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2018 UHMS Virtual Gulf Coast Chapter Meeting

Expiring soon on October 14, 2023. You must complete the full course before the termination date to receive credit. Price: Non-Member: $213.75 UHMS Member: Regular: $166.25 UHMS Member: Associate: $118.75 UHMS Member: NBDHMT Credit Only Rate: $50.00 Table of Contents: UHMS Gulf Coast ...Read more

  • Course Description
  • Course Credits

Expiring soon on October 14, 2023. You must complete the full course before the termination date to receive credit.


  • Non-Member: $213.75
  • UHMS Member: Regular: $166.25
  • UHMS Member: Associate: $118.75
  • UHMS Member: NBDHMT Credit Only Rate: $50.00

Table of Contents:

UHMS Gulf Coast Chapter 2018 Enduring Material Table of ContentsMinutes
Caroline Fife, MD: Can registry save us 59
Helen Gelly, MD: Targeted Probes 59
Nick Bird, MD: Altitude-Induced Decompression Illness 48
Michael Crouch, BS, CHT, CPC, CPMA: Chart Audits - Lessons Learned/Billing Issues 90
Jayesh Shah, MD: Atypical Ulcers - What the Heck is this? 48
Jayesh Shah, MD: Ethics Issues in Hyperbaric Medicine 54
AJ Applewhite, MD: Sea Creatures - Great and Small 30
Paul Harch, MD: Mild TBI Persistent Post-Concussion Syndrome, PTSD and HBO2 Review 70
Greg Brown, BS, CHT: The Use of UVC in Multiplace Hyperbaric Facilities 37
Tracy LeGros, MD: Diving Treatment Cases 38
Heather Murphy-Lavoie, MD: New Horizons in HBO Medicine 28



  1. Understand the possible uses of the Hyperbaric Oxygen Therapy Registry.
  2. Understand the role of the Qualified Clinical Data Registry (QCDR) for physicians subject to the Merit-Based Incentive Payment System (MIPS).
  3. Understand the WPS OIG report and consequences.
  4. Understand TPE.
  5. Understand how diving at altitude increases decompression stress.
  6. Understand the difference between acclimatization and inert gas equilibration.
  7. Describe how inadequate acclimatization can affect dive safety.
  8. Understand how we can account for altitude changes.
  9. Understand the importance of conducting chart audit reviews for Hospital Outpatient Departments (HOPDs) providing WC/HBO2 services.
  10. Understand the documentation requirements to support appropriate billing of WC/HBO2 services provided in a HOPD.
  11. Understand the lessons learned from current chart audit reviews of HOPDs providing WC/HBO2 services.
  12. Identify atypical wounds: clues in history and examination.
  13. Discuss an organized approach to diagnosis of atypical wounds.
  14. Understand role of wound biopsy in misdiagnosed wounds.
  15. Understand ethical issues in documentation and issues with copy and paste in electronic documentation.
  16. Explain and understand the role of an Advanced Beneficiary Notice.
  17. Discuss ethical issues with corporate practice of medicine.
  18. Discuss ethical issues with off-label use and hyeprbaric medicine.
  19. Review a variety of hazardous marine life.
  20. Learn signs and symptoms of various marine life attacks/envenomation.
  21. Learn treatment options for various marine life attacks/envenomation.
  22. To understand that hyperbaric oxygen therapy is a dual-component therapy consisting of increased pressure and hyperoxia.
  23. To understand that a sham hyperbaric treatment is a treatment that omits increased pressure and hyperoxia.
  24. To understand that the literature on HBO2 in mTBI/PPCS with or without PTSD suggests effectiveness of two doses of hyperbaric oxygen therapy, indeterminate or neutral effects of other doses, and toxicity of one dose in isolated mTBI/PPCS.
  25. Describe what ultraviolet is and how it can help in the hospital and hyperbaric environment.
  26. Explain how UV-C disinfects and what organisms it affects.
  27. Provide an understanding of how direct exposure of UV-C can affect acrylic and the damage this can cause.
  28. The audience will recognize and understand the provocative maneuvers and circumstances that surround the injury of civilian and commercial divers.
  29. The audience will also be able to recognize appropriate treatment tables and treatment options for the care of injured divers.
  30. Understand the role of hyperbaric oxygen in ulcerative colitis.
  31. Understand the role of hyperbaric oxygen in avascular necrosis.
  32. Review the latest literature on hyperbaric oxygen in emerging indications.

