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Dive  Emergency



Diving is a relatively safe sport, however, there will always be potential emergencies. Whether these emergencies evolve into a full blown accident or death often depends on the immediate care the victim receives.

To avoid accident with Dangerous Water Creatures, please check out the Danger Creatures Page.


GtB Dive Emergency CPR on the Spot
click to enlarge

"...The only emergency chamber is                         Emergency Number: 
           Located in  San Pedro."                                       +501 226 28 51


All divers worldwide should be aware of the causes, signs, and symptoms of potential diving emergencies and be prepared. Ensuring your dive buddies are properly trained in emergencies is just as important; the victim may not always be someone else, it could be you!!
The hyperbaric chamber is in San Pedro. This is the only recompression chamber in Belize and available 24 hours daily.

GtB Sign of the San Pedro Hyperbaric Chamber
When you land at the airstrip in San Pedro, Ambergris Caye, you may notice an white building on the north/west side of the airstrip behind the Maya Air Terminal. The building houses a Double-Lock Recompression Chamber owned by Subaquatics of Belize Ltd. It is the only recompression chamber in Belize.

Dive Accident

Diving accidents are also called „decompression accident“ or „decompression illness“ (DCI). These accidents are caused by rapid reduction of ambient pressure and are characterized by formation of gas bubbles in the blood and the tissues. Depending on the mechanism of bubble formation there are two diagnoses to be separated, „Decompression Sickness“ (DCS) and „Arterial Gas Embolism“ (AGE). In many cases the clinical picture does not allow a clear cut decision between DCS and AGE. Differential diagnoses may be e.g. barotrauma of the inner ear (rupture of the round window membrane), cerebral insult due to embolus or bleeding, vertebral disc herniation, myocardial infarction, hypoglycaemia or epilepsy.

DAN Emergency Dive Accident Flowchart

Symptoms

  • Pain
  • Bladder Problem
  • Dizziness
  • Extreme fatigue
  • Headache
  • Itching
  • Nausea
  • Numbness
  • Personality change
  • Paralysis
  • Reflex change
  • Restlessness
  • Skin Rash

Signs

  • Blotchy skin rash
  • Altered mental status
  • Coughing spasms
  • Shortness of breathe
  • Staggering
  • Weakness

First Aid

  • put diver in a supine position, if diver lost consciousness: put diver in the recovery position.
  • give 100% oxygen (start as soon as possible),
    a) if breathing sufficiently: via face mask with - demand valve or -
        closed circuit oxygen re-breathing system with CO2-scrubber, if
        not available: with constant flow (15-25 ltr./min, non
        re-breathing mask with oxygen reservoir)
    b) if not breathing sufficiently perform artificial respiration: -
        Ambu bag with 100% constant O2 flow (15-25 ltr./min)
        or - Ambu/Laerdal bag with demand valve or - closed circuit
        oxygen re-breathing system with CO2-scrubber.
    Give oxygen without breaks until reaching treatment chamber, give highest possible oxygen concentration even if oxygen supply is limited (no air-mix, no constant flow below 15 ltr./min).
  • fluids
    a) if victim is conscious with stable neurology and intact
        swallowing reflex: give fluids orally in small sips (0.5-1.0 ltr./h,
        no hypertonic fluids, no alcohol, no caffeine)
    b) if victim has impaired consciousness or swallowing reflex: do
        not give oral fluids
  • perform orientating neurological examination
  • if hypothermic: protect against further heat loss, no active re-warming
  • consult hyperbaric chamber on Ambergris Caye on marine radio
    or with your cellphone.
    Dive emergency  Service  24  houres daily
    Phone:  +501 226 31 95
    Fax:      +501 226 28 52
    Email: sssbelize@aol.com
    Emergency Number:     +501 226 28 51
    Dr. Otto Rodríguez: +501 226 28 54
    Antonia Guerrero:   +501 226 34 42

Transport to Hyperbaric Treatment Chamber

Transport by car, boat, Helicopter (Astrum), Tropic Air or Mayan Air (if possible < 1000 ft / 300 m above ground) or plane (cabin pressure close to 1.0 bar). Transport gentle and without reduction of ambient pressure. Carry on treatment, give oxygen without breaks until reaching hyperbaric chamber.

Treatment

Recompression alone was shown to be an effective treatment for minor DCS symptoms. Trough the effectiveness of recompression therapy utilizing oxygen it has become the standard of care for treatment of DCS. Recompression is normally carried out in a recompression chamber. In diving, a more risky alternative is in-water recompression. A decompression chamber is a steel tank that can be pressurized. Throughout treatment a specially trained helper stays with the diver in the chamber

GtB Entry of the Hyperbaric Chamber

Entry of the San Pedro Hyper- baric Chamber.
Oxygen first aid has been used as an emergency treatment for diving injuries for years. The success of recompression therapy as well as a decrease in the number of recompression treatments required has been shown if first aid oxygen is given within four hours after surfacing. Most fully closed-circuit rebreathers can deliver sustained high concentrations of oxygen-rich breathing gas and could be used as an alternative to pure open-circuit oxygen resuscitators.

A decompression chamber is a steel tank that can be pressurized. Throughout treatment a specially trained helper stays with the diver in the chamber.


GtB Controlls of the Hyperbaric Chamber

Control panel for adjusting the air / gas mix and the dive depth.

GtB Inside in the Hyperbaric Chamber in San Pedro Belize
At the end of the treatment, the chamber will have the air pressure in the chamber and outside will be equal and the patient will breathe normal air.

After treatment

At the end of the treatment, the diver will be kept for 24 hours for observation in case his condition deteriorates. In most instances one course of treatment is adequate, but occasionally several treatments may be needed. After every Hyperbaric Treatment, the patient should drink plenty of fluids, avoid hot showers or baths, non-prescribed medications, caffeine, carbonated beverages, alcohol, strenuous exercise, oily spicy foods, avoid exposure to higher elevations (more than 1000 ft / 300 m ) or fly until 72 hours after the last treatment or cleared by the doctor.

Diving after an accident

After treatment for decompression sickness, a diver should take a rest from diving. The length of this rest should be discussed with a specialist in divers' medicine "Diving Medicine Physician EDTC".

Chamber Access Program

The chamber access program is a system whereby the dive shops pay a membership fee to become part of the program. After they become members, the dive shops are asked to collect a nominal levy or fee (typically $1 USD for each tank dived) - and forward to the chamber at the end of every month. This money is used to pay for stand-by operating expenses, which include doctors, utilities, technical maintenance, upgrades, salaries etc.

This program gives direct access to chamber service at anytime for dive shops that are part of the program and are current with their payments. The contribution however, is not an insurance, the diver will still be asked to supply the chamber with all their insurance information. The company will bill the insurance carrier of the patient. If patient is lacking any health/accident insurance, the chamber shall apply a nominal cost recovery fee.

Never dive without insurance or without joining the chamber access program the cost for the Chamber are 850 US$ a hour and you need to give a deposit of 2'500 US$. Be sure your dive shop is joining the chamber access program. It's a good idea to join Divers DAN.

To avoid accident with dangerous water creatures, please check out the Danger Creatures Page.


Guide to Belize,  March 2017



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