Approximately a decade ago, I experienced a decompression illness hit while exploring The Pit in Mexico’s Yucatan Peninsula. Since that time, I have tried to share my experiences openly to help other divers understand that getting bent is a sport’s injury that we should be talking about. Not to belittle the serious of some DCI hits, I just think that we can all learn from each others’ experiences.
To begin with, there are two important things to ensure when you are technical diving. You should have supplemental oxygen available for treatment and a means to reach out to the emergency medical service and DAN or its equivalent.
I haven’t been bent in America, but I have taken plenty of fellow divers out to the local chamber for treatment. Having done this before, I can offer some other simple logistical advice if you live in or are visiting America, a country lacking a medical safety net for its citizens.
PREPARATION
Tell your buddy how to find your car keys, wallet, DAN card, health insurance information and emergency contact information. Share any medical issues that might be pertinent to diving risk assessment or treatment.
Ensure there is a way to call EMS and/or DAN. Know how to reach the closest hospital and local chambers.
ACTION IN EMERGENCY
Get the diver on oxygen with as high a percentage as possible (DAN O2 kit, CCR, demand valve regulator).
Cover basic first aid ABCs (airway, breathing, circulation).
Activate EMS if the situation is serious.
Call an expert, such as DAN to determine next step. Act as an advocate for the patient and handle the entire conversation until the physician asks to speak to the patient. This will lessen stress and aid in retention of information.
Ask diver to lie down in a horizontal position if they are describing early onset neurological symptoms. This will ensure the most blood to the heart, best perfusion and off-gassing as well as discouraging bubbles in arterial circulation form reaching the brain.
Hydrate orally if able using water or electrolyte substances such as Gatorade.
On DAN’s advice, either drive to the local emergency room, chamber or call an ambulance if you have not already done so.
On arrival at the emergency room, be very clear to the intake clerk that the patient is presenting with a diving emergency. Hospital clerks tend to put walk-ins on a low priority list because the signs of their injury are not apparent. If symptoms are worsening, ensure you communicate with the intake clerk to increase the likelihood of proper treatment. As as an advocate for your afflicted dive buddy.
Keep diver on oxygen and if you run out, inform hospital staff that you need more.
If you don’t see hospital staff start an IV, suggest that your buddy may be dehydrated. IV rehydration can be life saving in severe DCI cases and although its importance is less understood in less serious cases, it can almost never be bad.
Once your buddy reaches the chamber, continue your advocacy by speaking with family members who might not understand the process or potential outcomes.
AFTER THE CHAMBER
Be available to bring your buddy clothing, take them out for a meal after their chamber run and listen to their worries after the ordeal is over. The post-chamber psyche is delicate. Stress and depression are not uncommon, especially if the diver has encountered less-than-sensitive medical staff who may treat their injury as deserved for bad behavior.
Don’t judge. Assist your buddy with post-dive analysis. Uncover potential contributory factors or remind them that they may not have “done anything wrong.”
Insist that you dive buddy follow-up with DAN in order to increase the DAN research base and our understanding of the causes of DCI.
If you dive in the realm of technical depths and durations or even if you are a very active recreational diver, there is a reasonably high statistical likelihood that you will eventually get bent. Don’t be ashamed. Early recognition and rapid recompression will most often lead to your ability to resume your full diving activity, yet denial and delay can lead to permanent, perhaps avoidable damage. -- Jill Heinerth
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