Estimated time to complete this activity: 9.5 hours

Accreditation Statement: The Undersea and Hyperbaric Medical Society is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Disclosure: All faculty members and planners participating in continuing medical education activities sponsored by UHMS are expected to disclose to the participants any relevant financial relationships with commercial interests. Full disclosure of faculty and planner relevant financial relationships will be made at the activity.

Designation Statements (CME/CEU Approvals):

Physician CME: The Undersea & Hyperbaric Medical Society designates this enduring material for a maximum of 9.5 AMA PRA Category 1 Credits TM . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

MOC ABPM: The American Board of Preventive Medicine (ABPM) has approved this activity for a maximum of 9.5 LLSA credits towards ABPM MOC Part II requirements.

Nursing/RRT: This enduring material is approved for 9.5 contact hours provided by Florida Board of Registered Nursing/RRT Provider #50-10881.

For NBDHMT: This enduring material is approved for 4 Category A credit hours by National Board of Diving and Hyperbaric Medical Technology, 9 Medical Park, Suite 440, Columbia, South Carolina 29203.

“CHT re-certification requires a minimum of nine of the minimum 12 Category A credits relate directly to any combination of hyperbaric operations, related technical aspects and chamber safety”.

Launch Date: October 14, 2020
Termination Date: October 14, 2023

Disclaimer: The information provided by this CME material is for Continuing Medical Education purposes only. The lecture content, statements or opinions expressed however, do not necessarily represent those of the Undersea and Hyperbaric Medical Society (UHMS), its affiliates or its employees.

Goal: For over 40 years the UHMS has been the primary source of information for hyperbaric medicine and physiology worldwide. This enduring material has as its goal to address identified professional practice gaps and provide a quality CME opportunity which will improve scientific knowledge and skills for hyperbaric and wound care: physicians, nurses and technicians, and other clinicians and personnel whose practice includes hyperbaric medicine and wound care.

Target Audience – physicians, nurses, CHT’s or anyone with an interest in diving and hyperbaric oxygen therapy.

All individuals in control of content for this educational activity with their relevant financial relationship disclosed are listed below. ACCME defines a relevant financial relationship “as financial relationships in any amount occurring within the past 12 months that create a conflict of interest.” An individual who refuses to disclose relevant financial relationships will be disqualified from being a planning committee member, a teacher, or an author of CME, and cannot have control of, or responsibility for, the development, management, presentation or evaluation of the CME activity.

Name of IndividualIndividuals Role in ActivityName of Commercial Interest (If Applicable)Nature of Relationship
Kip Posey Planner None N/a
Nick Bird, MD Faculty None N/a
Helen Gelly, MD Faculty None N/a
Caroline Fife. MD Faculty None N/a
Michael Crouch Faculty None N/a
Jayesh Shah, MD Faculty None N/a
A.J. Applewhite, MD Faculty None N/a
Paul Harch, MD Faculty None N/a
Greg Brown, BS, CHT Faculty None N/a
Tracy LeGros, MD Faculty None N/a
Heather Murphy-Lavoie, MD Faculty None N/a
Stacy Harmon, BS UHMS Reviewer None N/a
Lisa Tidd Planner None N/a
Zachary Gaskill, MD Reviewer None N/a
Michael Harl, MD Reviewer None N/a
J. Benjamin Slade, MD Reviewer None N/a


About the presenters:

Dr. Caroline Fife completed a Family Medicine residency at the University of Texas, Southwestern in Dallas followed by a two year Fellowship in Undersea and Hyperbaric Medicine at Duke University. Until 2013 she was a Professor of Medicine at the University of Texas Health Science Center, Houston where she initiated the Memorial Hermann Center for Wound Healing and Hyperbaric Medicine and the Lymphedema Center. She is now a Professor of Geriatrics at Baylor College of Medicine in Houston, and the Medical Director of the CHI St. Luke's Wound Care Clinic in The Woodlands, Texas. She is also the Chief Medical Officer of Intellicure, Inc., an electronic medical records company, and the Executive Director of the U.S. Wound Registry, a non-profit organization recognized by CMS as a qualified clinical data registry. The USWR develops quality measures and helps wound care and hyperbaric practitioners meet the requirements of Medicare’s new Quality Payment Program.

