DAN_World_Alert_Diver_Q1_2019

Research, Education & Medicine

Incident Insights SYMPTOMS RETURN AFTER FLYING: DID THE DIVER FLY TOO SOON?

attempted some light activities with his clients, he felt short of breath and his breathing was difficult. Evacuation Required The DAN doctor recommended the diver be seen by a Hyperbaric Medical Specialist and told him that recompression treatment was a possibility. DAN determined that the closest facility capable and available to treat this diver at the time of his accident was in Singapore, so DAN began to coordinate his evacuation. While waiting to be evacuated to Singapore, the diver breathed oxygen for another three hours and reported feeling much better. In fact, he felt so much better that he considered calling DAN to say he was better, but that evening his symptoms returned. evaluated and ended up receiving two recompression treatments. His symptoms mostly resolved but he did express to the doctor that he still had shoulder discomfort post treatment. The doctor felt it wasn’t DCS and he was discharged from hospital. Conflicting “Do Not Fly” Advice The diving doctor advised the diver not to fly for three days, but DAN advised that this was insufficient and that he should hold off flying back to Timor for at least a week given the remoteness of his destination. The diver ended up flying home four days after treatment and upon his return the diver advised DAN that he was experiencing residual symptoms in his hip, shoulder and elbow. The DAN doctors advised the residual inflammation, remain hydrated and refrain from exercising or going to altitude. The diver’s condition did not deteriorate further, however improvement was very slow, to his frustration. diver to continue taking Ibuprofen for several days to help with the Treatment Once in Singapore, the diver was

By DAN (Divers Alert Network)

In this incident, a diver was evacuated for recompression, but flew home sooner than DAN advised, and unfortunately the symptoms returned and persisted for some time. Could this have been avoided if the diver had delayed his flight home? The Dives A 28-year-old dive instructor completed a long 45m dive on mixed gas with decompression. The next day he completed a dive (on air) to 26m for 65 minutes and afterwards noted that he felt more tired than usual. Symptoms Present The following day, more than 24 hours since his final dive, he felt an ache/burn in his right shoulder and the next day, when DAN was called, he had some altered sensation in his hip and elbow. He had been receiving oxygen first aid for six hours without any significant improvement when the call to DAN was made.

DAN’s Advice The DAN Diving Emergency Service (DES) doctor was not certain the diver was experiencing DCI based on the information provided. He was asked to continue breathing oxygen for a few more hours that evening and take Ibuprofen and in the morning, he would be re-assessed. As the diver was in Timor, where there are no recompression chamber facilities, he would need to be evacuated for treatment if symptoms did not improve. When DAN spoke to the diver the following day, he advised that he remained on oxygen for an additional six hours plus he received another hour that morning. He thinks the Ibuprofen relieved the “pressure” feeling in his lower back but advised the pain in his right shoulder and the hypersensitivity in his shoulder, arm and chest area were still present, along with the discomfort in his right hip. He was also getting waves of pain in his right elbow and had a stiff right little finger. When he

LEFT Prompt oxygen first aid is important when a diver exhibits DCI-related symptoms. (Image is for illustrative purposes only and is not the diver in this incident.)

Stephen Frink

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