By DAN Asia-Pacific’s John Lippman.
The Diver: Experienced.
The Location: Philippines.
The Dives: Three days including diving that predominantly involved exploring top-side attractions. Dive One was a standard no-decompression profile on a sandy slope, between 25–30m deep, there was no current and the water temperature was 28°C.
The Problem: Back at the resort, after completing the above dive, the diver went for a swim in the pool and on exiting felt a distinct weakness in the left leg: “It felt like rubber”. The diver asked to be put on O2. After 20 minutes the symptoms subsided. After another hour of breathing oxygen the diver felt almost symptom-free.
The Call to DAN: Upon calling the DAN/DES Hotline the doctor recommended another four hours of breathing O2. He was free of symptoms all afternoon. That afternoon another call was placed to the DAN/DES Hotline and it was decided to take the diver off oxygen for the night to observe if the symptoms returned. The diver had an oxygen tank on standby in case symptoms reappeared.
The next day: The diver woke free of symptoms. He walked to the restaurant for breakfast and when he stood up an hour later felt a slight recurrence of the symptoms in his left leg. Another call was put to the DAN/DES Hotline and due to the relapse a decision was made to evacuate the diver to the chamber in Cebu, which was 3.5 hours away by car/ferry.
The Treatment: On arrival at the Lapu Lapu Military Hospital the diver was clear of symptoms having breathed O2 throughout the journey. It was decided to put the diver on a Table 5 treatment. After 2.5 hours the diver left the chamber symptom free.
Comment by John Lippmann, DAN Asia-Pacific
Dive Computers: It is a misconception that if you stick within the limits of your dive computer you can’t get bent. This diver was diving within the no-deco limits of his computer and was therefore surprised that DCI resulted. Whilst dive computers are helpful in guiding decompression, they are not always accurate. These days, most divers who are treated for DCI have been diving within the limits of their computers and still got sick. They need to be used conservatively.
Oxygen Provision: This case highlights how important immediate oxygen provision is at the first onset of symptoms. DAN statistics highlight that prompt, appropriate and sustained provision of near-100% oxygen by either a demand valve or a high concentration constant flow mask can decrease the severity and longevity of symptoms associated with DCI. Importantly, diving medical advice is still essential and recompression may still be required.
Evacuation: An evacuation does not always involve an aeroplane or helicopter. When DAN recommends an evacuation several factors are taken into account when determining the best mode of transport: the severity of the diver’s condition, the location of the incident, local treatment facilities, weather and many more. Members rely on DAN’s expertise to determine the best course of action. In a relatively minor case, as in this case, the nearby chamber could provide the treatment required and a car/ferry combination was the most appropriate option.
Final Words from the Diver
“Don’t ever think it won’t ever happen to you! I’m very happy that my mishap occurred while I was diving with an operation that was equipped with sufficient oxygen and knowledgeable staff. I will never go on a dive boat that has no oxygen on board. My wife and I are eternally grateful for the amazing support we received from the DAN/DES doctor and DAN Asia-Pacific. I had no idea how stressful an incident like this would be on my partner or me.”
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