Chambers And Insurance

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Reku

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Messages
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Location
Great Lakes + Northern Florida + Marsh Harbor
# of dives
5000 - ∞
Why even have a Recompression chamber if you're not going to use it on the divers...


Edit: I did some learning lol. Apparently they are also used for healing and chronic illness. Oh and in order to have a diver use a chamber there needs to be a board certified doc and something else I don't remember. Well I guess I understand why they wouldn't want us to use them - they would have to keep a retainer on the board certified doc and the other person basically all the time. Hospitals are a for profit business so I guess that leaves us out of the equation. Since you know ... diving is huge a money pit of despair ... lol.
 
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Why even have a Recompression chamber if you're not going to use it on the divers...


Edit: I did some learning lol. Apparently they are also used for healing and chronic illness. Oh and in order to have a diver use a chamber there needs to be a board certified doc and something else I don't remember. Well I guess I understand why they wouldn't want us to use them - they would have to keep a retainer on the board certified doc and the other person basically all the time. Hospitals are a for profit business so I guess that leaves us out of the equation. Since you know ... diving is huge a money pit of despair ... lol.


Chambers make money by having multiple people in chambers for things like wound care, and I am sure they will take the emergency CO victims,but divers in hospital economics 101 are not profitable.
 
Most recompression chambers prime role (at least in Australia) is to treat illnesses and accidents, not decompression illness. For example, gangrene in legs and arms, smoke inhalation. DCS is secondary to this.
 
Divers are not profitable?

I would think just the opposite. Diving isn't exactly the least expensive sport, so I would assume a good majority of serious divers have good income and carry insurance, especially dive insurance (First thing I did after getting certified). And even more so for cave/tech divers. I can't imagine technical divers not carrying DAN or similar insurance, so when the bill comes from the hospital/chamber, they are getting paid. Unlike in years past where many people (non divers) didn't carry insurance and hospitals were not collecting.

People who have insurance are profitable to hospitals, those who don't are not.
 
To be available for diving emergencies it needs to be not routinely booked up for non-diving treatment. Let's make up some numbers here. Assume a wound treatment run takes 2 hours and makes them $1000 after expenses and they have 11 scheduled every single day. But instead a patient comes in with DSC, they want to run table 6. Which takes about 5 hours and makes you the same $1000 after expenses. It requires they have someone with different credentials on staff. And means 3 of your scheduled patients won't get treated, and requires that all the other patients gets shuffled around, because the hyperbaric treatments are supposed to be a certain interval apart so you can't just pushed the missed patients out a few weeks.

And 3 days later, when you have the schedule repaired and have apologized to the patients you left in the lobby for hours, you have to do it again. Except this DCS patient needs multiple treatments, so you need to reschedule 8 patents over the next 24 hours.
 
UK chambers manage this. If a diver comes in the non acute patients get bumped, this includes chronic wounds etc as well as divers on subsequent treatments.

The chamber knows it will be paid as we have a universal health service funded by the state.
 
We do that with our CT and MRIs. By having more multi-million dollar modalities, and the ones whose primary purpose is supporting the ED have limited patients scheduled and they are mostly inpatients. Unlike the outpatient modalities, which are booked solidly for days to weeks and run 16+ hours a day.

It's part of the requirements when you sign up to be a high level trauma center. I suspect there isn't anything comparable for DCS, so if there isn't a strong champion in the institution for DCS treatment...
 
To be available for diving emergencies it needs to be not routinely booked up for non-diving treatment. Let's make up some numbers here. Assume a wound treatment run takes 2 hours and makes them $1000 after expenses and they have 11 scheduled every single day. But instead a patient comes in with DSC, they want to run table 6. Which takes about 5 hours and makes you the same $1000 after expenses. It requires they have someone with different credentials on staff. And means 3 of your scheduled patients won't get treated, and requires that all the other patients gets shuffled around, because the hyperbaric treatments are supposed to be a certain interval apart so you can't just pushed the missed patients out a few weeks.

