Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 May 21:12:666503.
doi: 10.3389/fphys.2021.666503. eCollection 2021.

Emergency Medicine Cases in Underwater and Hyperbaric Environments: The Use of in situ Simulation as a Learning Technique

Matteo Paganini  1   2 , Giulia Mormando  2 , Sandro Savino  3 , Giacomo Garetto  1   2   3   4 , Giulia Tiozzo  2 , Enrico M Camporesi  1   2   3   4   5 , Fabrizio Fabris  3 , Gerardo Bosco  1
Affiliations

Emergency Medicine Cases in Underwater and Hyperbaric Environments: The Use of in situ Simulation as a Learning Technique

Matteo Paganini et al. Front Physiol. .

Abstract

Introduction: Hyperbaric chambers and underwater environments are challenging and at risk of serious accidents. Personnel aiming to assist patients and subjects should be appropriately trained, and several courses have been established all over the world. In healthcare, simulation is an effective learning technique. However, there have been few peer-reviewed articles published in the medical literature describing its use in diving and hyperbaric medicine.

Methods: We implemented the curriculum of the Master's degree in hyperbaric and diving medicine held at the University of Padova with emergency medicine seminars created by the faculty and validated by external experts. These seminars integrated traditional lectures and eight in situ simulation scenarios.

Results: For the hyperbaric medicine seminar, simulations were carried out inside a real hyperbaric chamber at the ATIP Hyperbaric Treatment Centre, only using air and reproducing compression noise without pressurization to avoid damages to the manikins. The four scenarios consisted of hyperoxic seizures, pneumothorax, hypoglycemia, and sudden cardiac arrest. Furthermore, we added a hands-on session to instruct participants to prepare an intubated patient undergoing hyperbaric oxygen treatment with a checklist and simulating the patient transfer inside and outside the hyperbaric chamber. The diving medicine seminar was held at the Y-40 The Deep Joy pool in Montegrotto Terme (Italy), also involving SCUBA/breath-hold diving (BHD) instructors to rescue subjects from the water. These diving medicine scenarios consisted of neurologic syndrome ("taravana/samba") in BHD, drowning of a breath-hold diver, pulmonary barotrauma in BHD, and decompression illness in a SCUBA diver.

Conclusion: With this experience, we report the integration of simulation in the curriculum of a teaching course in diving and hyperbaric medicine. Future studies should be performed to investigate learning advantages, concept retention, and satisfaction of participants.

Keywords: SCUBA diving; breath-hold diving; diving medicine; emergency medicine; environmental medicine; hyperbaric medicine; hyperbaric oxygen therapy; simulation.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Similar articles

See all similar articles

Cited by

References

    1. Al-Waili N. S., Butler G. J., Beale J., Abdullah M. S., Finkelstein M., Merrow M., et al. (2006). Influences of hyperbaric oxygen on blood pressure, heart rate and blood glucose levels in patients with diabetes mellitus and hypertension. Arch. Med. Res. 37 991–997. 10.1016/j.arcmed.2006.05.009 - DOI - PubMed
    1. American College of Surgeons Committee on Trauma (2018). “Chapter 4: Thoracic trauma,” in Advanced Trauma Life Support§Student Course Manual, 10th Edn, (Chicago, IL: American College of Surgeons; ), 66. Available online at: https://viaaerearcp.files.wordpress.com/2018/02/atls-2018.pdf
    1. Boet S., Cheng-Boivin O., Martin L., Hurskainen T., Etherington N. (2019). Evidence for simulation-based education in hyperbaric medicine: a systematic review. Diving Hyperb. Med. 49 209–215. 10.28920/dhm49.3.209-215 - DOI - PMC - PubMed
    1. Bosco G., Paganini M., Rizzato A., Martani L., Garetto G., Lion J., et al. (2020). Arterial blood gases in divers at surface after prolonged breath-hold. Eur. J. Appl. Physiol. 120 505–512. 10.1007/s00421-019-04296-2 - DOI - PubMed
    1. Bosco G., Rizzato A., Martani L., Schiavo S., Talamonti E., Garetto G., et al. (2018a). Arterial blood gas analysis in breath-hold divers at depth. Front. Physiol. 9:1558. 10.3389/fphys.2018.01558 - DOI - PMC - PubMed

LinkOut - more resources