Unknown Woody From “Dive Talk” DCS and Medical Journey

[Wallowa]

You won't typically be "admitted" to go for a chamber ride. By itself it's out-patient care. Can't pee, can't walk, need a catheter and your heart rhythm is unstable? Then you'll likely be admitted for those conditions/care. It's not up to medicare if you are admitted or not, it's based on your level of acuity and symptoms. Heck hip and knee replacements are outpatient nowadays.

Good points. I am addressing the injured diver that is under medical care and on advance life support [admitted] before ever arriving at a chamber. In a ground or air ambulance. Payment considerations [such as Medicare] are future concerns, first focus on initial treatment, transportation and chamber availability/treatment then who is to pay what amount can be resolved. ER room treatment of diving injuries requiring hyperbaric protocols are at best a hit or miss proposition since physicians seldom in my experience are versed in correct evaluations and treatment. Rapidly connecting a DAN doc directly to the treating physician is best bet for certain, but the treating physician mosst often remains the weak link. Next step of correct transportation to an available and again correct chamber can be a monumental disconnect by not being available or in taking too much time to get the needed personnel in place.

Not trying to be grim. Just back in the day decades ago, on West Coast we had three 6 ata chambers that were pretty much good to go 24hrs a day. Now the emphasis in medicine is CYA and emphasis on uses of hyperbaric treatments other than for divers. Or so it seems to me.

 

[rjack321]

If you are ACLS level critical you are very likely going to die or died en route. Getting that level care in a chamber by one nurse attendant is extremely challenging. Or even worse case in a monoplace chamber.

 

[cfberry]

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Woody had DCS after a cave dive in Abaco, Bahamas. He experienced neurological symptoms of DCS immediately after surfacing(slight symptom at depth as well).Woody was completely exhausted and could not catch his breath/ move and take his own gear off. He was on immediate 02. For some reason these symptoms were ignored and they did not seek help at this time. It wasn’t until Woody was going in and out of consciousness and being generally unresponsive back at the house. If you watch the linked video, I believe they could have acted faster to getting treatment. However, we are all ego driven and do not want to admit we need help. I know how easy it is to brush off symptoms and try to play it cool. In the same breath what Woody experienced upon surfacing after thousands of dives should have sent alarm bells to him(he’s not thinking clearly) but should have been obvious to outside observer as portrayed in their video. To let it get to the point of Woody passing in and out of consciousness is crazy but sadly believable because we all want to try to ignore symptoms and seeking hospital help.

Once they realized this was a full blown emergency, Woody was taken to a clinic and calls were made to DAN. Woody was in an unequipped clinic with no resources/hypo chamber to treat him. Gus contacted DAN and asked for immediate help as woody had neurological DCS symptoms, in and out of consciousness. DAN then sent woody forms to complete as he’s in a hospital bed in and out of consicousness. Stuff like “employers phone number, employers address, spouses employer and insurance, etc..” (They show the forms in video) woody completeled them in an hour or so, then DAN told Woody it’d be atleast 24 hours before he gets choppered to Nassau, where they have a hypo chamber. DAN told them that flights were impossible at night. (This is all from woody and Gus’s account, they claim to be getting transcripts and will release them).

Within a few minutes of google and speaking with staff woody found a plane to come pick him up and take him to Nassau, woody paid $8300 to get this service, zero help from DAN, he also claims most of his cards denied the charges as suspicious and what not(woody is a millionaire that owns beach front hotel so if he has trouble with his cards with this kind of charge then us non multi millionaires need to heed what he says) woodys last hope was an American Express that approved the charges.

Once In Nassau, they find their way to a private hospital with a hypo chamber. Woody claims he was told by DAN that it would all be covered under DAN and he was now being taken care of,. Woody is taken aback when the hospital explains that he needs to pay $18,000 to start treatment. Amex approved and he was then in full care.

Why did they take so long to get woody help? I think this is a problem of us not wanting to admit something is wrong,

Could you afford $26,000 expense at a moments notice at 11:00 pm at night in foreign country? *woody has since been reimbursed for both charges. But he still had to come outta pocket or he was SOL

I think this is an interesting case to follow. This will hopefully help all of us divers in case we ever have a problem and need help from DAN. Dive talk claims they will get the transcripts and release them all. They claim to have been invited to a meeting with DAN ceo to help address these problems.

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I hate reading stories like this

 

[Wallowa]

If you are ACLS level critical you are very likely going to die or died en route. Getting that level care in a chamber by one nurse attendant is extremely challenging. Or even worse case in a monoplace chamber.

