AD 2015 Q4
This is the “not do” component. It is also somewhat harder to define. After all, who determines the duty to care and the non-compliance thereto in unique emergency situations? Still, this component is more likely to lead to a recovery of damages. Put differently, when you are under a legal duty to take reasonable care and you do not do it, then you could be held liable for damages that are directly caused by the breach of that duty. The key elements are “reasonable care” and “directly caused”. Let’s break that down, starting with directly caused. This means that the damages are linked directly to the failure to perform the reasonable duty. This is called a causal connection. In other words, there must be a connection between the duty not complied with and the damages. deep diving are so hazardous that it may well be better to only jeopardise the life of one individual rather than two. That is, of course, as long as no one is put at risk during the subsequent body recovery or rescue efforts! Well, as a qualified instructor and dive leader, I shall continue to teach and advocate the buddy system. I do not like the idea of diving alone anyway. I prefer to share the joys of diving with someone able to share the memories of the dive. To me, diving is, and remains, a team sport. Which introduces another consideration: How would the principle of duty to take care be applied to children who dive? Training agencies impose age and depth restrictions on children who enter the sport before the age of 14. Depending on the age and diving course, a child may be required to dive with an instructor or at least another adult dive buddy. If the adult were to get into trouble, the child would not be expected to meet the duty of care of another adult. He/she would be held to an age appropriate standard. What about all those waivers? As mentioned in the previous article, waivers define the boundaries of the self-imposed risk divers are willing to take by requiring that they acknowledge them. Waivers do not remove all the potential claims for negligence and non-compliance with a duty of care. As such, it is left to our courts to ultimately interpret the content of a waiver within the actual context of damage or injury.
This is the “not do” component. It is also somewhat harder to define. After all, who determines the duty to care and the non-compliance thereto in unique emergency situations? Still, this component is more likely to lead to a recovery of damages. Put differently, when you are under a legal duty to take reasonable care and you do not do it, then you could be held liable for damages that are directly caused by the breach of that duty. The key elements are “reasonable care” and “directly caused”. Let’s break that down, starting with directly caused. This means that the damages are linked directly to the failure to perform the reasonable duty. This is called a causal connection. In other words, there must be a connection between the duty not complied with and the damages.
deep diving are so hazardous that it may well be better to only jeopardise the life of one individual rather than two. That is, of course, as long as no one is put at risk during the subsequent body recovery or rescue efforts! Well, as a qualified instructor and dive leader, I shall continue to teach and advocate the buddy system. I do not like the idea of diving alone anyway. I prefer to share the joys of diving with someone able to share the memories of the dive. To me, diving is, and remains, a team sport. Which introduces another consideration: How would the principle of duty to take care be applied to children who dive? Training agencies impose age and depth restrictions on children who enter the sport before the age of 14. Depending on the age and diving course, a child may be required to dive with an instructor or at least another adult dive buddy. If the adult were to get into trouble, the child would not be expected to meet the duty of care of another adult. He/she would be held to an age appropriate standard. What about all those waivers? As mentioned in the previous article, waivers define the boundaries of the self-imposed risk divers are willing to take by requiring that they acknowledge them. Waivers do not remove all the potential claims for negligence and non-compliance with a duty of care. As such, it is left to our courts to ultimately interpret the content of a waiver within the actual context of damage or injury.
