dive buddy got bent

[vladimir]

OK Folks, flame away.

You have to say something controversial if you want to get flamed.

 

[tonka97]

Flame War and Scubaboard??

tell me it ain't so.

Thank you Jimmy21, good luck to you and your buddy. Thanks for sharing your mis-adventure with DAN.....A lot of us will be reading the fine print, carrying our own oxygen, and reducing our expectations as we cut another check to DAN.

 

[jimmy71]

Thanks and stay safe. I am unsubscribing to this thread. If anyone wants anything more, contact me via PM. Hell, you can even flame me there if you want. :ugotmail:

 

[JB]

Interesting posts, I have a few questions and comments. Is it standard practice to wait until there is neurological fallout before recompression? If not, which I suspect is the case, there is an urgency to get recompressed. I can fully understand the level of anxiety and frustration that the OP experienced, and I must say I would have lost it with someone, and stormed off in a huff as well! I must wait several hours until the crisis is over (or more severe) before someone who knows very little about the condition deigns to see me??
In triage there is also a moral imperative to treat fit young healthy people who will go onto live another 60 productive years out of a wheelchair, before some demented "GOMER" who may be sicker at the time, but is destined to a limited quality of life of brief duration. If resources are limited, go for most bang for the buck.
There is, perhaps, a way of handling this situation that would have relieved the anxiety of the OP. One of the ER docs could have phoned a hyperbaric specialist, and then spoken to the OP reassuring him that all that was needed to be done was being done, and to notify him if any new symptoms occured. (ie. admit limited expertise in this area, reassure that expert advice has been sought and acted upon)
Most people in a state of stress just want to know they are being heard and that someone is taking them seriously. Communication is a huge part of healing. How would the hyperbaric specialist feel if someone at his hospital was mistreated and suffered an adverse outcome? Surely, since these cases are few and far between, he could make himself available for telephonic advice for these cases at all times? Most countries have a poisons center for 24 hour advice and I would assume DAN is the equivalent for diving injuries?
Triage requires some skill, shortly after an OD the person may be GCS 15, but with knowledge of the time and size of the dose, a competent ER would be able to predict that they will go to ground in an hour and require life support. I'm not sure they have the same experience and predicitive skills with DCI, hence the call to a specialist for advice early in the process.

 

[Jim Lapenta]

The ER doc apparently was not even given a chance to see the victim. They left. What was DAN supposed to do? Get on the phone and have a doc call the ER and tell them this was a confirmed case of DCS? Not their job and in fact no way they could have without actually seeing the patient. Had the vic stayed and allowed an assessment I'm sure the ER doc would have been amenable to a consult. As it was even if a DAN physician on call had called the ER what was he/she going to be told? The couple left.

 

[Hetland]

Interesting posts, I have a few questions and comments. Is it standard practice to wait until there is neurological fallout before recompression? If not, which I suspect is the case, there is an urgency to get recompressed.

Her symptoms disappeared with O2 delivery. There are risks to hyperbaric oxygen therapy. You want to risk her having a seizure in the chamber to cure the symptoms she is no longer having? If you have an infected toe, and the antibiotics clear the infection, are you then going to demand surgery or amputation to clear the infection that is no longer there? Same thing.

I can fully understand the level of anxiety and frustration that the OP experienced, and I must say I would have lost it with someone, and stormed off in a huff as well! I must wait several hours until the crisis is over (or more severe) before someone who knows very little about the condition deigns to see me?

She could breathe, she had a good airway, she was not losing blood, and she wasn't convulsing on the floor. People who have airway issues, breathing difficulty, circulation issues or can't use one side of their bodies go first, everyone else gets in line. Welcome to reality.

In triage there is also a moral imperative to treat fit young healthy people who will go onto live another 60 productive years out of a wheelchair, before some demented "GOMER" who may be sicker at the time, but is destined to a limited quality of life of brief duration. If resources are limited, go for most bang for the buck.

