Background
- A diver completed 11 dives over a 7-day period
- The max depth of the dives ranged from 15 msw to 23 msw (49 fsw to 75 fsw)
- Approximately 40 minutes after the last dive, the diver complained of feeling dizzy
Reported Incident
While on a diving vacation, the diver in question completed eleven total dives over the course of seven days. Before this incident, the diver completed three consecutive dives the day prior. After the second dive on the day of the incident, during the surface interval the diver mentioned feeling tired and almost opted out of the last dive.
All divers were individually guided by a divemaster. All dives were reported as uneventful, and the diver is said to have had good buoyancy and displayed skills of a competent diver.
The diver is Advanced Open Water certified with over seventy logged dives. It was not reported if they were using their own gear or if they were renting. The diver is reported as being overweight.
After the final dive of the day, the diver removed their equipment and logged the dive. Approximately forty minutes after the dive, they were complaining of dizziness and expressed that they believed to have “overdone it” climbing the ladder on to the boat. A short time after these remarks the diver was placed on 100% Oxygen and was being monitored by the boat staff en route back to the marina.
During this time, the diver remained conscious but described being too tired to talk. The diver declined an ambulance and was reluctant to even go to the hospital saying they were feeling a lot better. However, when the diver began to leave the boat, they could not walk without assistance. The diver was transported to the hospital in a vehicle, not by EMS, was on 100% Oxygen for the duration of the drive and remained conscious although disoriented. When asked questions about his medical history (SAMPLE), the diver denied having any allergies, being on medication or having any other medical concerns.
When the diver arrived at the hospital their vitals appeared within normal range and blood oxygen levels were reported to be 98-99%. The diver was examined for a stroke and after further questioning they admitted to having cervical arthritis and believed the pain and stress were caused by this when climbing back onto the boat.
The diver called their general practitioner for consultation and was advised by his practitioner that if they felt better, they could leave and return to the hospital for follow up the next day or wait until returning from the vacation.
It is reported that the diver seemed weak but lucid. When the diver went to leave the hospital, they immediately felt dizzy again. At this point all agreed to keep the diver in hospital overnight.
Bloodwork and x-rays were conducted. The diver stated to have vomited “a lot” in the night. The diver admitted to not drinking enough water and attributed dehydration to being sick. The diver was transferred to a different facility later that night and reported having a seizure at about 2:00am.
The diver, now in the new facility, was moved to the Intensive Care Unit (ICU). The diver was subjected to more tests, including an MRI, CT scan and more x-rays. While returning to their room, the diver complained of immense pain and suffered another seizure. It was much later in the day, after being seen by an ICU physician, neurologist and diving specific physician that the diver revealed their current medications for the cervical arthritis, vitamins, aspirin as well as blood pressure medication. Much later the diver also revealed having shoulder reconstruction many years ago.
It was not until 9:00pm two days after the diver’s last dive that they were diagnosed with DCS and began receiving treatment. The diver received three hyperbaric treatments, each lasting five hours. They were released from the hospital two days after final treatment.
Review
The diver in question survived decompression sickness, but not without some metaphorical scars. The significant delay in treatment highlights the importance of having access to a diving specialized physician. Had this diver seen a physician that specialized in diving sooner, they would have been treated sooner.
Recommendations
1. One can suspect DCS if symptoms occur after a dive especially those symptoms that are neurologic deficit or cardiovascular instability. Do not delay care.
2. Immediately begin 100% oxygen when DCS is suspected
3. Prompt evacuation to the nearest medical facility for evaluation and possibly transfer to a hyperbaric chamber if recompression is indicated.
4. Call DAN as soon as possible to assist in your care.
DAN Emergency Hotline is staffed with DAN medics that are available 24/7/365. This hotline is for emergencies only. If you have a dive emergency call (919)-684-9111. If it is not an emergency please contact the Customer Service Center for non-emergency inquiries.