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I recently attended a seminar at Adventure Outfitters in Tampa. Joe Dituri discussed diving physiology and review his Undersea Oxygen Clinic in Tampa. It is now open and is a DAN Treatment Center.
Seminar Overview - https://adventuretampa.com/tampas-un...oxygen-clinic/
Facebook Page - https://www.facebook.com/underseaoxygenclinic/
This is great news for diving all over Florida!
This is a silly question, will they treat divers? There are a lot of places that DAN has on their database,but aren't available to treat dive injuries. Thanks for sharingQuote:
Originally Posted by Walter Pickel
Yes, and they already have. Joe is a former US Navy saturation diver and one of the inventors of the NEWT suitQuote:
Originally Posted by Kelly Jessop
Fantastic news! where was this when I needed it in June!
Now the question is will DAN require you to go to an ER first or not. Last year I did two standard dives at Ginnie over two days. The first day I had some minor bruising around my shoulder. I thought it was from my harness. The second day the bruising worsened and my vision on the drive home was a little "starry". Late that evening when I figured it out, I called DAN who recommended an ER trip. I couldn't lose two days of work on short notice, so I chose to sit it out and take a month off of diving. The real issue was the ER visit. I knew I'd sit in the ER for 8 hours trying to get sent to a non-existent chamber facility. So with this new facility, can DAN refer you straight there if you have no concerning symptoms or does an ER visit always have to happen first in order for DAN to pay for it.
Which lends the question- does the chamber in Tampa have a Hospital/ER that acts as it's Medical Director?
If you don't really need an ER, you can be driven to Tampa, check into the chamber's affiliated ER, and hopefully be sent directly to the chamber by ER doctors who are familiar with chamber protocols???
This is what there FB page states
Quote:
Our team is available to ALL Florida Divers 24/7/365. Any diving injuries should call (727) 542-1959. While others are closing chambers to divers, we are opening them! - DAN approved referral Center!
Quote:
Originally Posted by Walter Pickel
They may say anything they so choose, however, DAN still has their SOP which includes ruling out other medical issues and safe medical transport to an HBOT facility if required.
There is a DAN link in the article that specifically identifies this fact. Only DAN can authorize HBOT treatment if you expect them to pay for it, unless I'm mistaken. Has anyone had a treatment covered when DAN wasn't directly involved from the start?
https://www.diversalertnetwork.org/m...on_Information
I'll try to contact DAN later today to confirm.
I had a similar experience and DAN instructed me to visit an ER. My team and I elected for in water re-compression instead. Wayne has O2 available 24/7. Thanks again Wayne.Quote:
Originally Posted by rddvet
If you need treatment, call 911 after DAN and take the ambulance there. That seems to help get in a chamber quickly. DCS often doesn't produce obvious physical symptoms and ER staff may not realize it can be life threatening, unfortunately you have to make them realize it.
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.
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. ;-)
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:
https://vimeo.com/120335768
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!
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.Quote:
Originally Posted by patpicos
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.Quote:
Originally Posted by Kevrumbo
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
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.Quote:
Originally Posted by CavePadawan
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?
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.
Quote:
Originally Posted by CavePadawan
That's perfect to hear. Being in my backyard is even better. In my case I chose to not undergo treatment because I knew the huge headache of dealing with an ER trying to come up with a diagnosis they rarely make, and then sit for hours while they find a chamber that will take me. The benefit didn't outweigh the headache for simple skin bends. On top of that, the fact that I had a headache got DAN jittery and forced their hand to require an ER visit. Your setup would have been perfect for my needs, as I suspect I would have been diagnosed and halfway through a chamber ride in the same amount of time the ER would have ruled out 80 other causes and finally agreed it could be DCS.