Wow. Who gets to decide the worth of a human being? Should your grandmother get less treatment for her heart attack because a 20 year old rich boy wrecked his daddy's car and broke his leg? I mean your grandmother is old, and probably doesn't have the quality of life that some rich boy does. Clearly his health is more important.

The only time "bang for your buck" comes into play is a mass casualty incident (train wreck, bus crash, etc.) You don't waste your resources doing cpr on someone, because they're already technically dead anyway. You take care of the people who are still alive and kicking.

 

[diverrex]

Wow. Who gets to decide the worth of a human being? Should your grandmother get less treatment for her heart attack because a 20 year old rich boy wrecked his daddy's car and broke his leg? I mean your grandmother is old, and probably doesn't have the quality of life that some rich boy does. Clearly his health is more important.

The only time "bang for your buck" comes into play is a mass casualty incident (train wreck, bus crash, etc.) You don't waste your resources doing cpr on someone, because they're already technically dead anyway. You take care of the people who are still alive and kicking.

Sorry for being way off topic but I couldn't resist. I don't have a problem with JB's line of thinking, resource allocation is what is needed in the health care system. You added the "rich boy" versus the "grandmother" to make your case sound better. We do have limited resources so they often get allocated by random chance, not any reasonable decision making. We do spend way too much money in this country keeping old people alive a few more months, a few more weeks, even just a few more days. We lose way too many young people because of lack of basic care. And I'm saying that as a 50+ person. When I'm old just let me go, don't waste $100,000's keeping me alive just a little bit longer. That's why I dive, I live now, I'll be ready to die later.

 

[ZenDiver.3D]

That is my problem clear and simple. Is this to much to ask? Am I wrong to expect that?

Bash me all you want. We are dumbass divers because she got bent. How stupid can we be. Of course only people who deserve it because they are incompetent and lesser humans get bent. It is a well known fact. I remember that in my initial training. It does not happen to REAL divers.

I know now that you need to have someone on your side with high enough credentials to get through the system. Unfortunately I guess i will now have that as I will have a doc trained in DCS's phone number after we do a follow up visit.
Lesson learned. I hope that others may learn from my mistakes. The mistakes that surprise/confuse me are not the ones that got her bent, but what happened afterward.

The problem you wanted input on, has been addressed.You didn't like the answers, but they were right on. DAN is there to assist you in finding the best diving medical treatment, not to treat you. They cannot overstep the bounds of advisors, which is what it seems you thought they should do. I wish you had not left the ER without being seen. The docs would have most likely Then called DAN for more advise and collaboration. A nurse has no authority to do that and will be severely punished if she did.

Now. As for what you just ranted about. People here do Not want to see you in accidents again with a "my buddy died today" story. They are returning to this to try to help. You are ignoring some serious problems. You Knew your buddy was dehydrated and she does this often when diving so she won't have to go pee??? So you are both knowingly allowing her to put herself at risk with the number one cause of DCS? Then go on to the rest of the gear issues. But really focus on what you wrote there. This is Not flaming. This is attempt to Help.

I have learned from my mistakes. Coming to a scuba forum for dive training is one i am not going to make. As a previous poster pointed out, I am not asking for help on how not to get bent or what we did wrong in the water. Please feel free to start another fresh post to discuss such things. I did not start that post because it was not what i was looking for. If I did not make that clear I am sorry. What i can not get from my local divers and instructors is if i have unrealistic expectations of DAN and there role/ ability to assist me. The fact that they are not able or willing to contact someone other than me even after i asked them to concerns the hell out of me and tells me that i need to look to spend my money elsewhere. Part of my planning is knowing that i have "DAN on my side" to help me through a system that I have little means to navigate myself.

If you had a problem with the law in another country, do you think you would be better off speaking to the law directly or having your embassy contact them on your behalf? Which method would you want? I thought DAN was my embassy. I seem to be wrong.

Your expectations are unrealistic. You came to a forum looking for validation for some bad decisions, and you didn't get that. Now you are pouting about it. You got DAN thinking they were your personal physicians and "embassy?" Again you were mistaken. So don't pout. Learn and get something useful from this.

