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Stacking the Deck: Applying Lessons Learned to Dive Safety Basics
FROM THE ARCHIVES
BY BILL ZIEFLE
IN 1982 DAN STAFF NOTED a growing demand among divers for information about dive medicine. To meet that demand and to enhance communication between DAN and its members, the organization published the first issue of Alert Diver the following year. The magazine, which at the time could more accurately be described as a newsletter, was a benefit of membership and a means to educate divers, dive professionals and even medical professionals about dive medicine.
The first issue included the following statement: “Alert Diver is a forum for ideas and information relative to diving safety, education and practice. It acts as a liaison between DAN’s diving medicine specialists, their health care colleagues, and the diving community at large. Any material that relates to diving safety or diving medicine is considered for publication.”
From that first eight-page, text-only issue, Alert Diver grew over the years to cover not only dive safety and medicine, but also dive research, industry news, incident reports, letters from DAN members, and more. In 2009 DAN expanded the magazine’s purview to feature dive destinations, marine life, underwater photography and other topics of general interest to divers. A renewed emphasis on world-class underwater images was intended to enhance the magazine’s appeal to divers. We knew DAN members were interested in diving, and by sharing stories and images by the world’s most experienced and eloquent dive journalists we believed we could reach even more people with important dive safety messages. After all, a spoonful of sugar helps the medicine go down.
This 2021 Special Edition is a collection of the most relevant and informative dive-safetyrelated articles that DAN has published since the 2009 redesign. We hope you enjoy this curated selection from the Alert Diver archives, and we hope you use the information in these articles to dive safely for years to come.
MEDICAL SERVICES
DAN was founded in 1980 as a hotline for injured divers to get access to the medical care they needed. Today DAN Medical Services operates not only the DAN Emergency Hotline, but also the DAN Medical Information Line, specializing in helping divers in emergencies as well as
answering questions about fitness to dive. In fielding these calls, DAN medics garner enormous expertise in managing dive emergencies and in-depth knowledge about the implications of diving with various medical conditions.
DAN Medical Services is an invaluable resource for injured divers as well as for divers, dive professionals and medical professionals seeking to prevent dive injuries. The Medical Services section in this issue of Alert Diver highlights articles that can help guide divers’ responses to the onset of symptoms after diving. It also covers important considerations for responding to hazardous marine life injuries, minimizing your risk of a dive accident and preparing yourself and those you dive with for safe and successful dives.
MEMBERSHIP AND INSURANCE
As a membership organization, DAN understands that one of the many appealing aspects of diving is the community of like-minded people with whom we dive. Divers are united by a love of being underwater, exploring the natural world and sharing adventures. It is DAN’s goal that all divers stay safe during their underwater excursions. That’s why DAN has published numerous articles promoting a culture of dive safety and encouraging our members to look out for themselves and other divers.
The articles in this issue’s Membership and Insurance section cover the ways that DAN empowers divers and dive professionals to advocate for themselves and each other and ways DAN membership and insurance programs are essential aspects of DAN’s mission to keep divers safe.
SAFETY SERVICES
The third section of this issue highlights the work of DAN Safety Services, which focuses on preventing incidents by offering first aid training, providing the dive industry with first aid and safety equipment, and helping divers and dive operators mitigate risks. With articles about emergency planning, social pressure and preventing gas contamination, this section is all about identifying potential hazards and taking the right steps to manage them.
While the dive community is largely familiar with DAN’s first aid courses and emergency oxygen units, much of DAN Safety Services’ work takes place behind the scenes. Throughout the world’s most popular diving destinations are hundreds of chamber facilities that are willing to treat divers but need support. Through DAN’s Recompression Chamber Assistance Program (RCAP), DAN provides chamber assessments, financial aid and consultations thus ensuring DAN members — and all divers — have access to the emergency medical services they need. DAN has also developed the industry’s most relevant and effective tool for helping dive professionals and businesses reduce incidents: the DAN Hazard Identification and Risk Assessment (HIRA) program. Since its creation in 2008, this program has fostered the development of safer diving communities and continues to promote safe operations worldwide.
