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11 HYPERBARIC MEDICINE ACTIVITIES IN INDONESIA Indonesian Maritime Specialist Society Mahdi.H, Susanto.A, Undari.J, Mahdi.D December 7 th. 2009 LAKESLA,

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Presentation on theme: "11 HYPERBARIC MEDICINE ACTIVITIES IN INDONESIA Indonesian Maritime Specialist Society Mahdi.H, Susanto.A, Undari.J, Mahdi.D December 7 th. 2009 LAKESLA,"— Presentation transcript:

1 11 HYPERBARIC MEDICINE ACTIVITIES IN INDONESIA Indonesian Maritime Specialist Society Mahdi.H, Susanto.A, Undari.J, Mahdi.D December 7 th. 2009 LAKESLA, SURABAYA

2 22 INDONESIA

3 33 Introduction Indonesia: Archipelago country, >> 17.000 islands, 2/3 seas enriched with marine’s biota, minerals and mining's, shipwreck’s treasures, beautiful fish and sea coral. Indonesia: Archipelago country, >> 17.000 islands, 2/3 seas enriched with marine’s biota, minerals and mining's, shipwreck’s treasures, beautiful fish and sea coral. The needs of undersea operation activities is very important: The needs of undersea operation activities is very important: Combat driver, underwater demolition, underwater construction, off shore drilling.Combat driver, underwater demolition, underwater construction, off shore drilling.

4 44 Recreational diving sites: Recreational diving sites: - Manado / Bunaken, Maluku / Banda Island, Bali, Lombok, Derawan Islands, Raja Ampat Island Supported by: Supported by: 17 hospitals with Hyperbaric Chamber17 hospitals with Hyperbaric Chamber 3 naval ships with HC3 naval ships with HC …introduction

5 55 Hyperbaric Medicine in Indonesia 1962 –1964 study to Poland and Japan 1962 Diving Center for Indonesian Navy Surabaya 1962 Graving dock and Hyperbaric Chamber (HC) Installation Surabaya 1964 Multiplace HC “Kurimoto” operational End of 1970 Indonesian Naval Health Institute (LAKESLA), Surabaya for Center of Excellence, east of Indonesia End of 1980 improvement for hyperbaric facilities at Dr.Mintohardjo Naval Hospital, Jakarta for Center of Excellence, west of Indonesia

6 66 Installation operating HC: Navy, Oil Company Pertamina, Dept of Health and Private Hospitals.Installation operating HC: Navy, Oil Company Pertamina, Dept of Health and Private Hospitals. Advance study: USA, Russia, Yugoslavia, Australia, France, Germany: deep diving and submarine medicine.Advance study: USA, Russia, Yugoslavia, Australia, France, Germany: deep diving and submarine medicine. 1980 decade, Indonesian Naval Health Institute started Hyperbaric Medicine course.1980 decade, Indonesian Naval Health Institute started Hyperbaric Medicine course. Hyperbaric Medicine in Indonesia

7 77 Ongoing process:Ongoing process:  Diving and Hyperbaric medicine service standardization for medical doctor and paramedic.  Standardization and competence for divers and underwater workers. Hyperbaric Medicine in Indonesia

8 88 Hyperbaric facilities in Indonesia

9 99 Jakarta Surabaya Tj. PinangAmbon KRI Rupat Lumba 2 Distribution of HC Indonesian Navy

10 10 Distribution of HC Biak Denpasar P. Pramuka Serang Makassar Manado Dept of Health

11 11 Distribution of Hyperbaric Chamber in Indonesia Distribution of HC Cilacap Aceh Balik papan Sorong Oil Company PERTAMINA

12 12 Distribution of HC SOLO JAKARTA Private

13 13 Center of Excellence West Indonesia HYPERBARIC CENTER Dr.MINTOHARDJO NAVAL HOSPITAL, JAKARTA East Indonesia INDONESIAN NAVAL HEALTH INSTITUTE (LAKESLA), SURABAYA

14 14 HYPERBARIC CENTER Dr. MINTOHARDJO

15 15 Indonesian Naval Health Institute (LAKESLA) Experimental HC (animal) Transport Monoplace Chamber Locking

16 16 LAKESLA

17 17 Indonesian Navy Monoplace HC KRI. P. RUPAT Lumba 2 Barge

18 18 HC Sanglah Denpasar, Bali Frequency HBOT for DCS is high Frequency HBOT for DCS is high Patients: Fisherman and recreational diver Patients: Fisherman and recreational diver

19 Hyperbaric Chamber  Support diving activities in Indonesia and Asean countries  T/ OHB : “ DCS “ and Cilical case  Preventive and Promoting  Research and Training

20 20 Personel for HC Medical doctor consultant Medical doctor consultant  Maritime medicine specialist  Doctor + hyperbaric medicine course  Inside Tender  Outside Tender  Technicians / operator

21 21 Education and Hyperbaric course Naval officer: underwater medicine (Lakesla) Naval officer: underwater medicine (Lakesla) Hyperbaric course: doctor, paramedic, operator and HC technicians Hyperbaric course: doctor, paramedic, operator and HC technicians Hyperbaric introduction for Medical student, Hyperbaric introduction for Medical student, Professional divers (Mintohardjo Naval Hospital) Professional divers (Mintohardjo Naval Hospital) Continuing degree environmental medicine majoring Hyperbaric (Mintohardjo Naval Hospital) Continuing degree environmental medicine majoring Hyperbaric (Mintohardjo Naval Hospital) Maritime medicine specialist (Faculty of Medicine University of Indonesia)

