Scuba Diver Australasia + Ocean Planet
Perspectives
EFFECTIVE OXYGEN FIRST AID
You may have noticed a common theme amongst DAN articles and that is the need for good, and prompt, oxygen first aid in the event of a diving accident/illness.
DAN AP has always advocated that all dive operators should not only have the correct oxygen equipment and training in how to use it, but they must also have enough oxygen to enable a diver to breathe good high-concentration oxygen (via demand valve or non-rebreather mask at 15 litres per minute) until ongoing care is available. Given that a lot of diving takes place in remote destinations, this can often mean an overnight supply.
Whilst it is a good start to have a portable oxygen kit with a small cylinder, the reality is that in the Asia-Pacific region it may take hours for transport to be organised; it may even be the next day. In cases where these delays occur, it is important that the diver continues to receive good high-concentration oxygen right through to the time they can be assessed and treated
(if necessary).
In cases where divers have milder symptoms, it has been shown that many of those who received prompt and sufficient oxygen first aid avoided the need for recompression, as their symptoms often resolved after several hours breathing high concentrations of oxygen.
In a recent case, a diver in Truk contacted the DAN funded Diving Emergency Service
(DES) hotline with symptoms of a skin rash that occurred after two dives to around 30 metres. He breathed oxygen when the symptoms first appeared and they mostly resolved, but then slowly returned when he stopped.
The diver was advised to return to breathing oxygen for at least four to five hours and to contact DAN if the symptoms worsened or any other symptoms appeared. DAN contacted the diver after the prescribed time and were advised that the symptoms had almost completely resolved.
This diver avoided a trip to the chamber because: • He stopped diving as soon as he noticed the symptoms (although he should have called
DAN or the DES hotline at this stage so that arrangements could be made in case the oxygen was not effective in resolving his symptoms).
• He was given oxygen first aid via a nonrebreather mask at the first onset of symptoms and this continued for around five hours.
• When the symptoms returned, he contacted DAN for further advice.
The operator should also be commended for having sufficient oxygen available to enable the diver to undergo two sessions of around five hours.
Provision of prompt and effective high concentration oxygen first aid is essential in the management of diving accidents. All divers should be asking the operators they dive with, not only if they have oxygen, but how much oxygen they have available, and whether staff are trained in oxygen first aid.
Dive safely,