Wound Care for the Hyperbaric Provider

Overview of the course:

The course will address wound care procedures within the hyperbaric setting. Such as diabetic foot ulcers, lymphedema, debridement, and dressings. The course will include panel discussion and some hands-on instruction for casting and wrapping.

Specifically, Becca Mackintosh will cover discussion of wound needs and dressings to meet the needs and include multiple photos while also covering treatment plans.

Michael Crouch will present a step-by-step outline of the revenue cycle process for an outpatient wound care program. It includes coverage, documentation, coding, and billing requirements for wound care and hyperbaric medicine services, as well as case studies of actual audits conducted at existing programs.

Dr. John Kirby will present common presentations of patient with lower extremity ulcerations and their initial work up that would lead to vascular referrals and vascular procedures. Diagnostic vascular procedures that any clinician can perform for the staging for severity of vascular disease leading to better objective criteria for later vascular procedures will be stressed and then a brief overview of those vascular procedures in the context of healing more ulcerations effectively will be summed up.  This lecture is meant for non-vascular surgeon clinicians to be able to better evaluate patients with vascular disease as part of their ulceration etiology and be more familiar with what vascular procedures might be considered for patients upon vascular referral.   

Dr. Clint Larsen will review why certain wounds need off-loading. He will discuss what types of offloading to use. how to apply offloading, and limitations of offloading.

Mainstream health care providers have an antiquated view of lymphedema and lymphatic impairments, associating the diagnosis with only extremely large limbs or edema following treatment for cancer. Furthermore, utilization of compression applications has been viewed as only appropriate for those with edema. Suzie Ehmann will provide the attendee with current evidence to dispel both myths. Case studies will be provided to demonstrate how compression science can be used to optimize patient outcomes.

Lecture Objectives Include:

• Review various wound types.
• Understand basic principles of dressing selection.
• Review commonly used dressings.
• Understand appropriate dressing selection for the various wound types.
• Understand microbial epidemiology of commonly seen wound infections.
• Be familiar with most relevant, recent studies related to antibiotic management of osteomyelitis.
• Understand important clinical considerations when administering antibiotics for wound infections.
• Understanding of the overall coding/billing/payment structure for a Hospital Outpatient Department (HOPD) and providers who are delivering wound care and hyperbaric medicine services in that setting.
• Understanding of the Documentation Requirements for wound care and hyperbaric medicine services.
• Understanding of the importance of Policies for a HOPD and how to access those guidelines.
• Review of audit case studies.
• The attendees will be able to list those vascular procedures recommended for an initial work up and management of patients with vascular disease and lower extremity ulcerations.
• The attendees will be able to list strategies for a good referral to vascular surgery.
• The attendees will be able to delineate the options and differences for common vascular procedures as well as associated medical management for optimal ulcer healing.
• Understand the evidence and science behind wound offloading.
• Understand when to use different offloading techniques.
• Be familiar with the complications of off loading.
• Discuss the role of lymphatic impairment as it relates to the following: chronic edema, chronic non-healing wounds, chronic/recurring infections.
• Identify trophic changes and the pathophysiologic causes associated with chronic edema and chronic wounds.
• Identify hemodynamic benefits of compression on circulation and integumentary healing – compression effects beyond edema reduction.
• Demonstrate knowledge of therapy options available to enhance lymphatic function beyond standard of care compression options.

Price:

• Non-Member: $146.25
• Regular: $113.75
• Associate: $81.25

Estimated time to complete this activity: 6.5 hours

Termination Date: March 14, 2026

Schedule:

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.

Designation Statements:

• Physician CME: The Undersea and Hyperbaric Medical Society designates this enduring material for a maximum of 6.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
• Nursing CEU:  Approved license types: Advanced Registered Nurse Practitioner; Clinical Nurse Specialist; Licensed Practical Nurse; Registered Nurse; Certified Nursing Assistant; Respiratory Care Practitioner Critical Care; Respiratory Care Practitioner Non-Critical Care; Registered Respiratory Therapist; Certified Respiratory Therapist.  This enduring material is approved for 6.5 contact hours by the Florida Board of Registered Nursing Provider #50-10881. 
• NBDHMT does not recognize this educational program as meeting their requirements and scope for credit.

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

The following individuals have disclosed a relevant financial relationship with ineligible companies. A financial relationship, in any amount, exists between the person in control of content and an ineligible company and;

• The content of the education is related to the products of an ineligible company with whom the person has a financial relationship and;
• The financial relationship existed during the past 24 months.
• All of the relevant financial relationships listed for these individuals have been mitigated.

