Report on Decompression Illness, Diving Fatalities - Divers Alert ...

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The effect of delay to recompression upon outcome was analyzed in391 cases from regions that reported more than five cases (10regions in North America and Caribbean including 66 chambers).Figure 45 shows the effect of delay to recompression on percent ofcases with complete relief at discharge. In 160 cases that wererecompressed within 12 hours after symptom onset, 79.4 percentachieved a complete relief at discharge, and in 237 cases with delayto recompression greater than 12 hours, only 65.8 percent of caseswere completely relieved of symptoms. The difference in percentcomplete relief between less than 12 hours and greater than 12hours was statistically significant.% of Cases with Complete Relief908070605040302010Fig 45Percent of caseswith completerelief at discharge(N=397).00-2 2-6 7-12 12-24 24-48 >48Delay to Recompression (hours)Table 8 shows treatment outcome by region with Mean PSI andMean Delay to recompression. The percent of injured divers achievingcomplete relief at the end of the treatment was greater in regionswith shorter delays to recompression. The regions with the shortestdelays to recompression were some of the most frequented divingdestinations. This descriptive analysis suggests that delay to recompressionmay be an important factor in treatment outcome, but theconclusion is premature pending analysis to control for other variables.Region # Chambers # DiversMeanPSIMean Delay to Complete ReliefRecompression at Discharge(Hours) # Divers %Turks & Caicos 1 8 2.3 13.8 8 100Mexico 3 51 1.8 20.0 44 86.3Belize 2 27 1.8 44.9 22 81.5US Northwest 5 95 2.6 39.8 77 81.1US Southwest 8 21 2.6 52.4 17 81US Gulf 5 14 3.1 41.0 10 71.4US Southeast 17 101 2.6 62.8 65 64.4Canada 4 10 2.8 55.1 6 60US Midwest 10 31 2.8 93.8 17 54.8US Northeast 11 33 2.8 95.0 17 51.5Table 8Outcome atdischarge byregion.DAN’s <strong>Report</strong> on Decompression Illness, Diving Fatalities and Project Dive Exploration: 2003 Edition 53
3. Dive FatalitiesDAN is not the primary investigative agency for dive fatalities.DAN compiles dive fatality data based on various sources: newspaperarticles, local contacts, medical examiners, eyewitnesses andfamily members. This information is often incomplete and less accuratethan data for dive injuries or Project Dive Exploration. The precipitatingcause of the fatalities and the cause of death are frequentlyunknown. Fatality investigation is limited to U.S. and Canadianresidents, as it is difficult to collect information from abroad.However, all information obtained on each dive fatality case isreviewed by a forensic pathologist who is also trained in dive medicine.There were 77 dive fatalities in 2001, involving 13 women and 64men. Autopsy reports were available for 51 cases. In 11 cases autopsywas conducted but reports were not sent to DAN. Four caseswere not autopsied, and the status of whether an autopsy was donein one case is unknown. The deceased diver was not recovered in 10cases.3.1 Characteristics of Divers Who DiedThe age distribution for male and female dive fatalities is shown inFigure 46. Sixty percent of all fatalities were in the 40- to 59-year-oldage group. The largest proportion of male divers who died (41 percent)was in the 40- to 49-year-old age group, and the largest proportionof females who died (39 percent) was in the 50- to 59-yearoldage group. Five percent of all fatalities were in the 10- to 19-yearoldage group. The average age was 43 for both male and femaledive fatalities, with ranges of 17-66 for males and 17-69 for females.Fig 46Age and genderdistribution ofdiving fatalities(n=77).% of Fatalities4540353025201564 Males13 Females105010-19 20-29 30-39 40-49 50-59 60-69Age (years)54DAN’s <strong>Report</strong> on Decompression Illness, Diving Fatalities and Project Dive Exploration: 2003 Edition