With all due respect Dr. Siddiqi, that is the major shortcoming of private stand-alone non-hospital/non-trauma center hyperbaric facilities: they either don't have a multiplace 6 ATA capable Chamber, and/or don't have Advanced Cardiac Life Support (ACLS) to treat Type 2 DCS or AGE -as well as the malpractice insurance to cover it all. . .Quote:
Originally Posted by CavePadawan
That you, Dr. Siddiqi, and Joe Dituri are willing to provide some 24/7 treatment options with DAN referral is commendable, but your facility is no where near the complete local emergency solution that the divers need up there in North/Northwest Florida, especially for the worst cases of hyper-acute to critical AGE with near drowning, going into full cardiorespiratory arrest.
---------
Again, there is a Level 1 Trauma Center up there in Gainesville at Shands/Univ. of Florida Medical Center. It also happens to be the state's major public teaching hospital and college of medicine, with a large pool of 24/7 available on-call Resident, Teaching Fellow, and Staff Attending Physicians specializing in Emergency and Hyperbaric Medicine. So why isn't there a state-funded 6 ATA Multiplace Recompression Chamber on the hospital campus available to treat the entire scope of Hyperbaric Patients (from routine outpatient wound care to acute emergency DCI)? WTF-does your Florida Dept of Health know about this crisis up there and what's going on? If not then how come you as a dive community and taxpayers there in North Florida aren't complaining about it and trying to resolve the problem?
This is our 6 ATA Multiplace Recompression Chamber for Dive Casualties only, with ACLS, that's been serving Southern California Divers 24/7 for over the past 40 years:
http://dornsife.usc.edu/hyperbaric/about/
http://dornsife.usc.edu/hyperbaric/
https://blogs.scientificamerican.com...baric-chamber/
https://m.youtube.com/watch?v=GXwbyMuL5OM
https://vimeo.com/35634004
The crisis and Shands chamber has been discussed ad nauseum, but this more likely is a study in hospital economics 101, which has effected the whole state. Where it is great you have a model that works in your region, the pity is comparing your region and Florida is truly apples and oranges. I for one am appreciative that a service has been made available, and although it may not cover all cases, at least there is an option we didn't have before.Quote:
Originally Posted by Kevrumbo;333416Again, [B
Seriously, you're getting tiresome with the same thing over and over again. Florida has added a new facility that can be helpful in less severe cases. That's a win in my book.Quote:
Originally Posted by Kevrumbo
Come start diving in Florida regularly then you can be so critical. You can't compare every diving location in the world to Catalina's exceptional option. This isn't California.
Pardon my ignorance if this item has already been flogged but have Government officials been petitioned to enhance services at Shands to better serve divers?Quote:
Originally Posted by Kelly Jessop
I suppose the tourism $ created by Cave divers and OW divers in Florida isn't sufficient in their minds to justify the expense.
Kevrumbo, what are your thoughts on how this could be sold if not to support tourism $?
Good god man, asking this question is like asking Ross about decompression theory. This has not only been flogged, the dead horse has beaten into a pulp, converted to cheap cat food, fed to the cat, crapped out, uncovered by a turd eating dog, and then thrown up all over the CDF.Quote:
Originally Posted by Michael F
Beetlejuice, Beetlejuice, Beetlejuice.Quote:
Originally Posted by Michael F
Please click on his name and just look at the thread responses he's had. It will be the same old tune over and over again. He likes to repeat the same thing over and over.
Go do the same on scubaboard and you can get 50-100 posts containing the same breakdown on his $1000s spent on just helium and luggage overages on his "expedition" to bikini atoll.
Beetlejuice may be fun the first couple times you call him, but eventually he's going to irritate the crap out of you.
Quote:
Originally Posted by Michael F
John, have you written any books? Seriously, I like the way you compose. Always graphic and entertaining. Communication can be fun when people make the effort. :clapperQuote:
Originally Posted by OFG-1
The last thing I want to do is aggravate people but if we don't make an effort to find a solution it will never improve. Kev does have a few ideas and maybe one of them could be part of a solution.
