RE­SEARCH, ED­U­CA­TION & MEDICINE

Alert Diver

Asian Diver (English) - - News -

Con­sider this sce­nario: A diver and his part­ner travel to an is­land off Fiji, which is only a rel­a­tively short dis­tance from Aus­tralia, and there­fore a pop­u­lar div­ing des­ti­na­tion.

As it hap­pens, a se­ri­ous incident oc­curs in­volv­ing paral­y­sis of the lower limbs and loss of vi­sion. A call is made to DAN for the doc­tor on-call to as­sess the diver based on the symp­toms he is exhibiting, the dive pro­files and lo­ca­tion of the incident. In this in­stance, it is quickly de­ter­mined that the diver needs higher level med­i­cal care that can­not be pro­vided at the lo­cal med­i­cal cen­tre.

DAN AP had pre­ferred to ar­range an air am­bu­lance to bring the diver di­rectly to Aus­tralia, but that would have taken time and there was con­cern the oxy­gen sup­ply at the lo­cal med­i­cal fa­cil­ity would run out be­fore the flight was avail­able.

As such, the de­ci­sion was made to evac­u­ate the diver via a short 35-minute he­li­copter trip to Suva hospi­tal, where a cham­ber was lo­cated. The diver was re­com­pressed, but needed a more ag­gres­sive treat­ment plan. DAN de­cided to evac­u­ate the diver by air am­bu­lance to Aus­tralia.

Ul­ti­mately, the two air evac­u­a­tions cost in ex­cess of US$110,000, ex­clud­ing the cham­ber costs, but the diver re­cov­ered well, and con­tin­ued to re­cover over the com­ing months.

CHAL­LENGES IN­VOLVED IN AN EVAC­U­A­TION

Even though DAN are the ex­perts in div­ing ac­ci­dent man­age­ment with over 30 years of ex­pe­ri­ence deal­ing with emer­gency med­i­cal evac­u­a­tions all over the world, the unique set of cir­cum­stances that present for each case can and do cre­ate chal­lenges. In this case, whilst the is­land of Ka­davu has a land­ing strip, it doesn’t have lights in or­der to guide a plane in for a safe land­ing, and there­fore night-flight re­stric­tions are im­posed. Plus, there was red tape that had to be met for air am­bu­lances to re­ceive per­mis­sion to en­ter the coun­try and land at Ka­davu.

Many peo­ple would be un­aware of the ar­ray of chal­lenges DAN

Case Man­agers face (in ad­di­tion to re­mote­ness) when ar­rang­ing a med­i­cal evac­u­a­tion for a diver. These chal­lenges can lead to time de­lays and frus­tra­tion for both par­ties.

These chal­lenges can in­clude: • En­sur­ing the diver is stable enough

to be evac­u­ated.

• Bad weather pre­vent­ing an air am­bu­lance from land­ing or depart­ing.

• Meet­ing en­try and visa re­quire­ments.

Or­gan­is­ing a med­i­cal team for an air am­bu­lance to fly in from an­other coun­try. Lack of an air­port or ap­pro­pri­ate land­ing strip.

Some­times an air evac­u­a­tion isn’t pos­si­ble, and a boat needs to be sent to meet a live­aboard to evac­u­ate a diver.

Some­times it is quicker for the dive op­er­a­tor to or­gan­ise lo­cal trans­port but this should be done in con­sul­ta­tion with DAN if the trans­port cost is to be cov­ered by DAN.

As divers seek to ex­plore more re­mote lo­ca­tions, the trav­el­ling diver needs to be aware of the var­i­ous chal­lenges and take steps to min­imise the risk. Div­ing con­ser­va­tively, tak­ing long sur­face in­ter­vals, re­main­ing hy­drated, and get­ting lots of rest are all im­por­tant in re­duc­ing the risks. Divers should also en­sure that the op­er­a­tor they choose to dive with is pre­pared for a med­i­cal emer­gency with plenty of oxy­gen on board and a suit­able emer­gency ac­tion plan to fol­low.

Fi­nally, it goes with­out say­ing that hav­ing DAN cov­er­age is vi­tal. Evac­u­a­tions such as these are not easy to or­gan­ise and are cer­tainly not cheap. For DAN mem­bers, all this is taken care of, leav­ing you with much less to worry about.

Dive safely, Scott Jamieson, Gen­eral Man­ager DAN Asia-Pa­cific

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