My concern is that lay people will read things like this and try to drive them selves to what they think is the proper location. If your in trouble, use the system, it DOES work well and you WILL be taken to the proper location.
DCS treatment on a plane??
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P.S---Okay, guys, satisfied now??????????????
ArcticDiver
Contributor
Rob, you brought a smile to my face this morning with your post. Thanks.
Actually, given that you and I usually post in almost complete agreement I'm a bit surprised we came down on different sides of this. Must be that AK-TX thingy, eh?
This discussion reminds me of an old saying that may be pertinent here: "A lawyer who represents himself in court has a fool for client; or some such".
Anyway, wouldn't it be a ***** to know where the chamber is, do a correct assessment, with your last bit of energy, go to that separate building on the back side of the hospital campus, only to find that it was out of service for a maintenance problem? Or, that since most chambers aren't just sitting around empty waiting for a bent diver, that it is in use for a hyperbaric patient. Or, and we've all seen this, to be told that since you aren't in immediate danger of dying, ie bleeding all over the floor, to go to admissions first.
Anyhow, have fun and enjoy
Actually, given that you and I usually post in almost complete agreement I'm a bit surprised we came down on different sides of this. Must be that AK-TX thingy, eh?
This discussion reminds me of an old saying that may be pertinent here: "A lawyer who represents himself in court has a fool for client; or some such".
Anyway, wouldn't it be a ***** to know where the chamber is, do a correct assessment, with your last bit of energy, go to that separate building on the back side of the hospital campus, only to find that it was out of service for a maintenance problem? Or, that since most chambers aren't just sitting around empty waiting for a bent diver, that it is in use for a hyperbaric patient. Or, and we've all seen this, to be told that since you aren't in immediate danger of dying, ie bleeding all over the floor, to go to admissions first.
Anyhow, have fun and enjoy
mccabejc
Contributor
Interesting discussion. I went to the DAN site to see what they suggest, and here's what I found:
"Why DAN Doesn't Provide Chamber Location Information
DAN frequently consults on the care, transport and hyperbaric treatment of injured divers, but does not provide chamber location information. This is an effort to get divers with a suspected Decompression Illness into hospital care. In the past, divers would often drive past legitimate healthcare facilities to get to a recompression chamber. Even when divers surface with clear symptoms of an arterial gas embolism, the treatment of choice is the local emergency service and hospital. Your best option is to use existing emergency services for an injured diver.
The reasons:
Hospitals and urgent care facilities have an unlimited supply of oxygen, intravenous fluids and medications.
A physician/emergency care provider needs to rule out other illness such as pneumothorax (collapsed lung), myocardial infarction (heart attack), and neurological and musculoskeletal injuries with symptoms similar to DCI.
An injured patient needs to be stabilized before and during transport, and should be transferred under medical supervision.
Transporting a diver without a proper evaluation may adversely affect the diver's health and treatment outcome.
A chamber's operational status can change. Chambers may close for scheduled maintenance, staff vacation, or a limited staff because of a high daytime patient treatment 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. Finally, most hyperbaric facilities have regular daytime business hours and are not staffed in the evenings and on weekends. In fact, some chamber facilities choose not to staff their unit after hours and do not wish to treat divers. Most cases of decompression sickness report for evaluation after normal business hours.
If you suspect a diver has a dive-related injury and needs evaluation, you should safely:
Monitor Airway, Breathing, Circulation ? Provide 100 percent oxygen if you are a trained oxygen provider
Call the local EMS for transport or assist in the transport of the injured diver to medical care
Call the DAN Emergency number 919 684 8111 or 919 684 4DAN (4326) collect for consult and advice.
If you are uncertain about symptoms which occur hours or days after diving, and there is no emergency, or you wish to ask questions about the signs and symptoms of decompression illness, contact the DAN Information Line (919) 684-2948, 9 a.m. to 5 p.m. EST, Monday through Friday."
"Why DAN Doesn't Provide Chamber Location Information
DAN frequently consults on the care, transport and hyperbaric treatment of injured divers, but does not provide chamber location information. This is an effort to get divers with a suspected Decompression Illness into hospital care. In the past, divers would often drive past legitimate healthcare facilities to get to a recompression chamber. Even when divers surface with clear symptoms of an arterial gas embolism, the treatment of choice is the local emergency service and hospital. Your best option is to use existing emergency services for an injured diver.
