Dive Pacific Iss 171 Oct- Nov 2019

INCIDENTINSIGHTS WITH THE DIVERS ALERT NETWORK (DANAP]
By DAN World
Symptoms return after flying:
Did the diver fly too soon?
In this incident a diver was evacuated for recompression, but flew home sooner than DAN
advised and, unfortunately, the symptoms returned and persisted for some time. Could this have
been avoided if the diver had delayed his flight home?
The dives
A 28-year-old dive
instructor completed a long
45m dive on mixed gas
with decompression. The
next day he completed a
dive (on air) to 26m for 65
minutes, and afterwards
noted that he felt more
tired than usual.
Symptoms present
The following day, more
than 24 hours since his
final dive, he felt an ache/
burn in his right shoulder,
and the next day, when
DAN was called, he had
some altered sensation
in his hip and elbow. By
then he had been receiving
oxygen first aid for six
hours without any significant
improvement when the call
to DAN was made.
DAN’s advice
The DAN Diving Emergency
Service (DES) doctor was not
certain the diver was experiencing
DCI based on the information
provided. The diver was
asked to continue breathing
oxygen for a few more hours
that evening and take Ibuprofen,
and in the morning, he would be
re-assessed.
As the diver was in Timor where
there are no chamber facilities he
would need to be evacuated for
treatment if symptoms did not
improve.
When DAN spoke to the diver
the following day he told them
that he remained on oxygen
for an additional six hours and
continued breathing pure oxygen
for an hour that morning. He
thought the Ibuprofen relieved
the ‘pressure’ he felt in his lower
back but mentioned that pain in
his right shoulder and the hypersensitivity
in his shoulder, arm
and chest area were still present.
He also mentioned that he was
continuing to experience discomfort
in his right hip, felt waves of
pain flow through his right elbow
and had a stiff right little finger.
When he attempted some light
activities with his clients he had
difficulty breathing and experienced
shortness of breath.
Evacuation required
The DAN doctor recommended
the diver be seen by a Hyperbaric
Medical Specialist and told him
that recompression treatment
was a possibility. DAN determined
that the closest facility
capable and available to treat this
diver at the time of his accident
was in Singapore, so DAN began
to coordinate his evacuation.
While waiting to be evacuated
to Singapore the diver breathed
oxygen for another three hours
and reported feeling much better.
In fact, he felt so much better that
he considered calling DAN to say
he was better. But that evening
his symptoms returned.
52 Dive New Zealand | Dive Pacific