The Iceni
Medical Moderator
As I only recently returned to diving I am not (yet) a part of the British diving medical establishment, so may have a slightly different perspective than most.
As an experienced immediate care doctor providing the equivalent of ATLS and ACLS in the community, having been involved in the traning of first-aiders for St John Ambulance and the British Red Cross and the training of Britsh Army medics, I am aware of a number of shortcomings of a number of diver orientated first-aid courses. To my mind many are little more than a bog-standard course taught by a diving instructor, who did the course himself only the year before.
Is this good enough, I wonder?
In Britain at least, diving activities largely take place in remote areas, often 20 or so nautical miles from the nearest habitation, let alone close to a hospital. Even if a helicopter is mobilised to the scene of an incident the casualty is likely to remain untreated for over an hour, long past the golden hour for survival.
The US army recognised the value of early definitive treatment during WW II and in Vietnam, and introduced specialist training for combat medics, over and above that of simple first aid and CPR, thereby saving numerous lives.
There are a number of diving related injuries that are entirely specific to diving and are not normally seen in medical practice, so the chances of being treated by a doctor or paramedic with specialist knowledge of DCI, pulmonary barotrauma and acute hypothermia for example, is remote indeed. Unlike in the commercial sector, there is no statutory requirement for sport clubs to have qualified specialist medical or paramedical cover, which would be impractical in any case.
At risk of raising a few hackles, might I suggest that each club already has a number of divers who are well able to learn to recognise specific diving injuries and provide advanced first aid in cases of those injuries, provided they are adequately trained.
For example endotracheal intubation (or the modern equivalent of the oropharyngeal cuffed airway), needle decompression for pulmonary barotrauma and IV line fluid replacement for DCI, perhaps?
I know people do not take up diving or car driving in order to suffer injury but diving incidents and road traffic accidents do occur. At least in the latter case qualified paramedics are very soon on seen.
Your comments, ladies and gentlemen, please?
Paul T
As an experienced immediate care doctor providing the equivalent of ATLS and ACLS in the community, having been involved in the traning of first-aiders for St John Ambulance and the British Red Cross and the training of Britsh Army medics, I am aware of a number of shortcomings of a number of diver orientated first-aid courses. To my mind many are little more than a bog-standard course taught by a diving instructor, who did the course himself only the year before.
Is this good enough, I wonder?
In Britain at least, diving activities largely take place in remote areas, often 20 or so nautical miles from the nearest habitation, let alone close to a hospital. Even if a helicopter is mobilised to the scene of an incident the casualty is likely to remain untreated for over an hour, long past the golden hour for survival.
The US army recognised the value of early definitive treatment during WW II and in Vietnam, and introduced specialist training for combat medics, over and above that of simple first aid and CPR, thereby saving numerous lives.
There are a number of diving related injuries that are entirely specific to diving and are not normally seen in medical practice, so the chances of being treated by a doctor or paramedic with specialist knowledge of DCI, pulmonary barotrauma and acute hypothermia for example, is remote indeed. Unlike in the commercial sector, there is no statutory requirement for sport clubs to have qualified specialist medical or paramedical cover, which would be impractical in any case.
At risk of raising a few hackles, might I suggest that each club already has a number of divers who are well able to learn to recognise specific diving injuries and provide advanced first aid in cases of those injuries, provided they are adequately trained.
For example endotracheal intubation (or the modern equivalent of the oropharyngeal cuffed airway), needle decompression for pulmonary barotrauma and IV line fluid replacement for DCI, perhaps?
I know people do not take up diving or car driving in order to suffer injury but diving incidents and road traffic accidents do occur. At least in the latter case qualified paramedics are very soon on seen.
Your comments, ladies and gentlemen, please?
Paul T