Yet again thanks for the perspective I assume the ACLS refers to "Advanced Cardiac Life Support (ACLS)" which include strokes and perhaps many DCI issues. My reference as with Woody is the possibility of permanent neurological deficits including paralysis. Death is always possible but permanent disability is more often the outcome of delayed or inadequate DCI treatment. Totally agree a monoplace chamber, while not being a needed double lock 6ata chamber, negates advanced life support [ALS or ACLS] when pressed down during recompression and likewise the gold standard is to have a chamber qualified Diving Doc inside the chamber and one outside to monitor both physician and patient.

I will stop here. Don't mean to beat this any more. Just for me, especially after current events and responses involving DAN, if bent or embolized I can't count on timely or adequate treatment; with or without DAN intervention. Not all on DAN's shoulders, but largely the medical community is not prepared. Just as I see it......... so I need to avoid getting DCI.

Out Here.....and thanks for all the input.

 

[KevinNM]

You won't typically be "admitted" to go for a chamber ride. By itself it's out-patient care. Can't pee, can't walk, need a catheter and your heart rhythm is unstable? Then you'll likely be admitted for those conditions/care. It's not up to medicare if you are admitted or not, it's based on your level of acuity and symptoms. Heck hip and knee replacements are outpatient nowadays.

Though my coworker got admitted after blood clots from the knee replacement sent him to the ER.

 

[rjack321]

I will stop here. Don't mean to beat this any more. Just for me, especially after current events and responses involving DAN, if bent or embolized I can't count on timely or adequate treatment; with or without DAN intervention. Not all on DAN's shoulders, but largely the medical community is not prepared. Just as I see it......... so I need to avoid getting DCI.

You can't rely on "fast" treatment with or without supplemental insurance coverage unless you get bent next to a fully staffed operational chamber. Basically a commercial diving operation. Chambers can be full with other patients, on-call staff can get into car accidents on the drive in, some are out of order due to maintenance, bad weather or even something as simple as nighttime can get in the way of flights, many chambers aren't even associated with a hospital and many of those wont take a diver.

Hence the increasing prevalence of IWR.

 

[Wallowa]

You can't rely on "fast" treatment with or without supplemental insurance coverage unless you get bent next to a fully staffed operational chamber. Basically a commercial diving operation. Chambers can be full with other patients, on-call staff can get into car accidents on the drive in, some are out of order due to maintenance, bad weather or even something as simple as nighttime can get in the way of flights, many chambers aren't even associated with a hospital and many of those wont take a diver.

Hence the increasing prevalence of IWR.

"Chambers can be full with other patients, on-call staff can get into car accidents on the drive in, some are out of order due to maintenance, bad weather or even something as simple as nighttime can get in the way of flights, many chambers aren't even associated with a hospital and many of those wont take a diver."

.....Guess I was not clear, I only consider a true DCI chamber to be a 6ata chamber, if they don't take a diving accident, then what is the sense in a 6ata chamber...the chambers you are referring to "full of 'other' patients" are not 6ata but 2ata chambers....2ata chambers are great for treating many maladies and injuries, but only a 6ata is the gold standard for divers if they need to be pressed down to that pressure [164fsw]...Navy Tables 5and 4a....

 

[KevinNM]

There are chambers that are fully capable of running the full Navy tables that don’t treat divers. I’ve seen explanations from operators before and it comes down to money and people. Not many places can even break even treating DCS so if the chamber and staff isn’t funded as part of an emergency department there is a lot of pressure to do things that make money.

 

[Wallowa]

There are chambers that are fully capable of running the full Navy tables that don’t treat divers. I’ve seen explanations from operators before and it comes down to money and people. Not many places can even break even treating DCS so if the chamber and staff isn’t funded as part of an emergency department there is a lot of pressure to do things that make money.

That is a surprise...that 6ata chambers are available that will not treat a diver...not trying to criticize but can you name those chambers? I ask because I am trying to compile a list of nationwide 6ata chambers that will treat dives; this is personal, in case I need treatment. Currently DAN or any other agency does not maintain or publish an up to date list of what 6ata chambers are on-line for diver treatment.

Concur with you about $$.. my take is that all this 2.6ata chamber proliferation is based on making a profit [and the expansion of using hyperbaric 100% oxygen in treating maladies other than DCI] and yes a 6ata chamber with crew is expensive. Just as the world turns, we divers do not represent a substantial market for medical facility income. Side bar is that 6ata chambers use oxygen but from bibs and on a set time limit to limit toxicity....2ata chambers if double lock or monoplace are as I understand all 100% oxygen; which also introduces the increased element of a flash fire beyond that danger in a 6ata chamber.

 

[Capt Jim Wyatt]

can you name those chambers? I

Shands University of Florida is one that refuses to treat bent divers. It is the closest chamber to cave country...25 miles from Ginnie but they send bent divers to Tampa, Orlando or elsewhere.