22 22 Number of patients and visits : LAKESLA, 2006 and 2007 NoCases20062007 PatientsVisitPatientsVisit a Divers check up / OTT b DCS tipe II 31515 cFitness153649221947 d Clinical cases 73882549279224 1 DM complication* 19130742083340 2DM5145526230 3 Neurology * 481057661456 4 Orthopedic post op 4571852820 5 Sudden deafness 3639748505 6Osteoarthritis30614083 7Allergy2413722126 8 Post Stroke rehabilitation 2111935210 9Osteomyelitis1657517630 10Combustion1626220327 Others26013993931497 ∑1208 92321971 10998 *DM complication : gangrene, ulcus, cellulites, post amputation *Neurology : cephalgia,neuropathy, vertigo, tinnitus, bell’s palsy, etc

23 23 Number of patients and visit, RSMTH: 2006 and 2007 NoCases20062007 PatientsVisitPatientsVisit a Divers check up / OTT 390390335335 b DCS tipe II 359422128 cFitness3001143181718 d Clinical case 78584306995475 1 Sudden deafness 32324832362010 2 DM: complication* 14017431091005 3 Neurology * 88117174665 4 Post stroke rehabilitation 4553257664 5 Orthopedic post op 3152915149 6DM2723429117 7Osteomyelitis153243981 8 Ophthalmologic case 1013612177 9 Neuro surgery post op 595869 10Combustion598682 Others961085114456 ∑15101005712376656

24 24 Number of patients and visits, LAKESLA and RSMTH 2006 NoCasesLAKESLARSMTH VisitorsVisitVisitorsVisit a Divers check up 390390 bDCS3153594 cFitness1536493001143 d Clinical case 73882547858430 1 DM: complication 19130741401743 2DM5145527234 3Neurology481057881171 4 Orthopedic post op 4571831529 5 Sudden deafness 363973232483 6 Post stroke rehabilitation 2111945532 7Osteomyelitis1657515324 8Combustion16262598 9Others31415971111316 ∑1208 9232151010057

25 25 Number of patients and visits, LAKESLA and RSMTH 2007 NoCasesLAKESLARSMTH PatientsVisitPatientsVisit a Divers check up 335335 bDCS1522128 cFitness221947181718 d Clinical case 92792246995475 1 DM: complications 20833401091005 2DM2623029117 3Neurology66145674665 4 Orthopedic post op 5282015149 5 Sudden deafness 485052362010 6 Post stroke rehabilitation 3521057664 7Osteomyelitis176303981 8Combustion20327682 9Others4551706134702 ∑1971 1099812376656

26 Pra OHB OHB 10 x

27 27 Discussion Case : o Decompression Sickness: >> fisherman divers, recreational divers. o Military and professional divers ↓ o Routine medical check up for military divers, underwater professional worker, dive guides o Traditional and fisherman divers : + 27

28 28 o Sudden deafness  highest case in RSMTH Jakarta o The patient treated within golden period (2 x 24 hours), the improvement: 75-90% o DM case  to avoid amputation o Orthopedic post op, neuro surgery post op, and general surgery o Post stroke rehabilitation, neurological symptoms (headache) …discussions

29 29 o Ophthalmologic case: A. Centralis Retinae occlusion o Most of adjuvant therapy: oGood results o Kindwall oxygen treatment table …discussions

30 30 There are 17 hospitals with HC. There are 17 hospitals with HC. Two diving centers: Two diving centers: - Mintoharjo Naval hospital Jakarta - LAKESLA, Surabaya Indonesian Navy: diving school and ships Indonesian Navy: diving school and ships Conclusions

31 31 Improvement hyperbaric and diving medicine education / course for medical doctor, paramedics and medical/paramedic student Improvement hyperbaric and diving medicine education / course for medical doctor, paramedics and medical/paramedic student Clinical application: ↑ ↑ Clinical application: ↑ ↑ The need of more specialist in Maritime medicine and also Hyperbaric Chamber The need of more specialist in Maritime medicine and also Hyperbaric Chamber …conclusions

32 32 Maritime medicine specialist In University of Indonesia, Jakarta In University of Indonesia, Jakarta Students: general medicine Students: general medicine Six semesters Six semesters Diving, hyperbaric medicine, port health authority, quarantine procedures, ships hygiene, mental and health ships personnel Diving, hyperbaric medicine, port health authority, quarantine procedures, ships hygiene, mental and health ships personnel We have Maritime Medicine Specialist Society

33 Guinness of World record, Bunaken, Manado Indonesia 2009: Guinness of World record, Bunaken, Manado Indonesia 2009: August 16th, The Largest Scuba Diving Lessons, 2465 diversAugust 16th, The Largest Scuba Diving Lessons, 2465 divers August 17th, The Most Scuba Diving Simultaneously, 2486 diversAugust 17th, The Most Scuba Diving Simultaneously, 2486 divers Divers from Indonesia, Singapore, Thailand, Australia, USA, New ZealandDivers from Indonesia, Singapore, Thailand, Australia, USA, New Zealand Lead by First Adm. Iskandar Sitompul, Indonesian Navy. Lead by First Adm. Iskandar Sitompul, Indonesian Navy.

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