A DMT Explained

So What IS A DMT (“Diver Medic”)?
What’s that? You don’t know what a Diver Medic (DMT) is? That doesn’t surprise me, since there’s only been less than 2000 of us certified in the entire US (and only 555 currently certified.) Most doctors, Paramedics, Nurses, and other medical professionals have no idea who we are, or what we do.

The National Board of Diving and Hyperbaric Medical Technology describes a DMT as “a diving paramedic.”  Even if the DMT is not also a certified or licensed Paramedic/MICP, this is still an accurate description.

In EMS, a Paramedic can be described as a “physician extender.”  A Paramedic does advanced treatment and care until a patient reaches definitive care at a hospital.  Typically, this starts upon contact with the patient, and continues in the back of an ambulance until patient transfer has been completed at the receiving facility.

In commercial diving, difinitive care is usually hundreds, if not thousands, miles away.  The DMT is the extension of a physician on the oil platform, barge, boat, or wherever the job happens to be.  DMTs typically take care of non-emergency tasks as well, such as checking a rash, administering vaccination boosters (or other needed “shots”), and other “maintenance” tasks usually performed by a different medical professional in a more traditional setting.  Transport to a facility is either via helicopter or boat, which can sometimes mean days or even weeks of waiting.  In this case, the DMT is on the phone with a doctor describing the problem and treatment plan, and the doctor directs treatment from his office.

The simplified version of the above is simply, “a DMT is the physician extender in an extremely remote location, and most (if not all) all of their patients are divers.”

A brief description by Divers Alert Network also does a pretty good job of describing it: “Diver Medical Technicians (DMTs) serve at the critical first step in the diving medicine chain, caring for injured divers on the scene and acting as tenders in the hyperbaric chamber.” This is why we do training in the chamber, under actual pressure. Time is also spent learning how to operate the chamber, along with chamber safety, swapouts, and other tasks.

One of the best sites I’ve found so far that outlines the curriculum of the DMT program is here. You’ll notice that the program recently went through some major changes, in that they combined the two categories, Basic and Advanced, into a single designation, which now requires knowing (and being tested on) invasive skills.

So now you have a good idea about what a DMT is, or at least you know more after reading the above. A lot of you will be thinking to yourself, “So what? I’m a Paramedic – I know way more than they do!” While that may be true as far as invasive techniques and general emergency medical procedures are concerned, the areas that are not addressed in most Paramedic courses include:

– Diving Physics
– Nitrogen Narcosis
– Bubble Theory
– Decompression Theory
– Decompression Pathophysiology
– Decompression Sickness (Types I & II)
– Decompression Illness
– Arterial Gas Embolisms (cerebral, pulmonary, etc.)
– Neurological Examinations
– Hyperbaric Chamber Operations
– U.S. Navy, U.K., and other Treatment Tables
– Altitude Decompression
– Hyperbaric Oxygen Therapy (HBOT)
– Saturation Diving and High Pressure Nervous Syndrome
– Shallow Water Blackout
– Women and Diving
– and lots more…

OK, but where’d they come from?
Diver Medics came into being because of the demand by the oil industry (most predominately, offshore oil rigs) back in the 1970’s to address the need for trained medical personnel to be onsite in the event of a diving incident in remote locations where having physicians was not feasible.

The National Board of Diving and Hyperbaric Medical Technology has posted this document (PDF) that explains the history and significance of the DMT since its inception.

There’s a lot more, obviously, but that about covers the basics.

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