The reasons:
Hospitals and urgent care facilities have an unlimited supply of oxygen, intravenous fluids and medications.
A physician/emergency care provider needs to rule out other illness such as pneumothorax (collapsed lung), myocardial infarction (heart attack), and neurological and musculoskeletal injuries with symptoms similar to DCI.
An injured patient needs to be stabilized before and during transport, and should be transferred under medical supervision.
Transporting a diver without a proper evaluation may adversely affect the diver's health and treatment outcome.
A chamber's operational status can change. Chambers may close for scheduled maintenance, staff vacation, or a limited staff because of a high daytime patient treatment 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. Finally, most hyperbaric facilities have regular daytime business hours and are not staffed in the evenings and on weekends. In fact, some chamber facilities choose not to staff their unit after hours and do not wish to treat divers. Most cases of decompression sickness report for evaluation after normal business hours.
If you suspect a diver has a dive-related injury and needs evaluation, you should safely:
Monitor Airway, Breathing, Circulation ? Provide 100 percent oxygen if you are a trained oxygen provider
Call the local EMS for transport or assist in the transport of the injured diver to medical care
Call the DAN Emergency number 919 684 8111 or 919 684 4DAN (4326) collect for consult and advice.
If you are uncertain about symptoms which occur hours or days after diving, and there is no emergency, or you wish to ask questions about the signs and symptoms of decompression illness, contact the DAN Information Line (919) 684-2948, 9 a.m. to 5 p.m. EST, Monday through Friday."
Dr Deco
Contributor
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DAN has the experience with this. Their comments were very interesting.
Folks,
I will preface my remarks with this statement: "CLOSED COURSE. PROFESSIONAL OPERATORS. DO NOT ATTEMPT!"
My previous comments were intended as a discussion between professsionals in slightly different areas of the emergency medical field. They were actually NOT intended for the lay person. In fact, I was switching back and forth between this Board, and a Board populated only by highly experienced technical divers, and I rather lost my focus. My apologies to the general audience. Arctic Diver and Wildcard very rightly called me on that!
DAN has a broad responsibility to the general public, and their published statements have to be applicable to a VERY broad range of situations. As our own estimable Doc Deco points out: "They have the experience with this."
While it might be argued that there are exceptions to every rule, I would have to say very forcefully that unless you ARE a trained medical professional with experience in the field of DCS, you should follow DAN's stated guidelines. They will keep you out of further trouble more times than not.
BECOME A DAN MEMBER. GET THE DAN INSURANCE. CALL THEM IF YOU EVEN THINK YOU NEED TO. FOLLOW THEIR EXCELLENT GUIDANCE.
To paraphrase Mr. Natural: "Get the right advice for the job, kids!!"
Rob Davie :doctor:
I will preface my remarks with this statement: "CLOSED COURSE. PROFESSIONAL OPERATORS. DO NOT ATTEMPT!"
My previous comments were intended as a discussion between professsionals in slightly different areas of the emergency medical field. They were actually NOT intended for the lay person. In fact, I was switching back and forth between this Board, and a Board populated only by highly experienced technical divers, and I rather lost my focus. My apologies to the general audience. Arctic Diver and Wildcard very rightly called me on that!
DAN has a broad responsibility to the general public, and their published statements have to be applicable to a VERY broad range of situations. As our own estimable Doc Deco points out: "They have the experience with this."
While it might be argued that there are exceptions to every rule, I would have to say very forcefully that unless you ARE a trained medical professional with experience in the field of DCS, you should follow DAN's stated guidelines. They will keep you out of further trouble more times than not.
BECOME A DAN MEMBER. GET THE DAN INSURANCE. CALL THEM IF YOU EVEN THINK YOU NEED TO. FOLLOW THEIR EXCELLENT GUIDANCE.
To paraphrase Mr. Natural: "Get the right advice for the job, kids!!"