OK, fair enough. I read every post that Kev has made on CDF (and a few elsewhere) and I saw a reference to contacting various Florida officials concerning funding but I didn't see anything on the concept of funding/support/or promotion of having the chamber at Shands available for divers and/or in a standby capacity.Quote:
Originally Posted by rddvet
I will admit that I don't have the answer or possibly enough understanding of the complexity of a solution, however, I believe that if not working towards a solution we are accepting status quo. End of story.
I only visit Cave Country a few times per year at best and do not ever practice anything but conservative diving but Sh1t happens. I hope to invest in a full faced mask and plan to always keep an extra 80 of O2 available.
Quote:
Originally Posted by Michael F
Michael F, we as American Citizens here, it helps to know how to work with and apply the system (i.e. US Dept of Health & Human Services -getting help in applying for and writing a proposal for a Monetary Grant in Need, for example) -instead of uselessly whining why it can't be done -like the idiots below- because of redtape bureaucracy, state gov't politics and malpractice litigation. See link to a major source of these funds below.Quote:
Originally Posted by Michael F
Quote:
Originally Posted by OFG-1
There are numerous rural health grant opportunities aimed at improving the quality of health care in rural areas made available to hospitals in the form of public grants, federally-funded demonstration projects, and private grants. The single best resource for federal funding of rural health grant programs is Grants.govQuote:
Originally Posted by rddvet
https://www.grants.gov/web/grants/le...-services.html
Y'all are Federal Taxpayers too -how come you Florida Dive Community Residents are too stupid to know what your resources are???
If you ain't helping to find the solution, then y'all are part of the problem. . .
The almighty KevRumbo. Smarter than us dumb rednecks cause he's from california. He's so smart he can google him up something good like.Quote:
Originally Posted by Kevrumbo
I can see the bumper stickers now. Instead of keep christ in christmas.................keep kev in kalifornia.
Kevrumbo, as much as I appreciate your stamina and drive to push this concept, I think it could be more productive to remain friendly, polite, and respectful of others even if they have a different opinion than yours.Quote:
Originally Posted by Kevrumbo
I really appreciate the myriad of approaches and resources you have compiled and presented. Please try to work more diplomatically and maybe we can find a solution. Thanks,
Michael
Just a diver that loves Caves and Cave Country.
I think he's just trolling at this point. He keeps posting the exact same stuff over and over again.Quote:
Originally Posted by Michael F
Well if we'd all just convert to using Ratio Deco for all our dive planning we'd never get bent or need a chamber... just ask him how that's been working out for him ;)Quote:
Originally Posted by bent
Sent from my SM-G900T using Tapatalk
There is no evidence offered here on Cave Diver's Forum that any state department of health or state/federal gov't representative being aware of or helping to resolve the problem at Shands UF Gainesville.Quote:
Originally Posted by Michael F
For starters, DAN should be able to offer some advice to the local dive community and possibly help on how bring this urgent need to the attention of state gov't officials.
Shands UF is not a private medical center subject to basic for-profit economic models.. Do you understand?Quote:
Originally Posted by Kelly Jessop
N. Florida residents and the local dive community are being vitally underserved by a taxpayer supported public University of Florida School of Medicine and Regional Level 1 Trauma Center in Gainesville. You as state taxpayers are entitled to a higher quality of critical care improvement based on this level 1 trauma designation -go demand for it and get it instead of ignorantly rationalizing it away as due to basic "hospital economics 101".
"Florida" per se has nothing to do with this new clinic. The OP is an example of a private stand alone for-profit facility and a temporary band-aid solution that may very well dissolve again like all the other private ventures tried there before up in N/NW Florida. This is NOT a state funded and run, taxpayer supported facility.Quote:
Originally Posted by rddvet
Working on getting a 6ATA Multiplace w/ Auxiliary Lock Hyperbaric Chamber for Shands UF Gainesville with Federal Grant Money is the most viable solution they have. It's the best permanent and sustainable model, again because of its state publicly funded medical school, level 1 trauma center designation, and better legal protection and immunity.Quote:
Originally Posted by Michael F
They have to start "trolling" their elected state and/or federal government officials to help them resolve this crisis and implement this very workable solution. . .