I'm pretty sure they understood all they needed to.

Your GF was there sucking on O2, had no symptoms and was in no immediate danger.

All you had to do was sit there until they got to you, but you just got up and left.

flots.

yup.

I rarely post in these threads because I usually get flamed but I feel a bit sorry for Jimmy. He was nice enough to share a bad experience with us to try to prepare us for things that are unexpected.

I'm not saying that his expectations of DAN and the ER weren't set a too high (they were) but any one else that has those expectations needs to be aware of how things may be handled if they are ever in that situation.

The #1 thing that I took from this thread is have plenty of O2 on hand. That's what in my non-medical opinion kept the situation from being a lot worse.

Jimmy, I'm glad that your dive buddy is OK and didn't suffer any long term harm.

OK Folks, flame away.

He wasn't flamed. He was told the truth, but he didn't like it. That is not a flaming. You should take more from this thread than that. Practice good dive habits- they didn't. In a suspected dcs hit, do not expect to be treated like the only person on earth, be realistic, and don't stomp out an abandon treatment. Those are things you should have learned too.

It is a shame that the OP is too interested in validating his hissy fit about DAN, which is undeserved, to address the real issues here. I am glad his buddy is OK, but she should have been seen. They should have waited. Next dive, I hope they both change their dive practices and have safe dives. That is all anyone here is interested in.

 

[DandyDon]

This seems to be a DAN oriented discussion more than an injury discussion? DAN is a fine membership organization operating with benefits of 501(c)3 tax status, but they are far from perfect, even tho they are the best - and it's up to members to understand DAN as well as make membership desires known to the organization. Hehe, I called DAN once asking for the Ceo, wondering who I would land with to discuss an issue hot on my mind - and he took the call! :shocked2: Color me amazed. Very pleasant fellow. Anyway, with DAN...

Membership includes TravelAssist coverage which kicks in 50 miles from home, and you have to ask them to arrange;

For many of us it includes Dive insurance, hopefully not the bottom plan often mistaken as a starter plan by shoppers who don't look at benefits but just buy the cheapest - when the middle plan $10 higher is far superior, but that's another story.​

As a membership organization they are often very helpful, but they are real people and sometimes need prodding. They will not ignore your repeated calls tho.

I just joined DAN and now I am a little confused. Why would they not help to appropriate the treatment necessary? I thought that was the shinning light with DAN as many medical personnel do not understand DCS and the long term neurological damage it may cause!
Is there a liability issue with someone from DAN contacting the hospital to explain the situation in a scientific manner?
Are there possibilities that she may indeed suffer problems at a later date?
Thanks

I'm late here and it's difficult for me to speculate based on facts removed...

Ignore this

Last edited by jimmy71; Today at 07:54 PM.. Reason: i am done with it

But yeah they help you find treatment. They often make follow up calls to the treating facility and to the injured if given all the contact info correctly, but that would depend on the situation. The last time I called them on the way to see a doc, they said my problem did not sound dive related (it wasn't), but I should see a physician. I told them I was on the way so they treated me like an adult and left me alone, since I was not disabled - which is when they get more aggressive.

Hmmm.... so far, I can't see/determine a thing that DAN did wrong morally... ethically... contractually. What gripe do you have? You went to the local ER for treatment and you were unwilling to wait until they could see you (are you shocked that you were NOT a high priority considering her condition?)

If you think you'll get something different from Dive Assure or other insurer - you are going to be disapointed big time.... it's not their job to do anything more than what service you recieved from DAN).

I agree. But the OP offers up a healthy and much-needed dose of reality to the DAN faithful, and that is constructive, in my opinion.

Maybe; again I am not sure what his gripe was in his words as they are gone. Sometimes after all the exams a doctor will effectively say "take two analgesics and get a life," sometimes. Happened to a friend's daughter, but after the second round of exams they prescribed a laxative too. I suspect the placebo effect aided greatly in that case.

