I have been doing RMDIV℠ since 1995. I have performed over 195,000 treatments. We now up to the rate of 10-11,000 per year. Yes, it is absolutely necessary to get a training in this to do it correctly. It cannot be learned from a book or a "paper". However I am attaching a complete description of my Method. I am not in favor of using a pump. I feel "everything" that is happening throughout the treatment through the syringe. I would considered it an honor to have you come and train with me.
Regards,
Howard Robbins MD
Concerning "Air embolism", this is absolutely not possible with my Method!
The main objection against all forms of DIV is the fear of “the danger of "air embolism". Robins Method of Direct Intravenous Ozone Therapy℠ (a.k.a. RMDIV℠) uses only medical grade oxygen medical ozone generators with sealed systems, along with ozone resistant silicone tubing and glass tubes (currently the Zotzmann Ozone 2000 from Germany). If you look up “Air Embolism” in the medical literature you may be surprised. Most of the reports come from neurosurgery procedures where air often enters the venous system, and where 'clinical manifestations' of Vascular Air Embolism [VAE] appear in about 45% of the cases. Anesthesiology references indicate those lethal doses of air in humans range from 200 to 500 cc of entrained vascular air, or 3 to 5 ml/kg. That's a lot of air (well beyond RMDIV℠) at 4 ml/kg, which would mean 280 ml of air for a 154 lb person in a single dose. Not surprisingly, one report cites a fatal case of 100 ml of air per second entering circulation during a subclavian venipuncture using a 14gauge (RMDIV℠ uses a 27gauge butterfly) needle. (Flanagan, Gradisar, Gross, and Kelly)
Also, it is not just the volume of air involved, but the speed of injection that also makes a difference (Toung, Roosberg, Hutchins). In fact, an anesthesiology textbook indicates that "The Lethal Dose" [LD] in humans can be exceeded if the air is entrained slowly, allowing for hemodynamic compensation. A bolus of air tends to lead to an increase in central venous pressure [CVP], a decrease in pulmonary artery pressure [PAP], and shock that is thought to be related to an air lock in the right ventricle. On the contrary, a slow infusion of air results in an increase in CVP/PAP, with compensatory increase in cardiac output" (Mongan). Non-lethal doses of VAE are reported as 2ml/kg or less (Bricker). In a 154 lb person, this would amount to 140 ml of AIR (not oxygen) entering the venous circulatory system. "The lungs appear to have a large capacity to compensate for air embolus within the pulmonary arterial circulation" (Emby and Ho).
Other reports indicate "clinical manifestations" of VAE start appearing with dosages of 100 ml or more, particularly in neurosurgery procedures where air often enters the venous system. (Mongan). Anesthesiologists are trained to look out for these 'clinical manifestations', and to apply corrective measures. In fact, one of the measures taken is to have the patient breathe 100% oxygen. The points gathered from these cursory reference examples are fairly straightforward:
--A VAE lethal dose is a lot of air in the venous system; it is around 280 ml in a 154 lb person.
--140 ml or less of air in the venous system is considered non-lethal in the literature.
--Non-lethal VAE cases are fairly common in neurosurgery, are expected, and anesthesiologists are trained to deal with them.
(2) The RMDIV℠ protocol falls well within safe parameters reported in the medical literature. Moreover, it is never AIR that is injected in the RMDIV℠ procedure, but pure medical grade oxygen with a small percentage of ozone. Therefore there is no danger of “air embolism” feared by other ozone authorities and organizations.
Given that the oxygen-depleted hemoglobin will absorb some of the gas, it would seem that staying below a single dose of 140 ml of oxygen/ozone would avoid even the "clinical manifestations" which the literature mentions, and which anesthesiologists must attend to in about 45% of neurosurgery cases. Almost all RMDIV℠ treatments never exceed 115cc, but range between 5 and 115cc.
In the future it would be in the best interest of the medical ozone world if all discussions of various forms of intravenous ozone therapy were kept in the area of scientific knowledge and not unsupported feelings and opinions.
