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86
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WINTER 2012
F
or divers suffering decompression
illness (DCI), the immediate
availability of hyperbaric oxygen
therapy (HBOT) is imperative.
It has frequently proved to be
lifesaving. It has resolved paralysis
and overcome other forms of damage to the
brain and spinal cord. Just as frequently, it has
eliminated painful musculoskeletal injuries.
Of equal importance to many is that prompt
hyperbaric treatment frequently means the
difference between being able to return to diving
versus being declared medically and perhaps
permanently unfit to do so. For certain medical
patients, HBOT is likewise sparing of life and
central nervous system. It optimizes management
of gas gangrene, enhances skin flap survival and
reduces the rate of amputations in trauma victims
and people with diabetes.
Sadly, for divers injured in the U.S. and patients
with the medical conditions listed, there is much
to be concerned about. The harsh reality is that
the percentage of hyperbaric medicine programs
introduced during the last decade that are available
on a 24/7 basis to treat divers and these other
emergent conditions has collapsed into single
digits at best. This contrasts sharply with the prior
decade, in which a majority of new programs
were available 24/7; this availability was an almost
universal standard in previous years. Adding to this
conundrum is a growing trend among established
facilities to discontinue their existing 24/7 coverage.
This trend has increased in the past 24 months,
and the rate at which access is lost continues to
accelerate.
Before we examine the history that led to this
state of affairs or attempt to identify possible
solutions, it may be useful to put the crisis into a
human context using several recent case examples.
Some are tragic, and all were essentially avoidable.
DIVERS LOSING
ACCESS TO
EMERGENCY CARE
S T E P H E N F R I N K
Built-in
breathing
systems allow
those being
treated in
chambers to
receive air
breaks, which
mitigate the
risk of oxygen
toxicity during
treatment
for DCI.
Opposite: Staff
dedication is an
important factor
in keeping
hyperbaric
facilities
available for
after-hours
emergencies.
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