Page 197 - PJ MED OPS Handbook 8th Ed

16. Diving Emergencies

Guidelines and Considerations

• Transport rapidly to nearest hyperbaric chamber at or below the pressure altitude of the
point of departure/injury. If possible administer 100% oxygen by demand-valve mask during
transport.

CAUTION: Transportation by air at an altitude up to 200 feet above the point of departure/
injury may be done without major risk of worsening the patient’s symptoms, but should NOT
be considered when ground transportation is readily available and would not take much
longer.
• When in doubt consult the unit DMO/HMO/DMT or transport to chamber.
• Have evac plan before dive. Know where hyperbaric oxygen chambers are.
• Every member of the team should have the telephone number of both the dive cham-
ber and the trauma center or emergency room pre-programmed into their phones,
along with the addresses.

BLUF:
• Diagnose dive emergencies immediately: perform full history, physical exam, and neuro exam.
• Provide supportive care (ABCs, prevent hypothermia)/100% O2.
• Transport to dive chamber.
• Any loss of consciousness during the dive or within 10 minutes of surfacing should be as-
sumed to be an arterial gas embolism (AGE).
Non-Traumatic Dive Injuries:
1. Perform a physical/neurological assessment to determine if treatment is required.
2. If deficit is found during exam, place diver on 100% O2.
3. Transport diver and dive buddy to recompression chamber per dive med plan.
4. Treat symptoms en route.
5. Collect dive profile and patient history from both diver and dive buddy.
6. IF DIVER IS PULSELESS/APNEIC, ACCESS TO ACLS CARE TAKES PRIORITY OVER RECOMPRESSION
TREATMENT.

Traumatic Dive Injuries:
Treat traumatic injuries per appropriate protocol. If there is any suspicion of a non-trauma injury,
treat as-if and transport to a recompression chamber.

Chapter 16. Diving Emergencies n 195