By DAN Asia-Pacific’s John Lippman.
A recreational diver for 15 years and a dive professional for three with 1500+ logged dives.
The Dives & The Incident
The instructor was guiding eight certified divers on two easy reef dives. The problems commenced straight away. As the last buddy pair entered the water one went into full panic — regulator disregarded, mask thrown, thrashing and climbing onto me to stay afloat. She responded as trained: inflating his BCD, replacing his regulator and mask, and ensuring they remained connected to the boat via the tagline. The struggle on the surface lasted quite a while. She instructed the divers to get back on the boat and sit the dive out, whilst she completed the dive with the others.
The panicked diver did not participate, but his buddy proved problematic on this dive. He had no control over his buoyancy and kept crashing into the reef and the other divers. The instructor adjusted his buoyancy and administered a brief underwater scolding. She turned her head to check on the rest of the group and when she turned back he was gone. He had power-inflated himself to the surface. The instructor surfaced, told him not to leave her side for the rest of the dive and initiated a controlled descent onto a sand patch. Moments later, he was back on the surface. For the rest of the dive he continued racing to the surface or crashing uncontrollably onto the seafloor while the instructor continued ascending to help him back down or descending to lift him off the bottom.
The instructor says
Forty minutes into the dive, I began to feel a strange pain at the base of my skull. Something was wrong. I recalled the divers and signalled it was time to ascend. True to that group’s nature, two out of the six followed directions, while the other four looked at me, looked at their gauges and swam off ignoring my direction. I surfaced and left those certified divers to their own devices. As I climbed the ladder, everything looked strange, as though I was looking through someone else’s eyes. The pain was pulsing in my head. I went straight to the oxygen unit and put the mask to my face. That’s about when the tingling began. We called ahead and arranged for transportation to the hospital to be waiting for me at the dock. After much testing I was informed that I was going for a chamber ride. “Is this really happening?” was the one question that kept coming to my mind over and over again. Fortunately, DAN was with me every step of the way. Nothing is scarier than opening a huge medical bill and reading that it needs to be paid in full by the end of the month. Without DAN I would have lost everything simply because I was doing my job.
Comment from DAN Asia-Pacific’s John Lippmann
This diver is very experienced, active, fit and did not at all feel exerted on these dives. Both dives were to 9m with a 20 minute surface interval. Despite the shallow depth, a surface interval of 20 minutes is still very short. It is unlikely the diver had substantial nitrogen load, so it becomes more likely she suffered from a cerebral arterial gas embolism (CAGE), a form of decompression illness. Further supporting this is the fact the symptoms commenced in-water, which is less common. Normally, symptoms associated with DCI commence on the surface.
Back on the boat the diver initiated O2 First Aid, which was the right thing to do. It was 5-10 minutes into breathing O2 that she noticed the tingles had spread from the base of her skull down her arms, and after about 25 minutes she felt tingles in her legs. For the 40 minute boat ride back to shore, the 25 minute car trip to the hospital, whilst undergoing formalities at the hospital, and the entire time once admitted, she was breathing O2. Ultimately she underwent one 5-hour recompression treatment (US Navy Table 6), which cleared her symptoms.
The divers experience highlights the importance of appropriate O2 equipment, a good supply of O2 gas and having a trained O2 provider wherever diving is conducted. This is invaluable in reducing the severity and longevity of DCI symptoms, as well as the number of recompression treatments required.
In this case the total expenses amounted to US$28,000, which is something for uninsured diver’s to think about!”