care and may even exacerbate an injury that’s not actually
bubble-related. If a stroke is assumed to be DCI just because
a patient was diving earlier in the day, permanent damage,
which could have been prevented, might result. Not every
ache or pain that occurs after diving is the result of DCI.
Be very concerned if there is local interference with DAN’s
efforts to arrange a medical evacuation. DAN TravelAssist® is a
benefit available to all DAN members. When it is determined
that a member’s condition warrants a higher level of care than is
available in the current location, DAN will arrange to transport
the member to a more suitable medical facility. Members
should not make these arrangements themselves or ask anyone
other than DAN TravelAssist (via a call to the DAN Emergency
Hotline) to organize an evacuation.
Case 1
During a recent dive trip in the Caribbean, a DAN member
suffered a serious cut to her leg while diving on a shallow
wreck. First aid was given immediately, and the bleeding
was under control by the time the boat reached the dock.
Although efforts were made to have an ambulance meet the
boat, one was not available. Instead, a taxi was dispatched
to take the member to the local hospital. After learning that
his passenger had been diving, the taxi driver bypassed the
hospital and delivered the member to the local hyperbaric
chamber. The staff at the chamber examined the cut,
determined that the bleeding had stopped and, despite the
absence of any symptoms of decompression sickness (DCS),
recommended a precautionary Table 6 chamber treatment.
When the member came out of the chamber almost six hours
later, she was put into another taxi and transported to the
hospital, where the wound was finally cleaned and sutured.
Fortunately, this delay did not cause serious harm to the
injured member. A call to the DAN Emergency Hotline for
support and assistance could have precluded the absurd
and expensive chamber treatment and gotten the member
to needed medical care much more quickly. If treatment
inconsistent with your injuries is recommended, question the
judgment and motives of those making the recommendation.
You are entitled to a second opinion. You can trust DAN;
hundreds of thousands of divers have for more than 30 years.
Case 2
Following several days of diving, a member began to
experience symptoms that suggested DCS. The local
physician conducted a series of hyperbaric treatments over
the next few days. Although the member felt better after
each treatment, the symptoms always returned within a
few hours of exiting the chamber. The member called the
DAN Emergency Hotline; the physician to whom he spoke
suggested he be evacuated to the U.S. for further evaluation
and a higher level of care. Since the member was stable,
arrangements were made for a flight the next morning.
The member had mentioned to the resort staff that he
had other insurance in addition to his DAN coverage. Even
though the staff was fully aware a DAN evacuation had
been initiated, they offered to make alternate arrangements,
suggesting there was no reason to wait until the next
morning (even though the patient was stable after several
days of hyperbaric treatment). The member gave the resort
staff his insurance information and thought everything
would be arranged in coordination with DAN.
He had no further contact with DAN and was taken to the
airport at 2:30 a.m. by the resort staff for evacuation. When a
DAN medic called to check on the condition of the member the
following morning, he was advised that the patient had already
been evacuated. No one had called DAN to arrange an earlier
evacuation or to cancel the one that was already scheduled.
Several weeks later the member received an Explanation
of Benefits from his health-insurance company. It showed
a total cost for the evacuation of $62,000. With his $5,000
deductible and 20-percent copay for “out-of-network
services,” the member was billed $16,400. Had DAN
evacuated the member, his TravelAssist benefit would have
covered the full cost of the evacuation. DAN would have
paid the $62,000, and the member would have paid nothing.
Be sure you understand your membership benefits. DAN
TravelAssist and emergency medical evacuation are not
“
insurance” benefits, per se. They are services provided by
DAN TravelAssist, and DAN must make all the arrangements.
If you elect to have someone else provide these services,
under most insurance plans you will be liable for deductibles
and copays. Stay in contact with DAN at all times to ensure
you receive the full benefits of your membership and
insurance. DAN is here for you, but we have to be in the
communications loop to ensure your welfare.
Most of the hyperbaric facilities DAN members will
encounter are professionally staffed, modern, safe and
honorable. But a few people have found ways to exploit the
system to their own benefit — at the expense of traveling divers
who may be hurt and vulnerable. By sharing our experiences
with these unscrupulous individuals, we hope to improve divers’
understanding of how services should be delivered and what
practices are cause for concern.
AD
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FALL 2012
RESEARCH, EDUCATION & MEDICINE
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D A N W I L L B E T H E R E F O R Y O U
MORE INFO
DAN is available to help you, your traveling companions and local health-care
providers better understand your symptoms and make the correct diagnosis.
If you have symptoms after diving, call the DAN Emergency Hotline at
+1-919-684-9111.