Mild but persistent symptoms… a reminder that post-dive symptoms do not need to be extreme before a call is placed to DAN for advice/assistance.
Recently, DAN managed an incident involving a 31-year-old male diver who called the DAN DES Hotline from Coron, Philippines. He was on the first day of his dive trip and completed three dives without incident:
- Dive 1: Max depth of 28m for 30 minutes with a Surface Interval (SI) of 1 hour.
- Dive 2: Max depth of 19m for 30 minutes, SI of 1 hour.
- Dive 3: Max depth of 19m for 50 minutes.
Three to four hours after the last dive he developed numbness in his entire left arm, and shortly after pain developed in his shoulder and back. When he called DAN the following day he rated the pain as 2 out of 10.
DAN advised him to breathe oxygen and called the dive operator on his behalf to advise the required flow rate and duration. The oxygen was set at a flow rate of 15 litres per minute for two hours and provided via a simple face mask. He was also advised to take ibuprofen.
In the meantime, DAN commenced inquiries regarding air transport to Manila, in case it was determined the diver required Chamber treatment.
When DAN spoke to the diver after two hours the arm numbness was nearly gone but the shoulder and back pain persisted. He was advised to remain breathing oxygen for another two hours, and then call DAN for another update. He ended up breathing oxygen for a total of six hours at which point his symptoms had resolved. He was asked to call DAN one hour after waking in the morning to discuss how he was feeling and to see if symptoms had returned.
In the morning, the diver advised that he still had mild symptoms, so the decision was made to evacuate him via Air Ambulance to Manila for recompression.
DAN co-ordinated with the Chamber as to when the diver would be arriving, so the team would be ready to recompress the diver.
Below is the flight/transport schedule for this mission. The air ambulance was sent from Manila to pick up the diver and then returned straight back to Manila:
1200H – Departure of air ambulance from Manila.
1300H – Arrival of air ambulance in Busuanga airport to collect patient.
1330H – Departure of air ambulance from Busuanga.
1430H – Arrival of air ambulance in Manila with medical team and patient.
1445H – Departure from Manila Airport via road to Advance Hyperbaric Medical Center
1545H – Arrival of Medical team and patient at Advance Hyperbaric Medical Center.
Treatment: The diver underwent a single Table 6 chamber treatment with improvement.
He was advised not to fly back to Australia for at least 72-hours. Fortunately, the diver had family in Manila, and was able to rest for a full week before returning home symptom free.
This case serves as a reminder that post-dive symptoms do not need to be extreme before a call is placed to DAN for advice/assistance. If you are concerned about symptoms post-dive we encourage you to call a DAN Hotline quickly.
Had DAN been called the day the symptoms first presented, and oxygen first aid promptly commenced, it may have resolved the symptoms and prevented chamber treatment.
While oxygen is highly effective, a delay in treatment can hinder the effectiveness in resolving symptoms, even if they are minor. So the advice is always to call DAN at the first onset of symptoms and to commence breathing oxygen as soon as possible.
REMINDER: Symptoms You Should Not Ignore After Diving
Common Signs and Symptoms of DCI
- Unusual fatigue
- Difficulty walking
- Itching / rash
Other Signs and Symptoms of DCI
- Difficulty breathing
- Visual disturbance
- Decreased skin sensation
- Muscle twitching
- Speech disturbance
- Personality change
- Altered level of consciousness
- Bladder / bowel problems
- Hearing loss / ringing ears