Rob Davie :doctor:
ArcticDiver
Contributor
Rob:
Since you referenced another Board: Folks here may want to visit it to see what, in my estimation, was a very competent response to a very rare DCS accident. The web site is The DecoStop and it is posted under the Accident category. I haven't posted the link because The DecoStop requires people to register and sign in before they can view the main body of the site.
A gross summary: In that incident it was fairly clear that the diver had DCS. He had a too fast ascent and had missed most of a mandatory deco stop due to a runaway inflator hose and was showing symptoms. The boat crew put the patient on oxygen and called EMS. EMS met them at the dock and transported the patient appropriately. Net result is that the person will recover with little or no permanent damage. But check in over there and read it for yourself.
Actual DCS is rare enough that we need to learn from the few cases that are reported.
Since you referenced another Board: Folks here may want to visit it to see what, in my estimation, was a very competent response to a very rare DCS accident. The web site is The DecoStop and it is posted under the Accident category. I haven't posted the link because The DecoStop requires people to register and sign in before they can view the main body of the site.
A gross summary: In that incident it was fairly clear that the diver had DCS. He had a too fast ascent and had missed most of a mandatory deco stop due to a runaway inflator hose and was showing symptoms. The boat crew put the patient on oxygen and called EMS. EMS met them at the dock and transported the patient appropriately. Net result is that the person will recover with little or no permanent damage. But check in over there and read it for yourself.
Actual DCS is rare enough that we need to learn from the few cases that are reported.
Folks,
I am not certain if I am correct in this reference, but if the story I am thinking of is the one referred to by Arctic Diver, it really has more to do with training issues and recovery procedures in certain emergencies than what we were discussing. It also started a vigorous discussion about omitted deco procedures.
The story does point out one thing, however, and that is backed up by DAN's reports and studies. The immediate application of a 100% oxygen breathing gas supply to the affected diver will do more to help the recovery of the victim than anything! (It will help even more than a herd of EMS personnel, though they are still needed.----Editor's note: This is actually DAN's conclusion, but my emphasis is added....!
)
As for your heading on your comment above, AD, I would simply point out that I was neither in a "spin", nor recovering from one, nor even "spinning" my comments. Like Bill O'Reilly, I try to keep my contributions to this Board (and any others that I participate in) right in the "NO SPIN ZONE". It is simply a case for my readers of: "I report. You decide."
I will end my discussion of this with two observations:
(1) For the lay person, or average recreational diver, the answer is simple: Call DAN. Follow the DAN recommendations. Period. Full stop.
(2) As for my comments other than my two posts immediately above, remember this:
CLOSED COURSE. PROFESSIONAL OPERATORS. DO NOT ATTEMPT.
I did, in fact, discuss this by phone with some extremely reputable CHT's and DMT's around the country today. If anyone wishes to continue this discussion on a professional but private basis, they can PM me.
Cheers!
Rob Davie
I am not certain if I am correct in this reference, but if the story I am thinking of is the one referred to by Arctic Diver, it really has more to do with training issues and recovery procedures in certain emergencies than what we were discussing. It also started a vigorous discussion about omitted deco procedures.
The story does point out one thing, however, and that is backed up by DAN's reports and studies. The immediate application of a 100% oxygen breathing gas supply to the affected diver will do more to help the recovery of the victim than anything! (It will help even more than a herd of EMS personnel, though they are still needed.----Editor's note: This is actually DAN's conclusion, but my emphasis is added....!
)As for your heading on your comment above, AD, I would simply point out that I was neither in a "spin", nor recovering from one, nor even "spinning" my comments. Like Bill O'Reilly, I try to keep my contributions to this Board (and any others that I participate in) right in the "NO SPIN ZONE". It is simply a case for my readers of: "I report. You decide."
I will end my discussion of this with two observations:
(1) For the lay person, or average recreational diver, the answer is simple: Call DAN. Follow the DAN recommendations. Period. Full stop.
(2) As for my comments other than my two posts immediately above, remember this:
CLOSED COURSE. PROFESSIONAL OPERATORS. DO NOT ATTEMPT.
I did, in fact, discuss this by phone with some extremely reputable CHT's and DMT's around the country today. If anyone wishes to continue this discussion on a professional but private basis, they can PM me.
Cheers!
Rob Davie
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