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  1. #11
    Member
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    Apr 2013
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    Marlborough Ont, Canada
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    Default Excerpt from DAN Canada manual 2017

    If you need assistance, do not hesitate to call the DAN Emergency Hotline.+1-919-684-9111(Collect Calls Accepted)

    Things to know when you call:1. If the situation is life-threatening, call local EMS (911) first, then call DAN.

    *2. When you call DAN, the medic handling your call may make an immediate recommendation, or they may ask to call you back after making arrangements at an appropriate medical facility. Either way, your call will be immediately tended.

    3. If the DAN staffer needs to call you back, you will be asked to wait by the phone. The return call may take 30 minutes or longer, as several calls may be necessary to facilitate the assistance.

    *If your situation is not an emergency requiring an immediate answer or assistance, please call the Medical Information Line at +1-919-684-2948.DAN is a NC nonprofit organization.


  2. #12
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    Apr 2013
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    Marlborough Ont, Canada
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    285

    Default Just off the phone from speaking with Dan Emergency Medical Assistance

    Update; I was just informed by a DAN Medic that the SOP for dealing with any dive emergency will always include a visit to the ER. I personally like the idea of walking in attached to an O2 bottle and not giving it up until they replace it.

    If you get yourself there or via ambulance, all the same protocol applies. Call DAN asap and they will assist if necessary and in whatever capacity that is required.

    Should you suffer a significant injury such as an AGE and you're standing or slumped over next to the chamber, all the same protocol applies. Call 911 and DAN in that order.

    One other nugget I received from DAN, I was told the chamber in St Petersburg has some new and improved protocol or service to benefit divers. He mentioned something about a new director and better availability for emergency after hours recompression services.

    One last item FYI, for those less familiar with DAN. I am a paid DAN member, however, when I called the DAN Emergency Medical Assistance line a few minutes ago, I was never asked for my membership #. This is the way they usually operate, even when it comes to just providing info.

    You don't require to have a paid membership to get technical dive related info on the phone. If you have any questions about anything I've mentioned above, any dive related technical question, or just curious about DAN services or insurance, please don't hesitate to call them M-F 8:30am-5pm ET.

    I hope this clears up more questions than it creates.

    Last edited by Michael F; 10-06-2017 at 05:24 PM.
    The most powerful minds are the ones that can be changed.

  3. #13
    Time Out User
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    Apr 2016
    Location
    South Santa Monica Bay, Los Angeles CA
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    Default

    Still not an ideal 24/7 Emergency 6 ATA Recompression Chamber triage location for Dive Accident Victims from North Florida Cave Country or especially Northwest Florida /USS Oriskany -but it's better than nothing in the interim. I'm afraid though that this service will lapse and be discontinued like all the other privately run ventures tried out there as before. . .

    Again a privately run, for-profit hyperbaric clinic or hospital department that will treat dive casualties as needed is not a viable business model, because of the high malpractice insurance for such a low volume of infrequent DCI cases, and the expense to staff on-call personnel & private physicians to cover after hours and weekends on 24hr stand-by for emergency DCI cases. The only way these private clinics make money is Medicare Reimbursement and private healthcare insurance coverage from routine outpatient high volume diabetic wound care and other common conditions, Mon to Fri 9-5.

    You have to get back in operation with a 6 ATA Chamber capability for the state supported Univ of Florida Medical Center in Gainesville, for both routine clinical wound care, burns etc and emergency DCI treatments, and one in Pensacola on 24/7 stand-by only for Dive Casualties run by the local county/city gov't dept of health services/EMS and staffed with on-call Chamber Operation Volunteers along with professional EMT/Paramedics and an assigned county gov't health provider ER/Hyperbaric Physician. All state/county/city gov't health services are protected legally through statutes of Sovereign Immunity.

    Here is a state run university medical center and teaching hospital hyperbaric medicine example:
    https://health.ucsd.edu/specialties/...ages/dive.aspx

    And again the model for a Volunteer Chamber Crew/Dive Casualties Treatment Only:


  4. #14
    Member
    Join Date
    Nov 2004
    Location
    holiday,fl.
    Age
    60
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    27

    Default

    I went to the e.r. first. I asked them to call DAN. They wouldn't, so I called DAN from my cell. Then I passed off my phone to someone (I forget who it was) In the end the only bill sent to me was for the helicopter transport to Florida hospital in Orlando. Dan had me send them that bill and paid for everything!


  5. #15

    Default

    a new chamber opens up and people still find ways to complain *smh*

    while it might not be right in cave country, it is much closer than going to West Palm beach. Also, it is close to EN/Twin/ and other local deep caves.


  6. #16
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    Apr 2016
    Location
    South Santa Monica Bay, Los Angeles CA
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    Default

    Quote Originally Posted by patpicos View Post
    a new chamber opens up and people still find ways to complain *smh*

    while it might not be right in cave country, it is much closer than going to West Palm beach. Also, it is close to EN/Twin/ and other local deep caves.
    University of Florida/Shands Medical Center: A teaching hospital/college of medicine and a level 1 regional trauma center right there in Gainesville --and no capacity to treat emergent DCI cases from nearby cave country? And the nearest in-state referral and accepting emergency hyperbaric facility is over two hours drive time or a medevac flight to the south at a small private clinic in Tampa-St Pete? C'mon, that's awful & pathetic. Shame on UF healthcare and their Hyperbaric Medicine Dept.

    Local Florida dive community residents should be complaining AND trying to remedy this. . . And a vital delay in treatment that every visiting North Florida tourist diver should be aware of.