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STEPHEN FRINK<br />
has such issues, it is imperative for both of you to know<br />
what the other person’s usual state looks like. Before diving,<br />
discuss any existing pain, movement restrictions, weakness<br />
or other information that establishes a clear baseline.<br />
Communicating information about a diver’s normal state<br />
can be of great value. Any variation of symptoms from<br />
previous experience demands assessment but does not by<br />
itself constitute a definitive diagnosis. Divers with these sorts<br />
of problems should regularly get a detailed neuromuscular<br />
exam by a doctor. After a dive is no time to discover a<br />
deficit that may or may not have been there before.<br />
Drink responsibly; hangovers can cause you<br />
to miss dives and may involve symptoms that<br />
mimic — or mask — symptoms of DCS.<br />
THE MORNING AFTER<br />
A group of friends in their early 30s was on a dive<br />
vacation on a Caribbean island. They did four dives on<br />
their first day; their first dive was to 85 feet, and the<br />
next three were to 60 feet or shallower. They waited at<br />
least an hour between each dive, breathed air and had<br />
bottom times that were all within their dive computers’<br />
no-decompression limits. All dives were uneventful.<br />
The group went out for dinner and drinks that<br />
evening. The next morning they met for breakfast prior<br />
to boarding the dive boat. A 33-year-old male member<br />
of the group was absent. His roommate reported that<br />
when he left, the friend was in the bathroom and<br />
was expected to join the group later. After eating, the<br />
roommate and two others went to check on their friend.<br />
He was in bed and appeared pale. He complained of a<br />
severe headache, nausea, weakness and feeling “totally<br />
out of it.” The headache was severe enough that he was<br />
sensitive to light. He also reported vomiting “once or<br />
twice.” The group decided to take him to be evaluated at<br />
the local clinic; because they had been diving they were<br />
concerned about DCS. The diver had a slight stagger<br />
when walking but required no assistance.<br />
The clinic was a five-minute cab ride away from the<br />
resort. The physician on duty and her assistant obtained the<br />
diver’s vital signs and conducted a neurological examination.<br />
The physician also obtained a history of events. The diver<br />
denied any symptoms prior to going out for the evening.<br />
He also admitted that the events following dinner were not<br />
clear to him because he had consumed “a lot” of alcohol,<br />
which his friends confirmed. The physician ordered the<br />
administration of IV fluids, acetaminophen and meclizine<br />
(antinausea medication). The doctor also instructed the<br />
man to avoid diving for the next 24 hours and to return to<br />
the clinic if he didn’t feel better that day. The diver rested<br />
and was able to eat and drink (nonalcoholic beverages)<br />
over the course of the day, and he felt much better by that<br />
evening. The next morning he was feeling 100 percent<br />
better and resumed diving with no further issues.<br />
Having a good time on vacation is part of the<br />
experience, but overindulging in alcohol during a dive<br />
vacation is not prudent. There is suspicion that alcohol<br />
consumption before or after diving could contribute to<br />
DCS, but more importantly, the aftereffects can easily<br />
be confused with DCS. Many divers in similar situations<br />
have needlessly undergone hyperbaric treatments.<br />
CONCLUSION<br />
The signs and symptoms of DCS are not exclusive to that<br />
condition. However, when a person experiences signs or<br />
symptoms after diving, DCS is very often presumed to be<br />
the diagnosis. This is not all bad, because it encourages<br />
divers and dive staff to administer oxygen and ensure the<br />
injured diver gets prompt medical care. But it becomes<br />
a problem when divers refuse to accept alternative<br />
explanations and become fixated on the need for chamber<br />
therapy at the expense of other diagnostics and/or<br />
treatments that may be delayed. In addition, the diversion<br />
of a nondiving-related emergency from appropriate<br />
medical treatment for an unnecessary recompression<br />
treatment, especially by air late at night, can introduce<br />
additional risks to the patient as well as the aircrew. There<br />
are many medical conditions much more serious than<br />
DCS for which timely treatment is critical.<br />
In the event of symptoms after diving, provide oxygen<br />
and get the injured diver to the closest medical facility. Don’t<br />
hesitate to call EMS if the situation is serious, and feel free<br />
to call the DAN® Emergency Hotline (+1-919-684-9111)<br />
at any time. Tell the doctor that the person was diving,<br />
and encourage him or her to contact DAN for consultation.<br />
But keep in mind that there are more dangerous ailments<br />
than DCS, some of which must be considered first. <strong>AD</strong><br />
LEARN MORE<br />
For more information about the causes, mechanisms,<br />
manifestations, management and prevention of DCS,<br />
consult DAN’s Health and Diving Reference Series,<br />
available in print or online at DAN.org/health.<br />
ALERTDIVER.COM | 93
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