Recompression Chamber Safety

By Francois Burman, Pr. Eng, MSc.
DAN promotes safe chamber operations with research, education and training.

When a diver is injured in a remote location, the best course of action is not always apparent. Historically, the major dilemma was whether to get the diver to a nearby but less well-known treatment facility or to initiate an evacuation.

To promote the best outcomes in these situations, DAN® compiled a risk assessment guide1 in 2000 that drew from the many international publications that moderate and regulate the commercial diving and medical hyperbaric oxygen therapy industries. These publications include risk management philosophy and consideration of related issues such as occupational health and safety.

Instead of simply listing requirements relevant to the safe recompression of injured recreational divers, DAN identified real, likely hazards, quantified their significance and presented mitigation guidance for each. The purpose of this approach was to foster comprehension rather than just compliance — to focus on actual rather than hypothetical issues.

In 1998, two years before the first edition of the guide was published, DAN had embarked on an assessment process of recompression facilities around the world that would ultimately last 13 years and include 105 facilities. The data that resulted from this work formed the basis of not only the 2000 edition of the risk assessment guide but also two subsequent editions, published in 2011 and 2016.2

A DAN researcher analyzed the initial data to identify the most significant risks at all these facilities. He found 82 common risks and scored them using a dedicated recompression-chamber risk-assessment model that accounted for probability, consequences and frequency of occurrence. The most concerning risks, listed by rank, were as follows:
 
These results clearly show that effective management, administration and operation of a facility — human factors — affect patient safety more than technical factors do. Better-trained and motivated staff and more frequent use of the chamber also enhance safety. Recompression chamber facilities that establish systems for effective staff training, continuous risk awareness, appropriate medical supervision and reliable chamber operation and availability are well on their way to providing excellent care and improving outcomes.

DAN's promotion of safe chamber operations goes far beyond the creation and dissemination of risk assessment guides. Back in 1993 DAN created an international outreach initiative known as the Recompression Chamber Assistance Program (RCAP) to help improve underfunded chamber facilities around the world. Through RCAP, DAN has designed and conducted a series of safety education programs, provided on-site safety assessments at more than 150 facilities, paid for advanced training for facility staff and offered technical and operational support to chamber facilities that expressed interest in addressing their safety issues.

Through these continuing efforts to elevate the safety and capabilities of hyperbaric chambers around the world, DAN advances its mission: to help divers in need.


References
1. Burman F, Ramsay R, Cronjé FJ. IDAN risk assessment guide for recompression facilities. Durham, NC: International DAN, 2000.

2. Burman F, Cronjé FJ, Ramsay R. Risk assessment guide for recompression facilities. San Antonio, TX: International ATMO, 2016.