Dr. Helen Gelly is co-chair of the UHMS QUARC Committee, involved in Regulatory issues at CMS and at the MACs and is actively involved with the UHMS Education Committee. Dr. Gelly took her first hyperbaric medicine course in 1991, and for over 19 years did critical care and 24/7 call for emergency hyperbaric patients in the greater Atlanta area. She became sub-specialty certified in UHM in 2000 through the ABPM. She founded Hyperbaric Physicians of Georgia, and was its Medical Director and CEO until 2010. Concurrent with her academic practice of hyperbaric medicine, she opened a non-hospital affiliated hyperbaric center in 1993, which has now expanded into a 4 center hyperbaric medicine and wound care practice, which has both monoplace and multiplace hyperbaric units. Her first unit was the first non-hospital affiliated monoplace hyperbaric unit to be UHMS accredited, and currently all four centers have that distinction. She has also been involved in the establishment of a ;hyperbaric center in Amman, Jordan.

She has been active in the UHMS since 1991, and has been a UHMS accreditation surveyor since the program’s inception. She is a member of the Wound Healing Society, the American Academy of Wound Management, the European Underwater and Baromedical Society, as well as the International Congress of Hyperbaric Medicine. She served as Gulf Coast Chapter president from 2005-2007. Dr. Gelly has served on the Education committee of the UHMS since 2010, and has been co-chair of the Quality, Utilization, Authorization and Reimbursement committee of the UHMS since 2012. She served as the expert witness for the American College of Emergency Medicine’s defense of 99183 at the AMA RUC in February 2014, and has been active in regulatory issues on the national level. She has been asked to serve on the Georgia Medical Care Advisory Committee (MCAC) 2015-2017, and has long served as an expert for the Georgia state Medicaid program. She is a fellow of the UHMS as well as the American College of Hyperbaric Medicine.

Dr. Gelly lectures extensively, teaching an UHMS approved Introductory Course in Hyperbaric Medicine, and lecturing internationally on hyperbaric medicine and wound care. She has published in the field.

Dr. Nicholas Bird currently works in the Marshall Islands supporting the US Army missile defense garrison on Kwajalein. He is board certified in both family medicine and undersea and hyperbaric medicine. He has held senior leadership positions to include UHMS President, Chief Medical Officer and CEO of Divers Alert Network, Medical Director of Hyperbaric Medicine, and is a combat veteran and prior US Air Force flight surgeon.

Mr. Crouch is a Certified Professional Coder with more than 25 years’ experience in the Wound Care and Hyperbaric Medicine industry. He served as VP of Reimbursement for two different wound care management companies providing reimbursement and management support to more than 300 outpatient wound care departments. He also served as the Corporate Hyperbaric Safety Officer for more than 250 hyperbaric technicians providing competency training and 24/7 assistance for hyperbaric chamber emergencies. Additionally, Mr. Crouch served as Chair of the UHMS Associates (2003-2005), and was a former member of the UHMS Practice Compliance Committee. He has authored a number of hyperbaric articles and two hyperbaric textbook chapters.

Dr. Jayesh B. Shah is the President of South Texas Wound Associates, where he provides clinical wound care services in San Antonio since past 17 years; President of TIMEO2 Healing Concepts, LLC, which provides consulting and education services in wound care and hyperbaric medicine; Medical Director of Wound Healing Center at Northeast Baptist Hospital; Co-Medical Director of Mission Trail Baptist Wound Healing Center in San Antonio, Texas; current President of American College of Hyperbaric Medicine. He has published “Wound Care Certification Study Guide” in 2011, its second edition in 2016; Textbook of Chronic Wound Care: An Evidence-Based Approach to Diagnosis and Treatment in 2018, and created “WoundDoctor” App, a comprehensive wound care resource tool for physicians, nurses and physical therapists for iPhone, Android and iPad. He has authored over 40 chapters on wound topics in 4 books and 30+ scientific articles in wound care and hyperbaric medicine. As Assistant Editor of Journal of ACCWS, he writes a column on certification exam in wound care. To his credit, Dr Shah is the recipient of the Paul James Sheffield Education Award for Lifetime Dedication to Education in the field of Undersea and Hyperbaric Medicine (2014); Jefferson C. Davis Memorial Award for Excellence in Clinical Hyperbaric Medicine (2007 and 2011); Carolyn Sue Award (2009); Young Scientist/Medical Doctor Award (2008).

Dr. A. J. Applewhite is the Medical Director at Baylor University Medical Center’s Comprehensive Wound Center in Dallas, TX. He received his M.D. from the University of Texas Medical School in Houston and completed his Family Medicine Residency at UTMB. He has devoted his full time practice to wound care and hyperbaric medicine. He is doubled board certified, holding board certifications in both Undersea and Hyperbaric Medicine and Family Medicine. In addition to his Board Certifications, he is a Certified Wound Specialist Physician. He also serves as an Assistant Clinical Professor for the Texas A & M Medical School.

