SAFETY The Crisis Continues in Emergency Hyperbaric Treatment Availability – by Dan Orr, President, Dan Orr Consulting
A variation of the following article was orig- inally published in two other media sources with the goal of alerting the recreational diving community to an issue that can certainly have serious implications for the safety and well- being of those wishing to enjoy dive locations
were aware that there were five hyperbaric treatment facilities in the Pensacola area. These facilities had been providing hy- perbaric oxygen therapy for a variety of non-diving medical conditions, but the divers were totally unaware that not one of these facilities would provide the emergency care this se- verely injured diver badly needed. Instead of being treated at one of these treatment facilities only minutes away, this diver had to be transported to a treatment facility in Mobile, Alabama, which was willing to treat injured divers 24/7. The reality is that this facility in Mobile, Alabama, was one of the very few treatment facilities in the U.S. that had con- tinued to offer emergency care for injured divers 24/7. The most recent information regarding this facility indicates that, unfortunately, it is no longer available on a 24/7 emergent basis for the Gulf Coast diving community. The injured diver in this example was fortunately treated successfully with no residual symptoms, despite the treat-
that rely on medical facilities in the U.S. Unfortunately, since this issue was brought to the attention of the diving and medical communities, there has been no improvement in this situation that could have poten- tially, catastrophic implications for those injured in a diving accident. In fact, there are now even fewer hyperbaric facilities available 24/7. There are millions of recreational scuba divers in the U.S. and hundreds of thousands of traveling divers from coun- tries around the world making tens of millions of enjoyable recreational dives each year in unique dive locations all over America. In the unlikely event that any of these divers would suffer a pressure-related diving injury, they trust that the U.S.
medical system will provide state- of-the-art care for their injuries, especially in an emergency situa- tion. As these divers are preparing to enjoy a pleasurable dive in some of the world’s most popular dive locations in this country, little do they know that if a pressure- related injury were to occur while diving that would necessitate
ment delay. As accident data from Divers Alert Network (DAN) has shown, treatment delay, such as occurred during this diver’s care, is one of the most significant risk factors for a negative outcome when treating divers with decom- pression sickness or arterial gas embolism. This reduced capability to pro-
© Stephen Frink
treatment in a hyperbaric chamber, they may experience a delay in treatment that could adversely impact their chances for a successful and residual-free outcome. Unknown to most divers, there is a steadily decreasing number of hyperbaric treatment facilities in the U.S. willing and able to treat them, even in a life-threatening emergency, for decompression sickness or arterial gas embolism. This situation places all divers at a much greater risk than any of us have realized. For example, in May of 2020, a recreational diver made a dive off the coast of Pensacola, Florida. After surfacing, he experienced serious neurological symptoms that were indica- tive of a pressure-related diving injury. Divers in that area
vide emergency treatment for diving accidents also impacts local fire and police forces, many of which have diving res- cue teams; federal law enforcement agencies; fish and wildlife services; park services; and other state and federal agencies with dive teams, as well as military divers conducting training operations in areas away from the location of their unit chamber. There are approximately 1,300 hyperbaric treatment facil- ities (each of which has one or more hyperbaric chambers) that currently provide hyperbaric oxygen therapy in the United States. As recently as two decades ago, the large ma- jority of hyperbaric treatment facilities were available to pro-
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