RESEARCH
For decades DAN Research has conducted studies on safety and medical topics of practical interest to divers. Some of the department’s most well-known studies are on flying after diving, the effects of aging on diver health, the significance of patent foramen ovale to divers, diabetes and diving, and the causes of decompression illness.
Historically, DAN Research has conducted studies on the water as well as in chambers, and today there are opportunities for divers to take part. In addition to publishing studies in scientific journals and publishing the DAN Annual Diving Report each year, DAN Research hosts workshops and conferences involving industry experts who come together to share knowledge and establish guidelines. DAN also supports the future of dive medical research through the DAN Internship Program.
The final section of this issue features important lessons learned through dive medical research as well as expert opinions from some of the world’s most respected dive scientists. Topics include aging and diving, cardiovascular health and fitness, decompression sickness risk and more.
THANK YOU
At DAN, everything we do is possible because of you, our members. Thank you for your support. If there are any dive safety topics you would like to see us cover in a future issue of Alert Diver, please don’t hesitate to contact us at Letters@DAN.org. AD
2 0 2 1 S P E C I A L E D I T I O N
MEDICAL SERVICES
10 Stacking the Deck 16 Lionfish Stings 18 Back to Basics: Understanding DCI 22 Women’s Health and Diving 26 Marine Envenomations 28 Children and Diving 32 Uncertainity After Diving
STACKING THE DECK
APPLYING LESSONS LEARNED TO DIVE SAFETY BASICS
BY NICHOLAS BIRD, M.D., MMM
THERE IS A CERTAIN WANDERLUST among divers. Like the seafaring explorers of old, many in the diving community travel farther, dive deeper and consistently search the horizon and plumb the depths for new adventure. As a group, we are continually seeking ways to safely spend more time in the water. Since diving became a recognized endeavor for the general public, training organizations have worked diligently to provide techniques and procedures that facilitate safety and enjoyment.
Divers Alert Network® (DAN®) was founded 30 years ago with dive safety as its core mission. Over time, DAN’s reach has expanded to include research, training and a robust medical call center for divers. DAN’s services include medical referrals, consultation, evacuation assistance and repatriation. Over the course of our history, we have learned many lessons about dive safety and accident prevention.
These lessons are based on our collective experience and are the synthesis of years of accident management. With time, we have noted recurring issues associated with poor outcomes, many of which were avoidable. The majority of accidents that could have been avoided are the result of multiple factors that come together in a domino effect. Our goal is to support safe practices; and the more you build safety into your travel plans and diving activities, the happier memories you will have of successful trips and the more trouble you will avoid. Let’s take a look at some dive safety basics that, while important every time you dive, are especially important when you’re away from home.
TAKE CARE OF YOURSELF
A critical aspect of dive safety is personal readiness. In this context, readiness encompasses health, physical conditioning, proper skills and equipment preparation. The primary goal here is to ensure that your skills, equipment and health status are commensurate with the type of diving you plan to do and the environmental conditions you expect. Ideally, you should be fit enough to perform comfortably in the anticipated conditions, and your fitness level should provide you with a reserve in case of an emergency. Fatigue and exhaustion may lead to poor decision making and are common triggers of dive accidents. Optimal preparation for diving should include strength and cardiovascular training at least three times a week throughout the year and finswimming training before the dive season.
Health problems may cause accidents directly or indirectly by compromising physical fitness. DAN fields thousands of informational calls and emails every year and has an extensive referral network of dive-medicine trained physicians to help you. If you have concerns, or if your health status has changed since you last had a dive physical, please call +1–919–684–2948 or contact us via DAN.org/Ask-a-Medic for a referral. An easy way to decrease the risk of accidents is by keeping your gear in working order. Regulators and buoyancy compensators must be serviced annually. For those diving with rebreathers and other technical equipment, consult your manufacturer’s recommendations and have the gear evaluated regularly by a professional, especially in the event of any malfunction. For those diving in cold water, ensure your drysuits are functioning correctly — that seals are intact and valves have been regularly maintained and work perfectly.
