The Magazine of Divers Alert Network Asia-Pacific
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The Magazine of Divers Alert Network Asia-Pacific REMOTE RESTRICTIONS BUOYANCY MASTERCLASS THE VALUE OF EXPERIENCE PLASTIC’S IMPACT Quarter 4, 2015 danap.org ON THE COVER Contents A diver explores a canyon in the Solomon Islands Image © Stephen Frink Settings: f/15,1/80s, ISO320 62 51 Perspectives WHAT IS REMOTE? by Scott Jamieson Content Coordinator Stephen Frink Incident Insight 52 Editors REMOTE RESTRICTIONS by DAN AP’s Scott Jamieson, John Lippmann and Mel Cefai Brian Harper and Diana Palmer Founder, Director of Research & Skills & Safety 58 Chairman of the Board BUOYANCY CONTROL by John Lippmann, DAN AP Founder & Chairman and John Lippmann Stan Bugg, DAN AP Director General Manager 62 Expert Opinions Scott Jamieson THE EFFECT OF EXPERIENCE ON RISK Administration Manager by Peter Buzzacott, PhD Sim Huber 68 Life Aquatic Marketing & Communications OCEANS OF PLASTIC Manager by Melissa Gaskill Melissa Cefai 70 Gear DAN AP Board of Directors WEIGHT UP! 68 John Lippmann, David Natoli, by Marty McCafferty, EMT-P, DMT, and Patty Seery, MHS, DMT Malcolm Hill, Dr David Wilkinson, Mick Jackson, Stan Bugg, Tom Wodak, Nicholas Cheong ALERT DIVER’S PHILOSOPHY Memberships & Certifications Alert Diver is a forum for ideas and information Alert Diver is published as a separate, Heidi Powell, Julie Parsonson, relative to diving safety, education and practice. independent magazine within Scuba Diver Cynthia Van Zyl, Mina Chivotti, Any material relating to dive safety or dive AUSTRALASIA (SDAA) magazine. DAN Asia- Adam Lippmann, Sophie Kayne, Pacific is not responsible for the content provided medicine or accident management is considered and Diane Boyle for publication. Ideas, comments and support are elsewhere within SDAA, and therefore this content encouraged and appreciated. The views expressed should not be assumed to represent the views, Training policies or practices of DAN Asia-Pacific or Alert by contributors are not necessarily those John Lippmann, David Natoli advocated by DAN Asia-Pacific. DAN is a neutral Diver magazine. public service organisation which attempts to and Tim Vernon-Smith ©Alert Diver text, illustration or photographs interact with all diving-related organisations Marketing Assistants or persons with equal deference. Alert Diver is may not be reproduced or reprinted without the published for the use of the diving public and it expressed consent of Divers Alert Network and Haili Mu & Adam Lippmann is not a medical journal. The use and dosage of its authors, artists and photographers. Many any medication by a diver should be under the articles are reprinted with the kind permission of Accounts supervision of his or her physician. DAN America. Anny Limbek Email: DAN AP does not necessarily endorse the [email protected] products or services of any organization For more information on membership, insurances and training programmes, or company whose advisements appear in visit our website: www.danap.org Alert Diver Perspectives From DAN Asia-Pacific WHAT IS REMOTE? With more divers adventuring to far-flung locations, DAN is managing incidents that present increasing challenges By Scott Jamieson AS DIVERS, the thrill of diving a virgin wreck or During the past month I assisted a DAN a reef or cave system that has seen few divers Member who had travelled to an island in Fiji is enticing, so it isn’t surprising that increasing that was less than a one hour flight from Nadi numbers of DAN Members are travelling to International Airport. Whilst the island doesn’t remote, untouched diving destinations. However, sound remote it did present challenges, such remoteness creates issues for DAN and our as the fact the island had a landing strip but no assistance providers, as we find ourselves lights in order for a plane to safely land in the helping increasing numbers of divers in remote evening. You can read more about this particular regions with infrastructure that often isn’t ideal challenge, and others, in our “Incident Insight” when managing a diving emergency. section on page 52. But what is considered a remote location? This incident demonstrates that even if a The dictionary defines remote as being: a place location is not geographically distant from a that is situated far from the main centres of major centre it can still be considered “remote” population. However, in the event of a diving when an emergency evacuation is required. Part of the DAN Asia Pacific team. accident, we can modify this a little bit to include Diving always carries some risk and the From left, Mel, Cynthia, Julie, John, Heidi, Scott, Haili, Anny, places that are distant from the services we more remote you are, the greater that risk Adam, Sim would expect in a main centre of population. becomes. As responsible divers you should be aware of the fact that remote doesn’t just mean a long air flight to get to your holiday destination but it can mean the facilities at your destination are more rustic than ideal in the event of an incident. It is up to you, the diver, to make sure you minimise the risks, especially as you go more remote. Dive conservatively, try to limit your number of daily dives, take longer surface intervals, drink lots of water, and stay well rested. And make sure that DAN coverage is part of your dive kit. Enjoy your travels, evaluate the risks and dive safely and conservatively. Scott Jamieson, DAN AP General Manager Dive Tip Engage with DAN on Facebook for insights into various dive safety and medical issues. Scan here or search DAN Asia Pacific. 