauppauge, NY

Long Island Community Hospital-Patchogue
Patchogue, NY

Texas Health Presbyterian Hospital Dallas
Dallas, TX


December 2023     


Northwell Health Plainview Hospital
Plainview, NY

St. Joseph Hospital
Bethpage, NY

* With Distinction*

Use of Registry data to study HBO2 use, outcomes, and adverse events

  • A study by Kinjal Sethuraman, MD (University of Maryland) et a, highlighting the need for increased availability of emergency HBO2 treatment facilities, was submitted for presentation at the annual meeting of the Society for Academic Emergency Medicine (SAEM) scheduled for May of 2024. Dr. Sethuraman examined over 8,000 patient entries in the registry, spanning 13 years, to describe the frequency of urgent indications that might worsen without HBO2 being initiated within 24 hours. 36.5% of the cases were urgent, and the most frequent urgent indications were carbon monoxide poisoning (25.2%) and compromised grafts and flaps (22.4%).
  • This is an important issue, as fewer than 10% of hyperbaric treatment facilities offer 24/7 service, so there may be an unmet need, given the frequency with which these indications appear in the registry. However, a barrier to expanding hyperbaric oxygen access is the limited data to show the benefit of urgently treating these conditions with HBO2. Therefore, it is imperative that efforts in the registry continue to collect and publish patient outcome data so we can show the benefits of these urgent treatments.

    • Members of one wound center recently discovered that their rate of ear tube placement in patients undergoing HBO2 seemed higher than others based on registry data. They are using that information to launch a quality improvement project to reduce the number of referrals for myringotomies.

    Growth of the registry process:

    Members of the registry meet quarterly via Zoom to discuss treatment experience in individual centers and challenges that may be encountered using the registry system. This allows for regular improvements and adaptations of the data collection protocols. For example, a recent update added more anatomical sites under the indication of “ischemia.” Improved standardization of data entry will improve the reliability of information by assuring comparison of patients being treated for similar clinical presentations.

    The figures below illustrate the growth of cases entered yearly into the registry and cumulative treatments between 2010 and 2022 (2023 data is still incomplete):
Referrals treatments by year update
Total number of cases referred and treated across participating centers, by year (not all referrals are treated)
Total number of treatments entered into the registry across participating centers, by year


Thank you to all of the participating treatment centers. The more data collected on patient outcomes, the more we can build on experience to improve patient care and potentially establish additional accepted applications for HBO2.

Information on joining the registry may be found on the UHMS website through the following link:

Multicenter Registry for Hyperbaric Oxygen Therapy - Undersea & Hyperbaric Medical Society (