REFERENCES:
Flanagan JP, Gradisar IA,Gross RJ, Kelly TR: "Air Embolus--a lethal complication of subclavian venipuncture -New England J Med, 1969 Aug 28;
Toung TJ, Rossberg, MI, Hutchins, GM: "Volume of Air in a Lethal Venous Air Embolism".- Anesthesiology, 2001 Feb; 94(2)
Mongan P. "A Practical Approach To Neuroanesthesia". - Lippincott, 2013
Bricker S: "The Anaesthesia Science"- Cambridge University Press, second edition, 2009
Emby DJ, Ho K:"Air embolus revisited-a diagnostic and interventional radiological perspective" SA Journal of Radiology. March 2006
Han D, Lee KS, Franquet T, et. al.: "Thrombotic and nonthrombotic pulmonary arterial embolism: spectrum of imagining findings - Radiographics. November 2003, Vol 23 (6)
O Donnell JM, Nacul, FE, Editors: "Surgical Intensive Care Medicine, second edition.. Springer, 2009
Muth CM, shank ES. Primary care: Gas embolism. New England J of Medicine. 2000;342:476–82
Fibel KH, Barness RP, Kinderknecht JJ: "Pressurized Intravenous Fluids Administration in the Professional Football Player. A Unique Setting for Venous Air Embolism". Clin J Sport Med. 2015; 25(4):e67-9
Platz,E:"Tangential gunshot wound to the chest causing venous air embolism: a case report and review" - The Journal of Emergency Medicine.41 (2).2008
Quote:
THE HEALING CENTER: “The world leader in DIV Ozone Therapy”
Dr. Howard F. Robins, DPM. Director 200 West 57th Street Suite 807 New York, NY 10019
Telephone (212) 581-0101 Cell 516-967-1009 Email:
drhowardrobins@gmail.comRobins Method of Direct Intravenous Ozone Therapy℠ (RMDIV ℠)
1. Pick the most proximal best vein by your best techniques
2. Fill a 60cc syringe with ozone at 55 gamma past the 60cc mark to about 65cc
3. Attach a 27-gauge butterfly.
4. Push 5 cc ozone out through the butterfly to flush it up to the 60cc mark
5. Apply tourniquet, Insert the butterfly into vein and watch for flash
6. Release tourniquet
7. Slowly push in the requisite volume. Begin with 20cc first treatment for person 90lbs.(40.8K) or more. Treatment time is about 1-2 minutes for 20 cc. Push rate is about 1cc every 5-15 seconds.
8. Increase by 10cc each treatment unless the patient has Herxheimer reaction, expresses discomfort, cough, chest tightness, facial flush, or vein irritation not helped by slowing infusion.
9. If there is vein discomfort, slow the push. Make sure there is no infiltration.
10. If there is obstruction, squeeze the arm above venipuncture site in “milking” movements toward the heart in order to relieve “traffic jam” (blockage) of gas.
11. Keep arms and legs extended and neck straight. Best to keep patient in semi recumbent position.
12. Always leave 5cc ozone in the syringe to keep syringe sterile. Syringe is reusable until you see a black ring
inside from plunger, or the plunger gets too stiff to move it, or graduation markings become obscure.
13. Keep the maximum treatment volume at 55 cc through treatments # 10-12.
14. Then you can add a second syringe doing the same method as above, increasing volume by 10cc each session to about 110 cc.
15. Always rotate veins and arms to avoid repeated trauma.
16. Can “sandwich” in a syringe of IV push GSH 1000 mg. dividing the ozone volume in half. Give half the amount of ozone, then the GSH, then the other half of ozone.
17. After butterfly is removed, patient must compress vein for 5 minutes without bending arm. Must observe patient for at least 10 minutes before the patient leaves. Note cough, chest tightness or anything unexpected.
18. Smaller veins need slower rate of push than larger veins. Have patient “pump some iron” with 2lb. weights before inserting needle.
19. Wait 3 hours in between 2 or more DIV treatments in the same day. Treat at least 3 times per week, up to 12 times (two per day) weekly. No treatments at least one day per week for body to process waste.
20. A cerebral paresis has been observed by Robins in ~1:10,000 treatments. A feeling of paresis may begin on one side of the body within the first 30 minutes after the push starts. It lasts from 2-30 minutes after DIV and has not led to any residual effects. It is only a feeling of weakness, not actual weakness. Never has happened with the first DIV, or during the actual treatment.
21. If the patient has experienced cough or chest tightness, do not increase the dose until he/she has the same dose again without any such experience.
22. If severe chest symptoms, give oxygen at 3 liters per minute via nasal cannula to speed the resolution of the chest discomfort. Do not let the patient leave until he is well past the symptoms. Make them wait 5-10 minutes after the symptoms disappear before patient leaves. Should be breathing O2 the whole time.
23. No deep breathing during the DIV injection, nor during chest tightness or cough. Shallow breathing only. Try to suppress any cough.
24. For vein irritation, warm compresses every 10 minutes, Traumeel cream, and as last resort, ibuprofen. To prevent vein irritation make sure the patient is taking vitamin C to gut tolerance every 2 hours, 5-6 times a day. Also drink 1 gallon of water everyday, and take Zana Bio-juice at least 3 ozs daily to replenish bacteria in intestinal wall.