Hey I am not the only one with an AED and O2 when we dive kewl.. I remember reading in my DAN insurance that it doesn't kick in until I am a certain ways from home. That may be why there is such a change in the way this situation was handled as compared to the one reported here earlier

Sorry, but I think you remember wrong. TravelAssist coverage mentioned above starts 50 miles from home see link but dive insurance has no such stipulation - see link. Looks like an example of an accomplished diver not understanding DAN which is essential in case guano hits the fan.

You made to the ER, right? What else is DAN supposed to do? Your expectation seems unrealistic. Waiting for hours in the ER is not unheard of. It sounds like triage worked the way it was designed to.

I'm more interested in how she managed to get bent.

since my rescue diver course, i always add hospital and evacuation plan while doing my diving plan for local diving just in case of.

i was expecting more follow up from DAN too..

interesting thread!

DAN is not likely to post here. The injured diver can call them to talk, or sue them for something - whatever. Expect to lose tho...

As my bud & I made the last mile our dive site last weekend, I pointed out the local hospital with "ER" close to the hole and mentioned that they see a lot of dive related accidents - but I don't know that anyone in the building ever studied dive medicine, and I really doubt that the docs on call there turned down prestigious hospitals to practice in a town of 2,000 in the middle of the desert. I asked that if I got hurt that he activate EMS of course, but then call DAN repeatedly until he arranged my transportation, and I would do the same. We both knew where both cell phones and both Dan cards were. If I had also responded to O2 well as it sounds the case here, then I would take over the calls until I became happy I was ok.

BTW, neither DAN nor Dive Assure (another fine dive insurance source if licensed in your state) can guarantee that the facility will take assignment of benefits without payment. Both warn against expecting that. You can phone them back saying "Hey, they want payment up front and I am broke. Can you wire money?" In many cases they will, but neither will volunteer that.

That DA is primary rather than secondary is paperwork thing that has little effect on anything of importance but some are impressed at the marketing. Buy it if you want to; just don't dive without one or the other.

Ummm Didn't the patient walk out of the ER without treatment?

If the symptoms were so mild they were not willing to wait on a doc, then how could they also be so severe that they should have been bumped to the front of the line? You can't have it both ways.

Bottom line, this is a triage/ER matter. An insurance company (DAN) is not going to be able to bump you to the front of the line. It is your SYMPTOMS that determine how quickly you are treated in an ER setting.

Here is an example of DAN in action:
http://www.scubaboard.com/forums/ac...eniseggs-incident-near-miss-jackson-blue.html

The difference is that Denise's symptoms were much more severe, and she got to a doc much faster.

Oh over my years as a dumb kid (how many decades were involved is debatable there), a farmer/cowboy before Osha (I drove a cow truck at 12), rolling vehicles (I highly recommend seat belts having done it both ways), and seeking initial treatment at the local quack house - I learned in high school how to say "Mom, I am going to Lubbock tomorrow to find a better doctor. Wanta go?" Sometimes that is necessary too. I have at times refused to sit and wait my turn too, but survived ok...

Oh Jimmy: hope your GF is well in spite of impatience.

 

[vladimir]

The ER doc apparently was not even given a chance to see the victim. They left.

I wish you had not left the ER without being seen.

Unfortunately, we no longer have the original post to refer to, which was a fairly clear presentation. If I recall correctly, the OP's buddy was seen by a physician, who happened to be a diver, and who ruled out AGE. She told the OP that she was trying to find out who the hyperbaric physicians at the hospital were and to contact one. The OP gave her their contact information, which had already been given to him by DAN directly. The OP and his buddy were then relegated to the waiting room for 2-1/2 hours, at which point they left.

The docs would have most likely Then called DAN for more advise and collaboration.

The crux of the OP's complaint, if I'm not mistaken, is that this consultation didn't happen. He had expected, though, and specifically requested, that DAN take the initiative and contact the hospital, which they were not willing to do.