Recompression Chamber Policy

Divers Alert Network Southern Africa (DAN-SA) receives regular requests for information and/or contact numbers of recompression chambers (also known as hyperbaric chambers) by divers who are training as dive masters or dive leaders, or by divers who think that it may be in their best interest to know the number and location of the nearest recompression chamber. Although this information may be helpful, it often compromises dive safety by creating the impression that rushing an injured diver to the nearest chamber is the most important consideration in an emergency. Often, this is not the case and it may even be dangerous to do so. DAN-SA therefore does not provide information on recompression chambers to divers on request. We encourage that injured divers be given immediate emergency first aid and 100% oxygen, and be taken to the nearest 24-hour casualty as quickly as possible.

The following variables impact on the accessibility of recompression chambers, attesting to why immediate first-aid and proper diagnosing is crucial before rushing an injured diver to a recompression chamber:

• Location: The nearest recompression chamber may not always be the best suited in treating a particular diving injury. Only four out of 15 recompression chambers in the DAN-SA region are equipped in treating unconscious, unstable or non-breathing divers without needing additional expertise, medical assistance and equipment to do so. These recompression chambers are only able to treat fairly minor and stable cases of decompression illness. Taking a seriously injured diver to such facilities without adequate information, may thus delay treatment.
• Access: Many recompression chambers are not set up to provide 24-hour service, operating at irregular hours or by appointment only, thus the hyperbaric team may need time to prepare for treating an injured diver. Contacting DAN-SA first avoids taking an injured diver to a recompression chamber only to find the facility is closed or out of service.
• Staff availability: Several facilities only have access to a single doctor who is trained in treating DCI. When this person is absent, there is often no one available or able to handle a casualty.
• Diagnosis: The injured diver may not necessarily have DCI. He or she may be suffering from a heart attack, stroke or some other medical disorder. Therefore, rather than rushing a diver in distress to a recompression chamber, it is more appropriate to take him or her to the nearest 24-hour casualty first and to obtain a more detailed assessment of the problem, establish a diagnosis and provide adequate stabilisation.
• Contact details: Most recompression treatment chambers are constantly being upgraded, thus addresses, contact details and operative availability may be subject to variation.
• Chamber facilities: DAN-SA does not own any recompression chambers and the chambers within or outside of our region (accredited or not) are under the ownership of the facility, business or private/public entity. Thus DAN-SA does not have any administrative, technical or medical jurisdiction over any chamber whatsoever.

The above-mentioned reasons make it virtually impossible for any recreational diver to keep abreast of all these factors and variables, and to be expected to make the best medical decision when confronted with an injured diver. Obsolete or incorrect information may generate dangerous situations and harmful delays if it is employed in an emergency.

DAN-SA’s primary mission is to provide a 24-hour hotline for injured divers. We maintain all the relevant information on the recompression chambers in the particular regions and thus we are in the best position to provide assistance and advice when necessary. Each diving incident is unique, and medical decisions, which may sometimes be of critical importance, must be based on specialised individual assessments. Establishing where to treat an injured diver may require an intensive medical assessment. Contacting DAN-SA in a diving emergency is the single most important step in ensuring appropriate care, after providing immediate emergency first aid.

DAN-SA recommends the following guidelines in case of an injured diver

• Address any life-threatening situations first. Keep the injured diver in a horizontal position and carry out CPR if necessary.
• Administer 100% oxygen for as long as possible, ensuring that the injured diver is breathing adequately. If not, provide mouth-to-mouth with the appropriate protection barrier or equipment-assisted ventilation. (Take the DAN-SA Oxygen Provider course in order to understand and be confident in the administration of emergency oxygen first aid.)
• Provide oral fluids only if the injured diver is fully conscious and able to drink unaided.
• Call DAN-SA on +27 82 810 6010 for advice, assistance and evacuation as needed. DAN-SA will make the necessary arrangements and liaise with healthcare professionals who are managing the diving emergency to facilitate appropriate treatment of the injured diver.
• If possible, transport the injured diver to the nearest 24-hour casualty centre.
• Join DAN-SA and encourage other divers to join this valuable service. This ensures that there are no delays in the evacuation and treatment of an injured diver.