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WINTER 2012
FROM THE SAFETY STOP
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P E R S P E C T I V E S
W
e dedicated considerable space in this issue
to hyperbaric medical care. The growing
crisis of diminishing 24/7 chamber access
described in Dick Clarke’s article (“Divers
Losing Access to Emergency Care,” Page 86) may be the most
important issue in dive medicine today. It is DAN’s intention
to keep our members abreast of this evolving concern.
Reduced chamber access affects injured divers, care
providers and DAN
®
. As divers learn of this trend within
hyperbaric medicine, a few questions invariably arise, principal
among them, “Where will I go if I get injured?” Fortunately,
DAN maintains an extensive database of chambers willing
and able to treat divers. If you require hyperbaric therapy, we
will get you to a chamber. With shrinking 24/7 availability,
however, it is likely we will see longer transportation times
and increased travel distances.
Picking our Battles
A key service DAN provides to the diving and hyperbaric
community is education. A lack of training in dive medicine
is an important stumbling block for many chamber facilities
and contributes to treatment reluctance. Even before the
issue of reduced chamber access hit the radar, DAN began
addressing educational gaps within the hyperbaric medicine
community. In collaboration with our international DAN
partners, we developed courses for chamber operators,
chamber attendants and chamber maintenance. Recently
accredited by the National Board of Diving and Hyperbaric
Medical Technology, these three programs are integral to
our Recompression Chamber Assistance Program, through
which we provide training to remote and underserved
facilities. We are now preparing to provide these programs on
a wider scale, both domestically and abroad, in the hope that
chamber facilities will take advantage of additional training
opportunities. With increased availability of dive medicine
education, a lack of familiarity with diving accidents should no
longer be a barrier to treating injured divers.
Petar Denoble’s article (“Delay to Recompression,” Page
42) should provide some reassurance. While we all agree that
prompt hyperbaric therapy is the goal, delays of a few hours
have not been significantly associated with long-term sequelae
(secondary effects or complications) or reduced treatment
effectiveness. All cases of decompression illness (DCI) benefit
from surface oxygen, and its use should play a principal role
in the initial management of DCI cases — especially in light of
increasing transportation and evacuation times.
As a diving community we can make a difference and
support the remaining dive-medicine facilities by carrying
dive accident insurance. Coverage ensures health-care
facilities receive payment. Uninsured divers jeopardize the
sustainability of departments that remain available on a 24/7
basis. It is important to note that most of the hyperbaric
facilities that provide after-hours care do so because of the
commitment of their staff. We all need to do our part to
ensure they receive compensation for their dedication.
It is for the benefit of our members and the dive
community as a whole that we continue to address these
important dive-safety questions. We thank you for your
support — we wouldn’t be here without you.
AD
Responding
to Changing
Times
B y N I c h o l a s B I R d
S T E P H E N F R I N K
S T E P H E N F R I N K
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