As we pointed out in the spring 2013 edition of the Alert Diver, even being a dive buddy has potential legal implications. So, to bump this up a notch, what about the diver training organisations themselves? Where do they stand? How do they relate to South African law? Are they all considered the same under our legal system in spite of the differences in organisational structures and training programmes? How does this affect their respective instructors and trainee divers from a legal perspective? These are not exactly simple questions. It is certainly true that the respective training organisations differ in a number of ways. However, this does not imply that there are necessarily differential legal implications for each of them. In fact, under South African law, the legal principles are common in all matters. Therefore, if you suffer a loss and you (or your estate in the case of a fatality) wish to recover damages, the legal principles would be applied commonly; whether you are driving or diving. Although not a frequent occurrence, there have been quite a number of law suits associated with diving injuries and damages in South Africa. This is not surprising, as the occurrence of law suits is really a function of “numbers”. As training increases, so do the chances of injuries and, with it, the chances of legal recourse. So, it remains wise to insure yourself, your equipment or your business in a proper and effective way. But before getting back to the potential differences amongst the training agencies, let’s first explore the foundational legal principles on which any civil claim would be adjudicated: inherent risk, negligence and duty to take care.
RESEARCH, EDUCATION & MEDICINE FROM THE MEDICAL LINE including land sickness, disembarkment syndrome and mal de debarquement syndrome (MdDS). This syndrome occurs when the brain, having adjusted to the constant movement of the ship, has essentially forgotten how to handle a solid surface beneath the feet. The body finds the sensations of being on firm ground unfamiliar and abnormal. The vestibular system, which controls the body’s balance, is disrupted and typically takes a few hours to a few days to readjust to being on a nonmoving surface. Some individuals, however, report a much longer time for resolution. No test can definitively diagnose disembarkment syndrome; diagnosis is based on the exclusion of reasonable alternatives. While the main symptoms are a persistent rocking sensation and a sense of imbalance, other symptoms may include dizziness, fatigue, migraines, depression, nausea, difficulty concentrating and confusion. Typically, the condition is more pronounced when the person is sitting or lying down. Unlike motion sickness, the symptoms of disembarkment syndrome may improve with motion such as walking or riding in a vehicle. It is impossible to predict whether an individual will suffer from disembarkment syndrome after a cruise or voyage. Those who readily adjust to the motion of the sea seem to be more susceptible. Disembarkment syndrome is more common in women than men, but a specific hormonal tie has not been detected. To decrease the likelihood of disembarkment syndrome, start seasickness-prevention measures a few days before boarding a ship and continue them for a few days after returning to land. According to the MdDS Balance Disorder Foundation, there is no treatment for the condition since it typically subsides on its own. Motion-sickness YURLS/ISTOCKPHOTO.COM DAN Cares Together, we save lives. Whether it is assistance provided over DAN’s 24/7 diving emergency hotline, an important discovery through our continued research, or application of emergency first aid — all of these elements directly impact diver safety. With your help, we continue to invest in these initiatives because we care. Together, we make a difference. DAN.org/DANCares All contributions are tax deductible and benefit the DAN Foundation, a 501(c)(3) organization, Tax ID # 56-1696689. 56 | SPRING 2016
medications such as meclizine or scopolamine are not effective with MdDS. Instead, clonazepam, benzodiazepines or amitriptyline may be beneficial. Additionally, light physical activity such as walking or yoga, taking naps, and possibly acupuncture may help strengthen the vestibular system. Resources for additional information include the National Institutes of Health, the National Organization for Rare Disorders and the MdDs Balance Disorder Foundation. — Frances Smith, EMT-P, DMT a recent DAN article about exercise Q:In and diving, I read the following: Intense physical activity — generally with substantial muscular forces and joint loading (the application of forces on joints) — is believed to transiently increase micronuclei activity, the presumed agent of bubble formation. Are these micronuclei preexisting? Where do micronuclei come from, and how are they formed or created? A: The source point for bubble formation is one of the great mysteries in diving science. We know that bubbles form at relatively low gas supersaturations, suggesting some biological facilitation of the process, but we do not yet have the imaging tools to see the initial formation. This technology will come, but it’s not available yet. Other methods to identify the sites of formation also continue. Micronuclei may comprise multiple structures. Whatever they are, they are preexisting, and their activity of facilitating bubble formation can be influenced by acute events (most notably recent pressure excursions that act as preconditioning to alter the responsiveness). Altered responsiveness appears to be transient, indicating a dynamic state or ongoing replacement. If you want to see micronuclei in action, look at a glass of beer. You can often see streams of bubbles originating from apparently singular points on the side of the glass. These points are often associated with defects in the glass, effectively small cracks within which micronuclei formation points exist. It is thought that the micronuclei are lodged in the cracks and act to crank out bubble after bubble. Even if this cannot provide all the answers, it can make for a pleasant interlude if you enjoy beer. Ultimately, we can see bubbles best in the vascular system, and we have a good idea when they develop and what effects they can have. When we are vague on the specifics of the actual formation, it is an honest acknowledgment of understanding yet to come. AD — Neal W. Pollock, Ph.D. RICHARD RUDISILL/ISTOCKPHOTO.COM DIVE INTO THE BLUE With our world renowned dive crew; explore wrecks, reefs and marine life. Tel: (242) 373-1244 Freeport, Grand Bahama Near The Port Lucaya Marketplace unexso @unexsobahamas ALERTDIVER.COM | 57
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