Dizziness and Tingling in Manado

A new diver accidentally misses her safety stop and experiences DCI-related symptoms.

A new diver accidentally misses her safety stop and experiences DCI-related symptoms.

This Member completed a dive to 18m for a total dive time of 40 minutes the previous day. She had forgotten to complete her safety stop when ascending, so decided to descend again to 5m to complete it.

Upon surfacing she felt a little dizzy, but no further action was taken. The next morning, she still felt dizzy and also had some tingling in her hands. The DAN Diving Emergency Service (DES) Hotline was called and the doctor advised her to breathe oxygen for 2-3 hours at which time she was to be reassessed to determine if the symptoms had improved.

After two hours of breathing oxygen she was feeling better but still had tingling/itching in her hands and feet. As such, DAN looked at evacuating the diver to Manado, and proceeded with this plan once it was confirmed the chamber would be staffed and ready to receive the diver. Otherwise, DAN would have looked at evacuating the diver to Singapore or Denpasar.

When the diver arrived at Manado Hospital she was evaluated, and the decision was made to provide her with a single Table 5 treatment. Following treatment all symptoms had resolved and did no return.

DAN Comment

While there are many chambers dotted throughout the Asia-Pacific region they are not always open and ready to receive divers. So, before DAN directs a diver to a chamber, or before divers take themselves off to a chamber, it is important to know whether the chamber is:

  • Operational;
  • Not already treating other diver/s;
  • Has staff available and ready to treat a diver.

This is why DAN does not publicly list chamber locations throughout the region.

In this case, the diver was provided oxygen first aid for several hours, and when re-assessed the decision was made that she required recompression. This is often how mild cases of DCI in remote places are managed. Why? It is often the case that symptoms fully resolve with oxygen first aid, and therefore a diver can avoid the added stress of being evacuated (whether by car, boat or air) to a chamber and undergoing recompression.  However, in this case, the chamber wasn’t far away and the diver could have gone there for assessment if requested by the on-call doctor.

A safety stop at the end of every dive is a good idea and provides a benefit in terms of off-gassing and reducing the likelihood of DCI. However, if a diver misses it, they shouldn’t be overly concerned about re-descending to do it; although, if the conditions are favourable, the diver is symptom-free and they have a buddy with them,  re-descending to complete the stop is an option.

One of the advantages of a safety stop is that it provides a reason for divers to carefully monitor their speed during the last 10m of their ascent reducing the risk of rapid ascents, particularly in the zone of greatest pressure change. This is especially relevant for newer divers (as this member was) who may not have yet developed consistent buoyancy control.

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