And 3 days later, when you have the schedule repaired and have apologized to the patients you left in the lobby for hours, you have to do it again. Except this DCS patient needs multiple treatments, so you need to reschedule 8 patents over the next 24 hours.
We do that with our CT and MRIs. By having more multi-million dollar modalities, and the ones whose primary purpose is supporting the ED have limited patients scheduled and they are mostly inpatients. Unlike the outpatient modalities, which are booked solidly for days to weeks and run 16+ hours a day.

It's part of the requirements when you sign up to be a high level trauma center. I suspect there isn't anything comparable for DCS, so if there isn't a strong champion in the institution for DCS treatment...
Here in Southern California, most divers & all Dive-Ops know who to call first in a Dive Accident Emergency (and it sure isn't DAN). Unlike most Hyperbaric facilities in the nation & worldwide, we are fortunate to have the best run, most reliable non-profit Hyperbaric Chamber and County & Federal Government Emergency Medical Services support on Catalina Island specifically dedicated to treatment of acute DCS/AGE cases:

LA County Catalina Chamber vs Most Private Mainland Chambers

Private Hospital/Mainland Chamber:
Most seen are Clinical Patients
Inland Hospital/Clinic
Most Cases Delayed
ER Stabilization before sent to Chamber
Retreatments
Paid Staff Physician onsite
Funded by Clinical Patient Treatments

Catalina Island Chamber:
Treat Divers only 24/7
Location is Where the Divers are (Catalina/Channel Islands)
Acute/Urgent Cases medevac'd in by boat or US Coast Guard Helicopter

Extension of LA County Gov't/Univ of Southern Calif Medical Center ER Dept
Indigent patients always treated regardless of insurance coverage or ability to pay
Few Retreatments
Volunteer Crew
Fly on-call Physician in
Funded by LA County Gov't Grants & Donations

Home > USC Catalina Hyperbaric Chamber > USC Dana and David Dornsife College of Letters, Arts and Sciences
 
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It is great that California has a good network. It used to be for Florida divers, especially cave divers,if you had DAN insurance,you were okay. Now the insurance is important,but doing your homework and knowing what chambers will recompress divers in advance is very important. There are chambers still listed with DAN,but once you get there, they won't treat you, and then send you somewhere else, which is more lost time. Unless there is a severe medical emergency, DCS victims choose to drive themselves or be driven to the closest available facility. The other reality of it, IWR is becoming a consideration too.
 
Here in Southern California, most divers & all Dive-Ops know who to call first in a Dive Accident Emergency (and it sure isn't DAN) . . .

While Kevin is correct that we have an excellent local system in place with excellent co-ordination between all parties (USCG, Lifeguards/Baywatch/ boat captains, LA County Medic Alert system, USC Catalina Hyperbaric Chamber, and others) I would strongly disagree with his disparagement of DAN, especially if you're outside of L.A. County.

DAN is on-call 24/7 and they keep a list of which chambers are available and which aren't. If you choose on your own to seek out a chamber and they won't treat you, you've wasted valuable time and have no one but yourself to blame.

As many of you know, I lead trips with divers all over the world and on three or four occasions have been in remote locations and had to consult with DAN. In all occasions they provided timely advice and whatever help we needed with evac and chamber accessibility. Whether you carry their dive insurance or not, they'll help. (and if you don't carry SOME sort of dive insurance, IMHO you're being irresponsible and playing with fire.)

But back to the original point, yes, we have a wonderful chamber here in SoCal, but the way things are set up, it requires the help of the community to keep it going. And that's why (SHAMELESS PLUG ALERT) we annually have Chamber Day, the largest single-day scuba charity event in the U.S., and one which provides about 50% of the annual funding for our chamber.

You can help out no matter where you live because the research we do here, we share with others. So even if you don't dive in SoCal, you could benefit from the work done at our chamber. Find out more and make a donation at www.chamberday.org. (END OF SHAMELESS PLUG)
 
https://www.shearwater.com/products/peregrine/

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