Report on Decompression Illness, Diving Fatalities and Project Dive

Appendix A: Injury Case <strong>Report</strong>smade safety stops on all dives, and he usedcompressed air. He had no problem duringascents or with his equipment.About 20 minutes after he reached the surfaceand removed his gear, he noticed an ache,much like a stomach cramp in his abdomen. Itgradually moved up his chest and encircledhis lower trunk. He then noticed numbnessand weakness in his left arm, followed by backpain.The boat crew noticed that he could not communicateeffectively. He was immediatelystarted on high flow oxygen. Crew memberscontacted DAN for assistance in arranging anevacuation to the U.S. mainland. The divevessel was seven hours from the nearest land.A rescue helicopter was arranged to pick thediver up at sea and carry him to the nearesthospital and hyperbaric facility.The diver reached the hospital approximatelysix hours after he had surfaced from his dive.When he was admitted, he had weakness inhis legs and was unable to walk. His abdominalpain and left arm numbness and weaknesshad almost cleared. His mental status was stillaltered. Shortly after admission, he receivedTT6. He received a second TT6 later the sameday and a third the following day. Each timehe received some resolution of his symptoms.All symptoms resolved except for his backpain.On his third and final day of treatment hereceived two, two-hour treatments that didnot resolve his back pain. He was dischargedwith continuing mild pain.This is a case of serious paralytic form of DCS,which sometimes results in permanent disability.In this case, neurological symptomsresolved completely except mild back painthat may have been unrelated to diving. Thismay be due to beneficial effects of surface oxygenthe diver received early. He was also fortunatethat he received emergency assistancesoon enough from a helicopter during thedaylight hours. Thus, the diver could be transportedover a considerable distance. He wasable to return to scuba instruction and recreationaldiving.Case 7 — Spinal Cord DCI after a misseddecompression stopThe diver was a 46-year-old female, who hadbeen certified for three and a half years, hadmade more than 100 dives, 30 of whichoccurred in the past 12 months. She was physicallyfit, had no health concerns and was veryactive. She lived in the Caribbean and divedweekly.She performed a single dive to 130 feet (40meters) using her dive table. It was a multilevel,open-circuit scuba dive on air with asafety stop. Unfortunately, a later calculationfound that, given her total bottom time, sheshould have done a decompression stop.Approximately 15 minutes after leaving thewater, she began experiencing a sharp pain inher back, which shot around through her ribcage. This caused her to have difficulty breathing.She experienced altered vision like flashinglights, but she had no headache or sinusrelatedsymptoms. She then developed numbnessand tingling on the right side of her body,from her rib cage down her arm and leg.Thinking she must be having a migraineeadache, she continued with her day. She puther dive gear in the car and prepared to drivehome. During the drive home, she becamedizzy and nauseated. Friends then drove herto thehospital. While she was en route to the hospital,her dizziness and shortness of bre a t hbecame more extreme; she eventually lost consciousness.After a brief evaluation, she was placed in thehyperbaric chamber and a TT6 was adminis-DAN’s <strong>Report</strong> on Decompression Illness, Diving Fatalities and Project Dive Exploration: 2004 Edition 103