You almost had me on your side until you start with this nonsense. On what planet are you entitled to some service just because you pay taxes and need it for your own specific need? ..paid for by a vast majority that would never use it.Quote:
You as state taxpayers are entitled to a higher quality of critical care improvement based on this level 1 trauma designation -go demand for it and get it instead of ignorantly rationalizing it away as due to basic "hospital economics 101".
And Shands does still have to operate within a budget. Perhaps California could learn a thing or two about that.
That doesn't mean I would not appreciate and work towards that same model that you keep presenting. Only that the "hold my breath and make demands loudly" approach would not be a strategy I would support.
Because the rationale is that you have a state publicly funded university school of medicine and research center with a serious deficiency and lack of capability to treat critical DCI casualties, despite being state designated as a Regional Level 1 Trauma Center. And from looking through the Shands UF Medical Center/School of Medicine website, there doesn't seem to be a dedicated Department of Hyperbaric Medicine after all, nor even as a sub-specialty of Emergency Medicine --only a small off-campus mono-chamber type M-F/9-5 clinic for general outpatient wound care.Quote:
Originally Posted by Adler
So the motivation and justification is there as the state's primary public medical school and research/teaching hospital, to secure gov't funding and with private donations (and that's coming from Florida businesses like Dive Rite, Halcyon etc and from you -the Florida Resident Dive Community) to establish a dedicated on-campus Department of Hyperbaric Medicine with a large 6ATA Multiplace Chamber, able to treat the entire spectrum of patient care --from burns, diabetic wounds, gangrene, CO poisoning etc as inpatients/outpatients, to worst case 24/7 emergency near-drowning DCI casualties in support of the Level 1 Trauma Center.
Quote:
Originally Posted by Kevrumbo
Thanks so much. We'll get right on it. You're help has been great. We'll give you a call when we're done with all of that in a couple years. In the meantime we'll be very busy so don't bother us. We promise we'll let you know when we need more of your help.
Talk soon,
-Everybody in Florida.
Funny that you say that. During my discussions with DAN the other day, the medic offered to put me through to someone more familiar with starting the ball rolling with getting action at Shands.Quote:
Originally Posted by Kevrumbo
He assured me that DAN was familiar and experienced with the process to provoke government funding and support for the idea. I declined his offer, as I'm only another foreigner who visits a few times per year.
If anyone of my US Cave diving brothers would be interested, please call DAN and see what you can discover. Why not invest a bit of time in a phone call, it might be productive. PM me if I can assist in any way.
If DAN thinks it has possibilities, maybe it could be accomplished.
Of course it is possible and can be accomplished because the emergent medical need is so clearly obvious:Quote:
Originally Posted by Michael F
It doesn't make sense for a major public teaching hospital and level one trauma center like Shands/UF Medical Center Gainesville to potentially triage out an acute DCI casualty two hours drive time or medevac flight down south to Tampa, to a small stand-alone private hyperbaric facility like Undersea Oxygen Clinic with no Advanced Cardiac Life Support contingency or certification. That's an absolutely absurd scenario and gross public health service failure of the state's trauma care system.
Shands/UF Medical Center Gainesville deserves a large 6 ATA Multiplace Recompression Chamber with Auxiliary Lock Entrance to treat all routine inpatient/outpatient patients, as well as 24/7 emergency support of acute to critical DCI/near drowning dive accidents & casualties.
Moderator's note- Kevrumbo you are starting to tread outside the line of civil discussion. We are aware of your views, and this forum has heard it repetitively,but keep responses free of insults.
... and if trolling doesn't work I suggest pouting and stomping your feet.Quote:
Originally Posted by Kevrumbo
I have closed this thread, because it has outlived it's usefulness.Quote:
Originally Posted by bent
If you have any questions about the undersea oxygen clinic, CavePadwan will answer any private messages.