SoCal Hyperbaric Chamber For DCS/AGE: Always Go With LA County/USC Catalina. . .

[Kevrumbo]

USC Catalina Chamber vs Most Mainland Chambers

Mainland Chamber
Most seen are Clinical Patients
Inland Hospital/Clinic
Most Cases Delayed
ER Stabilization before sent to Chamber
Retreatments
Paid Staff Physician onsite
Funded by Clinical Patient Treatments

Catalina Chamber
Treat Divers only 24/7
Location is Where the Divers are
Fresh/Urgent Cases
Extension of LA County Medical Center ER
Few Retreatments
Volunteer Crew
Fly on-call Physician in
Funded by LA County Grants & Donations

Development of DCS Symptoms:
66% Within 30 Minutes
74% Within 2 Hours
95% Within 24 Hours
50% of divers Do Not Seek Treatment for >12 Hours after symptoms Develop (Serious Mistake!!!)

DCS Physiological Susceptibility Factors:
("An Alteration of Blood Flow")
Dehydration
Illness & Injury
Drugs & Alcohol
Cold Stress
Heavy Exertion
Obesity
Age
Anxiety
Patent Foramen Ovale
(above info from the USC Catalina Hyperbaric Chamber Mainland Based Volunteer Crew Program, class taken back on Oct 6-8 2006)

In my experience and in light of recent events here in off-shore LA County:

Simple straightforward triage as a First Responder (i.e. Boat Captain, Dive Master, Rescue Diver etc on the scene), based on initial reported symptoms and worst case scenario of a just surfaced conscious diver onboard in post-dive distress . . .Rule Out DCS and/or AGE.

Radio-in, rendezvous & evacuate patient by Baywatch Paramedic Boat or US Coast Guard Helicopter to Big Fisherman Cove West End Catalina while underway at sea. Evaluate and begin Oxygen Therapy at Catalina Hyperbaric Chamber as necessary with attending Emergency/Hyperbaric Physician on-call & enroute, and then post-treatment assessment & stabilize for transport. Helicopter patient back to mainland LA/USC County General Hospital for further diagnostic work-up/treatment as needed for secondary conditions or comorbid pathologies.

IMO, this is the preferred beginning of the standard chain of care for all dive accidents with suspected DCS/AGE --whether victim is conscious or unconscious; alert & oriented or in full cardiorespiratory arrest: the initial response and call for immediate aid should always be the same.

THIS ALSO IS STANDARD OPERATING PROCEDURE FOR ALL COMMERCIAL SPORTDIVE BOATS HERE IN OFFSHORE LOS ANGELES COUNTY FOR A DIVING ACCIDENT --TRANSPORT IMMEDIATELY TO THE CATALINA HYPERBARIC CHAMBER VIA BAYWATCH BOAT OR US COAST GUARD HELICOPTER ("WHEN IN DOUBT, CHOPPER 'EM OUT") . . . THIS IS THE BEST MOST PRUDENT COURSE OF ACTION TO TAKE AS EITHER A FIRST RESPONDER OR VICTIM!!!


USC Catalina Hyperbaric Chamber​

 

[drbill]

Well, I hope I never have to make the trip to the chamber here on Catalina... but if I do, I'll be glad I'm there!

 

[Kevrumbo]

(Some past dive accident stats, from Catalina Hyperbaric Volunteer Chamber Crew Program Class of Oct 6-8 2006):

Initial Reported or Observed Problem of Divers Brought to the Catalina Hyperbaric Chamber (1995 - 2000):

Buoyancy Problem: 12%
Air Supply Problem: 11%
Buddy Problems: 10%
Decompression Problem: 6%
Equalizing Problem: 6%
Pain: 6%
Uncomfortable: 5%
Environmental Problem: 4%
Equipment Problem: 3%
Medical Problem: 3%
Regulator Problem: 3%
Rapid Ascent: 2%
Fatigue: 2%
Rebreather Problem: 2%
Mask Problem: 2%
Aspiration (water): 1%
Panic: 1%
No Problems Noted: approx. 10% occurrence

Quote: Divers Brought to the Catalina Chamber
--Did They Panic During the Dive?
Panicked: 33%
Did not Panic: 42%
Unknown: 25%

Quote: Divers Brought to the Catalina Chamber and
Suffering From AGE/Drowning/Near Drowning
--Did They Panic During the Dive?
Panicked: 51%
Did not Panic: 19%
Unknown: 30%

Quote:Cases from 1995 thru 2000
Of 154 Divers Brought to the Chamber:
76 (49%) Recompressed:
43 (57%) of which were DCS related
33 (43%) of which were Air Embolism related

78 (51%) Not Recompressed:
23 (29%) Rule Out AGE
23 (29%) Rule Out DCS
19 (24%) Near Drowning
9 (12%) Drowning
4 (5%) AGE/DCS Refused Treatment Against Medical Advice

19 (12%) Full Arrest --Fatalities

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