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Chamber, Nearest Hospital or Go Home?

Discussion in 'Ask Dr. Decompression' started by PAL, Feb 8, 2001.

  1. PAL

    PAL Guest

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    If you are diving an hour off the coast of Atlantic City, NJ and you surface with pains in your arms and legs, which disappear when you go on oxygen, should you:
    a) Assume all is well;
    b) Go to the nearest trauma center 5 minutes from shore; or
    c) Go immediately to the nearest chamber, 60 miles away in Philadelphia?

     
  2. Mario S Caner

    Mario S Caner Member

    # of Dives: I'm a Fish!
    Location: San Diego, CA
    1,803
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    Hello Pal, welcome to the boards, it's great to have you aboard!

    As for your question, never assume all is well. Better safe than sorry. Take the trip to the Chamber and get checked out. Another little tip, make sure you have insurance that'll cover it. Usually speaking the DAN or the PADI dive insurance are the best out there.
     
  3. DiverInAk

    DiverInAk Nassau Grouper

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    Hmm, I would go to the truama center which is only 5 minutes away, and call DAN from there.
     
  4. Mario S Caner

    Mario S Caner Member

    # of Dives: I'm a Fish!
    Location: San Diego, CA
    1,803
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    I've been in this circumstance before, called DAN, taken a ride to the local hospital, then had to take a trip to the chamber. The hospital's are just not prepared or equipped to deal with DCS issues. The check-in process is also not immediate, so it may be a waste of valuable time in combating permanent, irreversible injuries.

    Just my $0.02 Been there, done that... got the T-shirt!
     
  5. DiverInAk

    DiverInAk Nassau Grouper

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    Sorry you had to make that trip! You make a good point, as usual. I was thinking more of the time/transportation issue. I figured DAN could arrange and I might be able to get an Ambulance faster, or an IV or additional oxygen etc..

     
  6. DocVikingo

    DocVikingo Senior Member

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    Hi PAL,

    I believe that Mario has nailed this one.

    1. No, it is imprudent to assume that everything is okay. Signs & symptoms of DCS can recrudesce after initial clearing with 02 inhalaton.

    2. Unless you have sustained severe DCI, such as Type II DCS with paralysis or life-threatening pulmonary barotrauma, it may be wisest to skip the standard hospital. A care center without dive medicine specialists on staff or hyperbaric services will very likely offer little other than delay in receiving proper DCI evaluation & treatment, and increased cost.

    3. The nearest location with dive medicine experts & chamber facilities can give you the most appropriate attention. You can locate said by calling DAN's 'round the clock hotline at 1-919-684-8111 or 1-919-684-4326(collect). Even if you are not a member of DAN, they will help you, although this of course means others who are will be paying for the assistance you receive. Also, if you do not carry a DAN diver protection policy, the organization can not pay for any medical services. In passing, I would mention that IMHO solid dive injury coverage is a must for those who scuba.

    Hope you are well.

    DocVikingo
     
  7. Warhammer

    Warhammer Manta Ray

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    DocV....I'm looking foward to your run down on Dive insurance, any chance of a sneak peek? I went ahead and bought the DAN, against my better judgement because of the pre-certification issue. I felt like even though that requirement was there that it would be accepted more widely and I hate not to support them since their so supportive of the industry in whole. But I may purchase an additional policy if I find one I can trust that's appealing. Is your article going to cover life insurance for divers, by chance?
     
  8. DocVikingo

    DocVikingo Senior Member

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    Hey Warhammer,

    Good to see you.

    I'd love to give you a sneak preview, but this detailed comparison of diver injury protection plans has already been submitted and is slated for publication in the April or May issue. I strongly suspect Ben Davison would take a dim view of any "peaks."

    As regards DAN diver coverage, the "pre-authorization" you're referring to is only absolute in the case of air evacuation. They are very strict about this, and when you see some of the international air evac bills I cite in the article you'll readily appreciate why. PADI does let you arrange your own, but as to this freedom I would ask, "How many injured divers, or their representative, are capable of quickly arranging for air evacuation, especially in a foreign location?" It should no more difficult to contact DAN, and in most cases very likely far easier, than calling the coast guard or air charter services, if such even exist in the area.

    To obtain emergency medical services (for covered injuries) at the nearest hospital or hyperbaric facility does not require "pre-authorization" by DAN. They nonetheless appreciate a call before your receive any medical services if at all possible. Given the breadth & depth of their expertise & reach, I can't imagine that an injured diver would not immediately touch base with them, situation permitting.

    I think you've made a smart move. Preferred Plan, I presume?

    DocVikingo


     
  9. Dr Deco

    Dr Deco Medical Moderator Staff Member

    # of Dives: I just don't log dives
    Location: Issaquah [20 miles east of Seattle], Washington.
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    Dear PAL :

    As the other respondents have answered, there is generally little value in going to a local hospital that does not have at least one available specialist in diving medicine if you have been involved in possible SCUBA mishap. They usually do not have the experience to discern what is wrong where barophysiology is concerned. Valuable time could be lost.

    I have heard of physicians drawing blood to see if there are gas bubbles present. Finding none, they stated that DCS was not possible. This type of physical diagnosis will not work, of course. :bonk:

    One factor, surprisingly, is that everyone to whom you speak realizes that this is a scuba diving problem. There has been more than one occasion where the situation was confused (on the phone) with diving into the water and injuring the head or neck. The wrong preparations were made. A call to DAN should alleviate this problem.

    The question of insurance is important, and has been discussed in this FORUM before. Chamber costs to a treating agency can be high and they are not pleased when they must absorb the whole thing because someone cannot pay. As has been said before, diving is an expensive sport - - cutting corners is ill advised. If you engage in recreational diving, you personally should have the necessary equipment, training, and medical backup (insurance). :rolleyes:

    Dr Deco[sp]
    For those with a special interest, here is the next scheduled
    Decompression Physiology course.
    http://wrigley.usc.edu/hyperbaric/advdeco.htm
     
  10. Warhammer

    Warhammer Manta Ray

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    I must have missed your response somehow. I just saw it while I was searching for this thread due to another insurance question posted on this board. But understand about the preview, I'm a subscriber so I see it when it comes out. To answer your question, I went with the Master Plan vs the Perferred.
     

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