  7. #17

    Default

    Quote Originally Posted by Kevrumbo View Post
    University of Florida/Shands Medical Center: A teaching hospital/college of medicine and a level 1 regional trauma center right there in Gainesville --and no capacity to treat emergent DCI cases from nearby cave country? And the nearest in-state referral and accepting emergency hyperbaric facility is over two hours drive time or a medevac flight to the south at a small private clinic in Tampa-St Pete? C'mon, that's awful & pathetic. Shame on UF and their Hyperbaric Medicine Dept.

    Local Florida dive community residents should be complaining AND trying to remedy this. . . And a vital delay in treatment that every visiting North Florida tourist diver should be aware of.
    While it's not perfect, it is still better than the options a couple weeks ago.

    I was unlucky that Valdosta couldn't take me (I was at Madison blue). I ended up having to fly to West Palm since they were the.closest willing to take me. Had I been in worse shape, yes I'd be worried to death.

    Any incremental step in chamber service is a good thing and better than nothing. However we should not settle for that.

    My comments were more targeted at whining about going to ER. This is pretty much a SOP.

    However, I have heard of stories where DAN called the ambulance service and overrode the delivery target from ER to a chamber if you press for it.

    Sent from my ONEPLUS A5000 using Tapatalk


  8. #18

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    Hi all,
    I am the directing physician at the new chamber in Tampa with Joe Dituri, PhD. My name is Farhan Siddiqi, MD. I am an orthopedic spine trauma surgeon and cave CCR trimix diver/hyperbaric doc. Joe is the owner of the chambers and he has 2 additional chamber operators. My team of physicians provides 24/7 emergency coverage for divers (amongst our other services non-related to diving)... yes we take almost every insurance and DAN insurance. Since we are a non-hospital attached chamber, we cannot take severe Type 2 DCS that may require an intensive care unit stay or inpatient admission. However Type 1 and mild-mod type 2, we can handle. We treated 2 in the last 3 weeks actually. Joe also has a multiplace chamber that is available for dive site surface decompression for exploration diving if needed. That is his area of expertise. He is a very well published Navy diver who is the chairman of the board of advisors at IANTD. DAN is your best resource if you feel bent as they will triage you and refer you to the proper facility based on your symptom constellation. Joe and I also published a research study also on in-water recompression in the Journal of Hyperbaric Medicine about 2 years ago if anyone has interest.
    And I agree with EGIB above... if ever in doubt, call 911 and DAN. The ER may not recognize the DCS right away, but it is always the best place to be if things get worse.
    Any questions, let me know.
    Take care all.


  9. #19
    Member
    Join Date
    Jun 2011
    Location
    St Petersburg, FL
    Posts
    2,446

    Default

    Quote Originally Posted by CavePadawan View Post
    Hi all,
    I am the directing physician at the new chamber in Tampa with Joe Dituri, PhD. My name is Farhan Siddiqi, MD. I am an orthopedic spine trauma surgeon and cave CCR trimix diver/hyperbaric doc. Joe is the owner of the chambers and he has 2 additional chamber operators. My team of physicians provides 24/7 emergency coverage for divers (amongst our other services non-related to diving)... yes we take almost every insurance and DAN insurance. Since we are a non-hospital attached chamber, we cannot take severe Type 2 DCS that may require an intensive care unit stay or inpatient admission. However Type 1 and mild-mod type 2, we can handle. We treated 2 in the last 3 weeks actually. Joe also has a multiplace chamber that is available for dive site surface decompression for exploration diving if needed. That is his area of expertise. He is a very well published Navy diver who is the chairman of the board of advisors at IANTD. DAN is your best resource if you feel bent as they will triage you and refer you to the proper facility based on your symptom constellation. Joe and I also published a research study also on in-water recompression in the Journal of Hyperbaric Medicine about 2 years ago if anyone has interest.
    And I agree with EGIB above... if ever in doubt, call 911 and DAN. The ER may not recognize the DCS right away, but it is always the best place to be if things get worse.
    Any questions, let me know.
    Take care all.
    Thanks for the info. In a case such as mine where I had minor to moderate skin bends as well as a headache is it possible that DAN may refer someone directly to you (either your physician's office or the chamber facility), or would they likely require an ER visit and then a visit to your facility? Obviously the answer is multifactorial, but I guess my point is it possible that a conversation with DAN could lead to a direct referal. Living in St Petersburg, I would petition with DAN if I had to call them to send me directly to your facility as opposed to an ER due to the typical delays in treatment in ERs.

    Also, as you said your physicians are capable of treating DCS, does that mean that anyone referred for treatment at your facility receives a consultation with a physician as part of the treatment, or are patients refered to you post-treatment for follow-up?


  10. #20

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    Yep, DAN will refer direct to us if indicated, and the patient will receive a full consultation, and if diagnosed with DCS will get a chamber treatment if needed. Obviously if the patient has a different diagnosis, then we would treat appropriately and if at any time the physician felt that an ER visit, hospitalization, or admission for inpatient intensive care services was required, the patient would be transferred immediately to a local ER. No need to petition DAN per se, they already refer to us. I would encourage everyone to always have their DAN insurance active if they cave dive. We have had patients that have been diving Trimix for years, even instructing. They do a relatively simple dive that they have done hundreds of times before and get bent. Also, have had patients that do 60 ft open water bounce dives too may times trying to spear fish at 50 yrs old, and they get bent. It can happen to anyone. It has happened to me. Also, another reason to have DAN is that often standard health insurance requires pre-authorization for treatment to get covered. DAN does not. If the patient is diagnosed with DCS, they cover it, almost no questions asked. Really unheard of in todays health care environment. worth every penny.



 

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