Written by DAN Asia-Pacific
“It was during the extended surface interval that my symptoms commenced with chest pain that felt like muscle strain. Upon lying down I felt nauseous, the chest pain intensified, and then severe itching of my chest and stomach began. Red welts appeared and spread over my torso.
I spoke to the Divemaster and suggested I should breathe O₂ but the Divemaster said the rash was an allergic reaction and I didn’t need it.
Over the coming hours the rash became dark red and very painful, so I sought advice from the Captain, who was also a Divemaster. Again I suggested breathing O₂, but he was also positive there was no need given it was more likely to be an allergic reaction.”
As it happens, this incident on a liveaboard in Malaysia is not an unusual scenario. Finally a call was made to DAN AP, and it was confirmed that the diver had a skin bend with some additional neurological symptoms that had gone unnoticed. She was advised to breathe O₂ until the boat returned to port the following day. Fortunately, the diver’s symptoms improved greatly with oxygen first aid and only one recompression treatment was required. The situation could have been much worse: It is inappropriate and unwise for dive professionals to withhold oxygen.
Comment by DAN Asia-Pacific’s John Lippmann
It is important for dive professionals not to try to diagnose whether a diver in their care has suffered a significant diving injury. Unless medically-qualified and trained or adequately orientated in diving medicine, most dive professionals simply don’t have the expertise and experience to diagnose a medical problem.
There are a variety of first aid-related courses available through diver training agencies as well as general first aid training organisations, and DAN. Although these are valuable for all divers and essential for dive professionals, they are focussed on the provision of first-line care, which is by definition first aid.
That is why, unless the problem is very minor and it is blatantly obvious what the issue is, it is important to contact a diving medical specialist for advice for any medical problems that have developed during or after scuba diving.
You might wonder why advice from a diving doctor is usually preferred. The diving environment exposes a diver to a variety of physical and physiological changes as a result of increased pressure, the effects of immersion, breathing compressed gas, and certain other factors. Most medical training includes little or no education on diving medicine and, as a result, many doctors have little idea of the impact of these changes, especially in divers with certain pre-existing medical conditions (e.g. epilepsy, diabetes, heart disease, among others).
By calling the DAN Diving Emergency Hotline (available 24/7, 365 days a year) you will speak to a diving medical specialist who will give advice on the appropriate first aid and appropriate follow-up assessment and treatment. The injured diver or caller doesn’t need to be a DAN member to get advice – it is available to anyone for free. The difference with a DAN Member, is that DAN will become involved in the management of the situation, and costs will be covered within the limits of their Membership and optional Dive Injury (Treatment) coverage.
It is certainly wise for dive professionals to use this service to help achieve the best outcome for divers in their care. It also transfers the decision-making from the dive professional to the doctor, removing the opportunity for the dive professional to make a bad decision and reducing potential liability.
Calls to the hotline are toll-free within Australia by dialling 1800-088200. The hotline can be reached from outside Australia by dialling +61-8-8212 9242.
In the event of a diving accident or illness, seek proper medical advice.