Page 1 and 2:
Report onDecompres
Page 3 and 4: Dedicated toDr. Peter B. BennettThe
Page 5 and 6: AcknowledgmentsData for the 2002 <s
Page 7 and 8: International DAN OfficesDAN Americ
Page 9 and 10: When divers have questions about th
Page 11 and 12: Flying After Diving (FAD) StudyIn 1
Page 13 and 14: In 2002, DAN trained six interns fr
Page 15 and 16: DAN Training ProgramsOxygen First A
Page 17 and 18: DAN members are also eligible for d
Page 19 and 20: DAN Diver Identification System (DI
Page 21 and 22: Instructors who don’t have access
Page 23 and 24: Of 522 reports submitted in 2001, 5
Page 25 and 26: 2. Dive Injuries2.1 Injury Data Des
Page 27 and 28: Arterial Gas Embolism (AGE)• Symp
Page 29 and 30: The pre-existing medical problems o
Page 31 and 32: Figure 7 shows the number of self-r
Page 33 and 34: As shown on Figure 11, most diving
Page 35 and 36: As in previous years, the largest p
Page 37 and 38: Figure 19 shows number of days divi
Page 39 and 40: Figure 23 shows the maximum depth o
Page 41 and 42: 2.4 Signs and Symptoms in Injured D
Page 43 and 44: Figure 29 shows symptoms reported b
Page 45 and 46: Fig 32Distribution ofcases by PSI.E
Page 47 and 48: Figure 35 shows the administration
Page 49 and 50: Figure 37 shows the type of recompr
Page 51 and 52: 2.6 Therapeutic OutcomeFigure 40 sh
Page 53: Figure 43 shows that AGE was more l
Page 57 and 58: Figure 49 shows the gender and cert
Page 59 and 60: Figure 53 shows the time of day at
Page 61 and 62: Figure 57 shows the distribution of
Page 63 and 64: Figure 61 shows the limited informa
Page 65 and 66: 4. Project DiveExplorationPDE is an
Page 67 and 68: Fig 65Cumulativenumber of PDEdives
Page 69 and 70: Table 10Number ofseries per diver.T
Page 71 and 72: Figure 69 illustrates the certifica
Page 73 and 74: 4.4 DivesMost PDE data (97 percent)
Page 75 and 76: 4.5 Dive SeriesPDE recorded 1,960 d
Page 77 and 78: The maximum depth of the dive serie
Page 79 and 80: The workload reported by divers in
Page 81 and 82: The pre-flight surface interval (PF
Page 83 and 84: Fig 88Percentageof dives bycertific
Page 85 and 86: Figure 90 shows the month in which
Page 87 and 88: All PDE divers were asked to report
Page 89 and 90: The incidence of DCS was different
Page 91 and 92: Figure 94 shows the proportion of m
Page 93 and 94: Fig 98Comparison ofdive purpose byp
Page 95 and 96: Figures 102 and 103 show how the po
Page 97 and 98: 6. Mixed-Gas DivingThis section off
Page 99 and 100: Figure 110 shows that injured diver
Page 101 and 102: GlossaryAGE — Arterial Gas Emboli
Page 103 and 104: Appendix A: Injury Case Rep
Page 105 and 106:
During the second day of diving, th
Page 107 and 108:
Case 6. Delayed Onset of Mild Neuro
Page 109 and 110:
Case 9. One Diver Treated Twice in
Page 111 and 112:
Appendix B: Fatality Case R
Page 113 and 114:
Proximate Cause: Drowning / AirEmbo
Page 115 and 116:
Proximate Cause: Cardiac01-05 Divin
Page 117 and 118:
the water with the instructor and a
Page 119 and 120:
01-22 Public safety diver who was o
Page 121 and 122:
dock. Fifteen minutes into the dive
Page 123 and 124:
end of the dive, but seemed to be d
Page 125 and 126:
01-67 Inexperienced diver, diving s
Page 127 and 128:
01-61 Novice diver lost control of
Page 129 and 130:
entry into a freshwater lake for a
Page 131 and 132:
2002 PublicationsBennett PB, Rostai
Page 133 and 134:
Notes132DAN’s Report</str
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