© Alert Diver — Q3 Summer 2017


Categories

 2019
 2018
 2016
Accidents After anaesthesia Air Quality Air exchange centre Air hose failure Altitude changes Altitude sickness Ama divers Anaerobic Metabolism Annual renewal Apnea Apnoea Arterial gas embolism Arthroscopic surgery Aurel hygiene BCD Back adjustment Back pain Back treatment Backextensors Badages Bag valve mask Bandaids Barbell back squat Bench press Blood flow Bone fractures Bouyancy compensators Boyle's Law Boyle\'s Law Bradycardia Brain Breast Cancer Breath Hold Diving Breath hold Breath-hold Breathing Gas Breathing Broken bones Bruising Buoyancy Burnshield CGASA CMAS CO2 Cabin pressure Camera settings Cancer Remission Cancer treatments Cancer Cannabis and diving Cannabis Cape Town Dive Festival Cape Town Carbon dioxide Cardio health Cardiomyopathy Chamber Safety Chamber science Charles' Law Charles\' Law Charles\\\' Law Charles\\\\\\\' Law Charles\\\\\\\\\\\\\\\' Law Chemotherapy Chiropractic Citizen Conservation Cleaning products Coastalexcursion Cold Water Cold care Cold Compressed gas Conservation Contaminants Contaminated air Corals Courtactions Crohns disease Crystal build up Crystallizing hoses Cutaneous decompression DAN Courses DAN Profile DAN Researchers DAN medics DAN report DCI DCS Decompressions sickness DCS theories DCS DM training DReams Dalton's Law Dalton\'s Law Dalton\\\'s Law Dalton\\\\\\\'s Law Dalton\\\\\\\\\\\\\\\'s Law Deco dives Decompression Illness Decompression Sickness Decompression illsnes Decompression treatment Decompression Diaphragms Diseases Dive Chamber Dive Industry Dive Instruction Dive Instructor Dive Pros Dive Research Dive Training Dive Travel Dive accidents Dive buddies Dive computers Dive excursions Dive gear Dive health Dive medicines Dive medicine Dive operators Dive safety Dive staff Diveleader training Diveleaders Diver Profile Diver infliencers Divers Alert Diving Kids Diving Trauma Diving career Diving emergencies Diving guidelines Diving injuries Diving suspended Diving Dizziness Domestic Donation Dowels Dr Rob Schneider Drysuit diving Drysuit valves Drysuits EAPs EAP Ear pressure Ear wax Ears injuries Education Emergency action planning Emergency decompression Emergency plans Emergency underwater Oxygen Recompression Emergency Enviromental Protection Environmental factors Environmental impact Environmental managment Equipment care Evacuations Evacuation Evaluations Exercise Exhaustion Extended divetime Extinguisher Extreme treatments Eye injuries FAQ Failures Fatigue Faulty equipment Fire Coral Fire Safety Firefighting First Aid Equipment First Aid Training First Aid kits Fish Fitness to dive Fitness Flying Francois Burman Free Student cover Free diving Free flow Freedive Training Freediver Freediving performance Gas Density Gas laws Gas mixes GasPerformance Gases Gastric bypass Gear Servicing Gordon Hiles HELP HIRA Haemorhoid treatment Hazard Description Hazardous Marine life Hazardous marinelife Health practitioner Heart Attack Heart Health Heart Rate monitor Heart rate Heart Heat stress Helium High temperatures Hip strength Hot Humans Hydrate Hydration Hydrogen Hydroids Hydrostatic pressure Hyperbaric Chamber Hyperbaric research Hypothermia Immine systems In Water Recompression Indemnity form Indian Ocean Indonesia Inert gas Infections Instinct Instruction Instructors Insurance Integrated Physiology International travel International Irritation Joint pain Kidneys Kids scubadiver Labour laws Learning to dive Legal advice Legislation Leukemis Liability Risks Liability releases Liability Life expectancy Lifestyle Low blood pressure Low pressure deterioration Low volume masks Lung function Lung injuries Lung surgery Lung MOD Maintenance Mammalian Dive Response Mammalian effect Marine Scientists Marine parks Marinelife Master scuba diver Maximum operating depth Medical Q Medical emergencies Medical questionaire Medical statement Middle ear pressure Mike Bartick Military front press Mixed Gas Mono Fins Mooring lines More pressure Motion sickness Muscle pain Mycobacterium marinum Nausea Nautilus Nitrogen build up Nitrox No-decompression Non-rebreather Mask Normal Air Nosebleeds O2 providers O2 servicing OOxygen maintenance Ocean pollution Open water divers Orbital implants Oronasal mask Oxygen Cylinder Oxygen Units Oxygen deficit Oxygen deicit Oxygen ears Oxygen equipment Oxygen masks Oxygen supply Oxygen therapy Oxygen P J Prinsloo PFI PJP Tech Part 3 Phillipines Photography Pistons Planning Plastic Pneumonia Pneumothorax Pollution Pool Diving Preparation Prepared diver Press Release Professional rights Provider course Pulmanologist Pulmonary Bleb Punture wounds Purge RAID South Africa RCAP Radio communications Range of motion Rashes Recompression chamber Recompression treatment Recompression Recycle Regulator failure Regulators Regulator Remote areas Renewable Report incidents Rescue training Resume diving Risk Assessments Risk assesments Risk assessment Risk elements Risk management SABS 019 Safety Stop Safety Saturation Diving Save our seas Science Scuba Air Quality Scuba Injury Scuba Instructor Scuba children Scuba dive Scuba health Scubalearners Sealife Shoulder strength Sideplank Signs and Symptoms Skin Bends Skin outbreak Skin rash Snorkeling Snorkels Sodwana Bay South Africa Spinal pain Splits Squeezes Standars Step ups Stroke Sulawesi Supplemental oxygen Surgeries Surgery TRavel safety Tattoes Technical Diving The Bends The truth Thermal Notions Tides Tips and trick Transplants Travel tips Travel Tweezers Unconsciousness Underwater photographer Underwater pho Vaccines Vagus nerve Valsalva manoeuvers Vape Vaping Vasvagal Syncope Venting Volatile fuels Washout treatments Wastewater Water Weakness Weigang Xu West Papua Wetsuit fitting Wetsuits White balance Winter Woman in diving Work of Breathing Wound dressings Wreck dive Wreckdiving Youth diver abrasion air-cushioned alert diver altitude anemia antibiotics antiseptics bandages bent-over barbell rows body art breathing air calories burn cardiovascular checklist chemo port child clearances closed circuit scuba currents cuts dead lift decompression algorithms decongestants dehydration dive injuries dive medicing dive ready child dive reflex dive tribe diver rescue diver training dive diving attraction doctors domestic travel dri-suits dry mucous membranes dry suits dry e-cigarettes ear spaces elearning electrolyte imbalance electroytes emergency action plans emergency assessment equalizing exposure injuries eyes fEMAL DIVERS fire rescue fitnes flexible tubing frediving gas bubble health hospital humidity immersion pulmonary edema (IPE join DAN knee longevity lower stress marine pathogens medical issues medical procedures medical risk assesment mental challenge micro-organisims minor illness mucous membranes nasal steroids nasal nematocysts newdivers nitrogen bubbles off-gassed operating theatre operations orthopeadic outgas pain perforation phillippines physical challenges pinched nerves plasters polyester-TPU polyether-TPU post dive preserve prevention pulmunary barotrauma rebreather mask rebreathers retinal detachment risk areas safety stops saturation scissors scuba equipment scuba single use sinus infections smoking snorkeling. spearfishing stings strength sub-aquatic swimmers ears tattoo care tecnical diver thermal protection training trimix unified standards vision impaired warmers water quality