The following individual(s) in control of content (planners/faculty/reviewers/authors) for this educational activity have relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

Suzie Ehmann, PT, DPT, CWS, CLT-LANA
3M: Consultant/Speakers Bureau
Compression Dynamics: Consultant/Unrestricted Educational Grant
Milliken: Consultant/Speakers Bureau
Jobst/Essity: Consultant/Speakers Bureau
L&R: Consultant/Speakers Bureau
Urgo: Consultant/Speakers Bureau/Advisory Board
Medline: Consultant/Speakers Bureau

All relevant financial relationships with ineligible companies were resolved prior to the individual’s participation through peer review of the content by an unbiased reviewer.

Commercial support was received for this activity:
Smith & Nephew: $1,500 educational grant provided for the live meeting.

Disclaimer: 
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.

Meet the expert faculty:

Becca Mackintosh APRN, FNP-C, CWCN
• Worked in wound care since 2006. Initially as WC RN in clinic/hospital settings
• Have worked as NP since 2013 in clinic and hospital setting
• Retired from full time job but currently part time provider doing home visits
• On call wound care for hospital system in my area
• Hobbies- jack of all trades but master of none. Enjoy preparing wool for spinning, then spinning the wool, knitting, tatting, gardening, traveling.

Todd Vento, MD
Experienced Medical Director and Physician with a demonstrated history of success at all levels of the healthcare system. Skilled in Clinical Medicine (Infectious Diseases/Internal Medicine), Program Development, Healthcare Leadership, Population and Global Health, and Medical Education. Strong healthcare professional with a Master of Public Health (MPH) in Epidemiology/International Health from Johns Hopkins School of Public Health. Retired Army Medical Officer with extensive operational and leadership experience, providing infectious diseases/public health expertise in support of military and civilian healthcare programs on five continents.

Michael J. Crouch, CHT, CPC, CPMA
Michael is a Certified Professional Coder and Medical Auditor with more than 25 years’ experience in the Wound Care and Hyperbaric Medicine industry. He served as VP of Reimbursement and Corporate Hyperbaric Safety Officer for two different wound care management companies providing reimbursement and management support to more than 200 outpatient wound care departments. Additionally, Mr. Crouch was a Program Director for two different wound care centers (both multi- and monoplace). He has extensive experience in conducting revenue cycle and compliance audits, training and education for both revenue cycle and hyperbaric operations.

He is a former member of the American Association for Wound Care Management (AAWCM) subcommittee and former surveyor for the UHMS Hyperbaric Facility Accreditation Program. He served as Chair of the UHMS Associates (2003-2005) and was a former member of the UHMS Practice Compliance Committee. Mr. Crouch has authored several hyperbaric articles and textbook chapters. He currently operates a consulting firm that he established 5 years ago that specializes in revenue cycle management for outpatient wound care programs.

John Kirby, MD
Dr. Kirby is an Acute & Critical Care Surgeon at Barnes-Jewish Hospital and Washington University School of Medicine in St Louis and is the Medical Director for their Wound and HBO programs. He works with a multi-disciplinary team to develop wound healing and limb preservation programmatic strategies including the close collaboration with vascular surgery as well as plastics surgery, podiatric surgery, and physical medicine and rehabilitation to study optimal patient care outcomes in wound healing.

Clint Larsen, DPM
Dr. Larsen is a Podiatry Specialist in Murray, UT and has over 14 years of experience in the medical field. He graduated from California College of Podiatric Medicine medical school in 2008. He is affiliated with medical facilities such as Alta View Hospital and Intermountain Medical Center.

Suzie Ehmann, PT DPT, CWS, CLT-LANA,
Suzie is clinical specialist working at Atrium Health Stanly. Over the last 20 years, she has dedicated her practice to the evaluation and comprehensive treatment of patients with lymphatic disorders and chronic non-healing wounds. Dr. Ehmann has a focused interest on the science of compression and impact of edema management on functional ability and mobility. Currently she is pursuing her PhD with a focus on the impact of an alternating compression profile. She has spoken nationally and internationally on this topic.

Suzie is a Certified Lymphedema Therapist through the Lymphology Association of North American; a Certified Wound Specialist through the American Board of Wound Management. She has been a featured speaker at national and international conferences, such as the Symposium for Advance Wound Care, Wild On Wounds, National Lymphedema Network International Conference, International Lymphatic Framework Conference, European Wound Management Association, International Compression Club and numerous regional lymphedema and wound conferences. In addition, she has authored several articles published in peer reviewed journals.