DIVERS ALERT NETWORK: EUROPE
DAN Europe is an international non-profit medical and research organisation dedicated to the safety and health of divers. WWW.DANEUROPE.ORG
WHY DAN DOESN’T SHARE CHAMBER LOCATIONS OR AVAILABILITY
D
AN frequently consults on the care, transportation and hyperbaric treatment of injured divers. However, DAN does not generally provide information about the location or availability of chambers. This is because injured divers with suspected decompression illness (DCI) need to be evaluated at a hospital or emergency clinic first. Divers have driven past healthcare facilities to get to a recompression chamber, believing a chamber was the solution for just about any malady or injury. Even when divers surface with symptoms of an apparent arterial gas embolism, the best course of action is to have the diver assessed at the closest medical facility. An urgent care clinic or a hospital’s emergency department is better than a dedicated chamber facility.
• The closest recompression chamber might not be the most appropriate. • A chamber’s operational status can change. • Chambers may close for scheduled maintenance or staff holiday’s or may have limited staff available because of a high daytime patient load. • The chamber you are driving to may not be available. • Prior notification from an evaluating facility is usually necessary to begin the call-in procedure to staff a hyperbaric treatment. • Most hyperbaric facilities have regular daytime business hours and are not staffed in the evenings or on weekends. Some chamber facilities choose not to staff their unit after hours. Others simply do not treat divers.
Recompression treatment
• Unlike most freestanding hyperbaric facilities, hospital settings have advanced diagnostic capabilities. • A multidisciplinary setting ensures proper diagnosis and a stable patient before recompression therapy. • Hospitals and urgent-care facilities have a virtually unlimited supply of oxygen, intravenous fluids and medications.
The best option for an injured diver is always to use the best locally available medical services. • A differential diagnosis comes first. Not everything that can happen to a diver warrants hyperbaric treatment. • A physician needs to rule out illnesses such as heart attack and other neurological and musculoskeletal injuries that could be confused with decompression illness. • Advanced diagnostic procedures will rule out complications (such as a collapsed lung) and other additional factors that could make recompression therapy inappropriate or dangerous. • A physician needs to make sure the patient can withstand recompression therapy.
Chamber capabilities
• Not all hyperbaric facilities can deal with all cases.
DAN Membership
Before taking the plunge make sure your DAN membership is still active. If it isn’t, join DAN or renew your membership at: www.daneurope.org Your DAN membership ensures the services of the biggest international network for assisting divers anywhere, during any emergency.
42
Hospital capabilities
Transportation
• A critically ill patient needs to be stabilised before and during transport to a chamber and should be transferred under medical supervision. • Transporting a diver without a proper evaluation may adversely affect the diver’s health and treatment outcome.
When in doubt, call DAN
DAN maintains a database of hyperbaric facilities willing to and capable of treating divers. It is challenging to ensure this database is current, as most chambers do not routinely report their status to DAN. Once you have begun administering first aid and activated local emergency medical services (EMS), DAN can help you and EMS determine the best course of action for the case as reported. If the need for recompression therapy seems obvious, DAN can confirm chamber availability with the closest facility. The nearest medical facility will not necessarily have hyperbaric medicine but is still the
WWW.SCUBADIVERMAG.COM
