TGH Chamber News

[Axeman]

Check out the article in todays paper

http://www.thestar.com/NASApp/cs/Co...984&call_pageid=968350130169&col=969483202845

also from Robert Shannon of Oakville divers.

Re: Current Status of Hyperbaric Oxygen Therapy in Ontario



On 11 Mar 04 the largest multiplace chamber in the Ontario was closed to “stretcher” cases. This decision means that if you cannot walk into the chamber, you will not be treated in this chamber. Therefore, the only 24/7 hyperbaric service for all nonambulatory patients is the Hamilton General Hospital. Unfortunately this service has had to close on occasion e.g. 11 Apr 04 and 12 Apr 04 (Easter Sunday and Monday). Also only one of the two monoplace chambers in Hamilton can treat critically ill patients. i.e. one space for the twelve million people of Ontario.

What are the consequences of this withdrawl of service for all divers in Ontario?

Divers can require hyperbaric oxygen therapy for two reasons: 1) Air embolism from too rapid ascent; or 2) Decompression Sickness (“Bends”). Treatment can be delayed for any number of reasons and permanent disability can be the consequence of delayed or inadequate therapy.

At present the “gold standard” of treatment is a US Navy Table 6A for gas embolism or delayed treatment of serious Decompression Sickness. A US Navy Table 6 is normally used for Decompression Sickness.

However there is now no 24/7 chamber in Ontario, which can go to 6 ATA (165 feet pressure equivalent). Therefore it is now not possible to do a US Navy Table 6A in Ontario on an emergency basis. At present patients with Decompression Sickness will have to lie, completely alone, for at least 5 hours and 20 minutes in the monoplace unit at Hamilton if they are unable to walk.

It has been stated that transport to the US or Quebec will be provided. Obviously, applying Boyle’s Law, a patient with air embolism or decompression sickness cannot be safely transported unless one ATA pressure is maintained. The only common aircraft, which can manage this trick, are the Lear Jet and Hercules aircraft, to the best of my knowledge. Have you seen many of these around?

A low flying helicopter is better but not perfect. One of my colleagues actually got decompression sickness going up the elevator in his condo. Land transport is likewise not perfect. The last thing anyone needs is a lengthy transport to the US or Quebec. Time is brain.

Diving in Ontario has now become a lot more exciting. I would recommend all Ontario divers have DAN coverage, so that they can receive premium transport to the nearest appropriate hyperbaric chamber as we now have hyperbaric service on par with many a third world country. Above all dive very, very conservatively.

What can be done to remedy this disaster?

Write your elected officials. Email your elected officials.

It is possible to provide better Emergency coverage by treating the MD’s who provide this needed service properly. Some MD’s, who are qualified as specialists in other areas, would have to take a pay cut for the stress of providing emergency on call service due to the complicated rules regulating on call payment. This situation can be fixed tomorrow and more qualified MD’s would provide coverage immediately.

The Canadian Council on Clinical Hyperbaric Oxygen Therapy has developed a detailed, practical plan to develop a large, 20-person facility adjacent to the Toronto General Hospital. This independent unit would report to the MOH and would be set up for the purpose of emergency and planned treatment, training, and research. We need your help to make this happen, so that future divers can get the emergency care they need, when they need it.

Diving is an inherently safe sport and thank God for that!

Health care bureaucrats have created a situation, which is dangerous to us all. Let’s work together and fix this mess before someone dies or is crippled!



Sincerely,

R C Shannon

This is a letter I recieved today. The star article is good also.

 

[SoScuba]

There was a post a few months ago on this topic. Its not new. Heres the thread www.scubaboard.com/t54044.html
Response # 33 is the official response from TGH.

 

[Axeman]

I know it is not new...... I participated in the other thread too.
The star article is not new.

While there was an official response I thought the voice of this diving professional should be heard. After all he and his family have been around longer than most of us in this biz.

Like typical Canadians we bend over and let it happen.

While the staff etc all think the new chamber is stupid.... they say oh.... we consulted with the staff. They say that even the EMS were consulted.... they all say it is inadequate...... so why consult with anyone when they went and did the oposite anyways?

The letter and article do also have some other POV and things not perviously discussed.