3 Research, Education & Medicine Image © Jan Novak/123rf Incident Insight During the safety stop, Sam felt as though REMOTE RESTRICTIONS everything was spinning around him. He Evacuations to the high-level medical care can be surfaced and swam to the boat, at which point hampered by unexpected restrictions in remote places he lost all feeling in his body. His wife described Text by DAN AP’s Scott Jamieson, John Lippmann and Mel Cefai him as having his eyes open but not responding. The diver has full memory of these events but was unable to respond, as he had no movement CASE REPORT in his limbs. The boat crew commenced oxygen Sam (not his real name) is a healthy 47-year-old (O2) first aid immediately. Sam breathed O2 via a man who was diving with his wife in Kadavu, Fiji. non-rebreather mask with a flow rate of 10 litres He had completed a total of 120 lifetime dives per minute (lpm) and regained some feeling in and is described as fit and healthy. Sam has had his legs and arms. no previous history of decompression illness. Upon reaching shore a call was immediately The incident occurred on Sam’s fourth day placed to the DAN/DES (Diving Emergency on Kadavu. On both the Monday and Tuesday the Service) Hotline. diver completed two dives that were uneventful After being given the details of the dives from a safety/incident perspective. He rested undertaken and the description of symptoms, on the Wednesday. On the Thursday he dived to the diving doctor assessed the cause as possible 27m for a total bottom time of 41 minutes. His CAGE (cerebral arterial gas embolism) with computer displayed no warnings, however, he the need for further medical evaluation and felt dizzy and disoriented on his way to the safety recompression treatment. Symptoms commonly stop. He completed approximately two minutes associated with a CAGE diagnosis include at the 5m safety stop before he underwent a disorientation, as well as difficulty walking and rapid ascent to the surface. talking; all symptoms exhibited by Sam. 4 There is no recompression chamber located on oxygen was located and he was able to continue Kadavu so DAN Asia-Pacific connected with DAN breathing oxygen at 10lpm via a non-rebreather TravelAssist to prepare an assistance plan. Two mask without any breaks. options were considered: Whilst his condition did improve, in that he was able to move all extremities and his speech 1 An air evacuation 2 An air evacuation was no longer slurred, he remained unable to Suva on the to Nadi (also on to urinate. It is understandable that both Sam main island, Viti Viti Levu), where and his wife were anxious and restless. DAN Levu, where a the international continued to reassure them that many people recompression airport is located, were working on getting him to higher-level chamber is approximately a medical treatment. located. 50-minute flight The next morning, Sam was evacuated by time from Kadavu, helicopter from Kadavu to the Colonial Memorial and then a further Hospital in Suva for evaluation and treatment. He flight to Brisbane, received a treatment (approximately two hours in Australia. the chamber), and underwent the same treatment the following day. The DAN/DES doctors still recommended The preferred option was getting Sam straight an air evacuation to Brisbane for further to Australia for higher-level care. However, treatment and this was organised accordingly. the evacuation company advised that a landing While the air evacuation was co-ordinated, permit would be required for an international Sam underwent another treatment with some rescue plane and medical team to land in Fiji, improvement. However, his wife reported that which would take approximately 6–18 hours. As his walking was limited to a shuffle and he still such, it was decided that getting Sam to Suva could not urinate. Upon reaching the Royal and into the chamber for treatment was the best Brisbane Hospital he was diagnosed with spinal option given his condition and the unknown time decompression illness and underwent a T62/T6 it would take to secure a landing permit. treatment, spending approximately five hours in Another issue arose as night was the chamber.