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Dr Dives To Medical History

Dr Dives To Medical History

Christchurch emergency physician Dr Sandy Inglis will make New Zealand medical history on April 27th when he becomes the first doctor to graduate with a Postgraduate Diploma in Diving and Hyperbaric Medicine from The University of Auckland.

The diploma programme and a Master of Science specialisation in the field are run by Associate Professor Michael Davis, Medical Director of Christchurch Hospital's Hyperbaric Medicine Unit, which is one of only two units in the country equipped to treat scuba divers suffering from "the bends".

Professor Des Gorman, Head of the School of Medicine at Auckland's Faculty of Medical and Health Sciences, congratulated Dr Inglis on becoming the first to graduate from the programme, which was introduced in 2004.

A former Director of Medical Services for the Royal New Zealand Navy from 1989 to 1995, Professor Gorman says hyperbaric medicine is a growing field and its effectiveness is becoming widely recognised for treatment of a range of medical conditions, not only for decompression illness.

"The programme was introduced in response to a growing need. It equips doctors to practise effective clinical diving medicine in a primary care setting or to embark on clinical practice within a hyperbaric medicine environment."

The "bends" or decompression illness occurs when a diver returns to the surface of the water too quickly and accumulated nitrogen, which has not been exhaled, forms bubbles in the bloodstream. These may cause paralysis, severe joint pain or other neurological symptoms.

Sometimes, bubbles go straight to the brain, causing a cerebral arterial gas embolism (CAGE). This may result in a seizure when the diver comes to the surface and, if not acted upon very quickly, death soon afterwards.

Dr Inglis, who completed his undergraduate medical degree at Capetown University and now works at the Christchurch Hospital unit, says he first became interested in diving and hyperbaric medicine when he was living in Perth where he worked in the Fremantle Hyperbaric Medicine Unit.

His only formal training previously was a two-week course in Sydney and he says the Postgraduate Diploma, offered at Auckland, was a great opportunity to get formal training in diving and hyperbaric medicine.

"It has given me the credibility of a formal university qualification and exposure to experts in the field," he said.

Treating sick scuba divers is only a small part of his work at the Christchurch Hospital unit, says Dr Inglis, where most of the unit's work is related to treating patients in the decompression chamber for other medical conditions.

Up to eight patients a day are treated at the unit five days a week for four to six weeks each and often hyperbaric oxygen treatment (HBOT) is successful where "everything else" has failed.

HBOT has been shown to be effective in healing wounds, particularly those in diabetic patients and in patients who have had radiotherapy for cancer. Other indications for HBOT include crush injuries, severe life - threatening tissue infections and carbon monoxide poisoning.

"We put these patients into the room-shaped chamber, which sits up to four patients and a nurse attendant, and we pressure the room with air to the equivalent depth of 14 to 18 metres underwater. Once we have simulated that depth, we apply 100 per cent oxygen through a face mask or hood.

"It is a combination of the depth and the oxygen that provides the therapeutic effect. You can't just do air and depth, or 100 per cent oxygen at the surface, you have to do both. This treatment helps tiny new blood vessels to form and frequently these wounds do very well.

"I am an emergency doctor. I came into this from that background and was interested in scuba divers. I wasn't interested particularly in diabetic wounds but I have seen them get better. Often they have been treated for months and months by other means and they haven't healed. They come to our unit and six weeks later their wounds are closed up. It's pretty convincing and I'm happy that what I am doing is useful."

The University of Auckland is only one of two universities in the English-speaking world to introduce a Master of Medical Science or a Postgraduate Diploma in Diving and Hyperbaric Medicine. The distance learning programme is open to registered medical practitioners and is available internationally without any resident component in Auckland. However, attendance at a recognised short course in diving medicine is a component of the introductory course.

Topics include: physiology and medicine of diving; health surveillance of divers and hyperbaric workers; hyperbaric medicine; clinical diving and hyperbaric practice and a research essay or project.


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