Thanks

 

[CAPT Robert c]

The reason this was reposted is because the TGH response was untruthful. No medical critical care beds for an injured diver in Ontario are available and will not be until 2007.........the way things are going. That means no 6ata table 1a chambers or critical care staff to treat diving injuries and none is on order. Also the sport dive community could help others who need to use the chamber. 5000 Ontario residents with diabetes lose a limb every year and 75% of them could save that limb with chamber treatments. Firefighters and people with carbon dioxide poisoning need a chamber for treatment. Police and commercial divers need a chamber for work place safety. Severe crush injuries as in compact car crashes. Severe Blood loss injuries. Brain abscess. Compound wounds and healing of feastering wounds. My all time favorite flesh eating diseases. Prostate cancer ............... just to name a few. So if you are a diver in Ontario you are in need of medical insurance Dan, padi whatever to protect yourself incases of a diving accident. So the diving community could do a great service in making some noise and focusing more attention on this lack of critical care beds, medical trained staff and multi-place chambers for all types of treatments. So basically I am begging for some help with this. It’s the squeaky wheel that gets the oil as they say. I need the local dive community to help the public at large and themselves in getting this job done. I need your help……… Thank you for reading this and anything you can do to help would be always appreciated. R Shannon

 

[CAPT Robert c]

Thanks for the tips I will pass this on to all who have an interest in helping. I have every intension of getting the job done.................. Thanks to Chris for your help.
Does anyone reading this have connections to police and fire lets get them on board. I will call the ones I know, but what about other police and fire dept. in Ontario. Lets get them involved. Robert




Hi Robert,

If you read the original thread you can see most fell hook line and sinker for the TGH bunk. And that included dive professionals like Brian at Dive Source and some experienced technical divers.

The bottom line is occupational health and safety has deemed the chamber unsafe for long rides by the staff and that will trump any hope of ever getting it up and running as it was before. I understand even that the MOL's safety review concluded the same thing as TGH's review. You can be sure that the admin is now more worried about their WSIB rates going up than seeing that a CO poisoned or DCS patient gets prompt needed attention.

I really don't think the recreational dive community understands the issues (flying to Ottawa or Buffalo and the time delays) so personally I think it will be up to the commercial folks, police, and fire departments to crank up the heat on the hospital and MOH.

The only way out of this bad situation (aptly described as 3rd world) is to force the MOH and TGH to expedite the purchase of a new multiplace chamber. I understand though that a contract has not even been issued so we may be looking at a few years until a new chamber shows up.

I'd suggest you join forces with the OPP and Metro dive teams, the fire department, and the Toronto Star to bring this to the public's attention. In the meantime I'd ensure that your DAN insurance is paid up for that chopper ride and that you have O2 on board any place you dive.

The whole situation is just reflective of how poor our provincial health care quality has become.

Good luck, Dive people p.s. I think that Brian and the others will come on line when they find out the truth.......... R

 

[CDN ff]

Does anyone reading this have connections to police and fire lets get them on board. I will call the ones I know, but what about other police and fire dept. in Ontario. Lets get them involved. Robert




R

Robert,
I am with the Toronto Fire Department. If you contact me privately, I will pass information on to our Union, and see if we can get anywhere. Fortunately, one of the few good things about amalgamation in Toronto is that we are now the fourth largest fire dept. in North America, so we DO have a little bit of influence....

 

[d33ps1x]

In what specific areas were they untruthful?

Perhaps when you reply with specifics we can have Alex from the TGH come on here and answer you directly from the horses mouth so as to prevent another rediculous run of internet experts chirping in.

Seems only fair to hear both sides of the story.

 

[vlada]

In what specific areas were they untruthful?

Perhaps when you reply with specifics we can have Alex from the TGH come on here and answer you directly from the horses mouth so as to prevent another rediculous run of internet experts chirping in.

Seems only fair to hear both sides of the story.

I thought the Alex from TGH was quite clear - if you need to be on a stretcher during the treatment, you are going to be flying someplace else loosing precious time

Anyone with severe Type 2 hit, CO2 poisining or anything requiring life support would have to be on a stretcher during treatment, so they are out of luck

My insurance is paid up

 

[d33ps1x]

I thought the Alex from TGH was quite clear..

I thought she was pretty clear and to the point as well which is why I am wondering what part was an untruth.

 

[CAPT Robert c]

If we could get each fireperson to contact his mp and mpp about the lack of care for themselves and the public that would be a great start. I think this would be a great thing for the fire and dive community to get involved in. We need to make up some info to educate everyone on the need for the multiplace chamber................. r