Dr. Paul G. Harch is a Clinical Professor of Medicine, Section of Emergency Medicine at LSU School of Medicine, New Orleans, a graduate of The Johns Hopkins University School of Medicine, and a magna cum laude/Phi Beta Kappa graduate of the University of California, Irvine. Dr. Harch is the director of the University Medical Center Hyperbaric Medicine Department and separately maintains an active private practice and research program where he has adapted the concepts of conventional hyperbaric oxygen therapy to wounds in the central nervous system. Beginning with brain injured divers and boxers in 1989, he applied his protocol to the first HBOT treated cerebral palsy and autistic children in this country and multiple other cerebral disorders, including most recently a subacute drowned child (Medical Gas Research 3/2017). He has successfully treated U.S. servicemen with TBI and PTSD, publishing the latest findings in Medical Gas Research 10/2017. His studies in brain-injured veterans have continued with a randomized trial funded by a Louisiana generated congressional appropriation. The early case experience was confirmed in an animal model of chronic traumatic brain injury that was published in Brain Research in October, 2007. He has presented his research four times to the U.S. Congress and been nominated for the NIH Director’s Pioneer Award. In April, 2007 he published the Oxygen Revolution with co-author Virginia McCullough. This groundbreaking book, which has been released in its third updated edition in 5/2016, explains HBOT as an epigenetic therapy with expected revolutionary effects on medicine and neurology.

Greg Brown, BS, CHT. My interest in hyperbarics started in 2008 when I did a report for my I-EMT class on the various EMT certifications. The next year I took a 40-hr CHT course and started working for Allina Health at a hospital with 3 monoplace chambers. Derall not only helped us at this facility, but was influential in my becoming a Surveyor. A few years later I took a Safety Director course and became the SD for a local hospital in St. Cloud. When HCMC built their new multiplace chamber, I was hired on to help run their 24/7 critical care facility. After working the new Fink chamber at HCMC for 5 years, the opportunity to work at The Center For Hyperbaric Medicine & Environmental Physiology at Duke University came around. My past military, deployment, mechanical, and scuba diving experience has prepared me not only for hyperbarics but also to manage the chambers research at Duke University Medical Center. I look forward to sharing this presentation and answering your questions. Thank you.

Dr. Tracy LeGros is a clinical professor in emergency medicine in the program director for the Anderson hyperbaric medicine fellowship at LSU in New Orleans. She is been in educator and LSU for 20 years and has trained approximately 300 emergency medicine residents and 50 hyperbaric fellows. She graduated from Charity emergency medicine residency and trained in Anderson hyperbaric medicine under Dr. Keith Van Meter.

Dr. Heather Murphy-Lavoie is a Clinical Professor of Medicine at the Louisiana State University School of Medicine, Director of Faculty Development, Section of Emergency Medicine, Chair of the UHMS Education Committee, Associate Program Director for the LSU Undersea and Hyperbaric Medicine Fellowship. Education: BS in biomedical engineering at Tulane University, MD from Tulane School of Medicine, Residency in Emergency Medicine at Charity Hospital and fellowship training with Keith Van Meter, MD.


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If at any time during participation in this online CME enduring material event, a learner can contact UHMS, by clicking on "Contact Us" tab located on the far right-hand side of the main menu bar found at the top of the screen. Also, the contact phone number and email address is always displayed on the top center of the screen, under the main menu bar.

Undersea and Hyperbaric Medical Society (UHMS)
631 U.S. Highway 1, Suite 307
North Palm Beach, FL 33408
Phone: +1-919- 490-5140/877- 533-8467
Fax: +1-919- 490-5140

Policy on Privacy and Confidentiality. It is the policy of the UHMS not to release any participants' name or contact information. As a registered member of UHMS, the organization will occasionally send out electronic correspondence relating to continuing educational events.

Copyright. For the purposes of this enduring material event, UHMS owns the rights to the recorded live event and distribution rights for the video material and write/copy-protected presentations. UHMS will NOT be distributing the individual editable presentations in PowerPoint format as it does not own the rights to the source material for the individual presentations.


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The information provided at this CME activity is for Continuing Medical Education purposes only. The lecture content, statements or opinions expressed, however, do not necessarily represent those of the Undersea and Hyperbaric Medical Society (UHMS), its affiliates or its employees.
Undersea and Hyperbaric Medical Society (UHMS)
631 U.S. Highway 1, Suite 307
North Palm Beach, FL 33408 USA

Phone: 1-919-490-5140
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Fax: +1-919-490-5140
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