Chambers Recompressing Divers in Cave Country

[lv2dive]

Kelly had a great idea for a thread but his thread grew into something more - there are recommendations for what should be done, commentary, etc, and IMHO it's hard to find the valuable posts with the data contained therein.

I have quoted most if not all of the posts with ON-TOPIC information from Kelly's thread and respectfully request this thread be limited to posts related on to chamber status.

[lv2dive]

See below for the quotes from Previous thread:

This is something I have harped on for the last few years, and having an accurate list of chambers that will recompress divers is critical (if not life saving). As much as I am a fan of DAN, they may not be as update to date as we'd like.

I will start with what is known,but needs verification.
Shands in Gainesville- has not shown a tendency to recompress divers,even when showing up during "business hours"
Tallahassee- recently heard of their not recompressing divers. Unsure if this is short term or long term
Valdosta, GA- has recompressed divers
Albany,GA- has the facilities and has not shown a tendency to turn away divers.
Tampa- DCS fatality at Ginnie I understand was sent there,but which hospital???


What needs to be added
Panama City
Jacksonville
Pensacola
Orlando


Where else?

I think Citrus County Memorial has a chamber because it is on standby for commercial diving emergencies where I work.

I will start
Phoebe Putney hospital,Albany GA. 229-312-1000
Wound care department that has the hyperbaric chamber 229-312-7600
Dr Bozzuto is the physician in charge of hyperbaric medicine

I was treated at the Florida Hospital in Orlando in Feb 2015. Their number is (407) 303-1549. Not sure if the doc is still there. As a note, they treated me after a referral from our flight docs at MacDill AFB. I assume they will recompress divers referred through civilian channels, but I can't confirm that.

St. Marys 561-844-6300 in West Palm Beach will accept divers. Use them at your own risk. There's a lot of horror stories going around, myself included.



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Add North Florida Hospital in Gainesville to the list that does not accept divers in the chamber.

Was told while in Valdosta that this facility has shut down its chambers permanently. This was only hearsay from the Valdosta staff, though (take it for what it is).

I was treated there a week ago.

Lee memorial in fort Myers had a chamber for divers I was just recompressed there in March.

On the topic of calling DAN, during my event I contacted DAN at 2am and was immediately placed through to the dive medic on call. After speaking with her for a few minutes she put me on a brief hold and then told me that Orlando or West Palm (I beleive) were the only two 24 hour chambers near me. We then decided based on time and distance and that my symptoms were not life threatening it would be best to go to a local er for confirmation of dcs, by then the chamber at lee memorial would be open and I could transfer there. DAN pretty much left the choice up to me if I wanted to go to one of the 24 hour chambers immediately or wait. I didn't feel any pressure to make a decision one way or another.

I took a DCS hit while spearfishing 100+ miles off shore in the Gulf of Mexico in October 2014... diving out of panama city and the hospital there would not treat divers. I was sent to Springhill, AL for treatment. 2 "dives" and 48hrs later I was headed home to Jacksonville. I tried to get an additional treatment upon my return and spent a full day sitting at a hyperbaric facility only to be turned away due to liability. I talked to DAN at the end of that day and they told me the treatment might help with healing but at that point all bubbles were gone, so I didn't bother fighting for a last treatment. The whole experience was very sobering as I always thought if you got bent minutes later DAN would have a chopper there to wisk you to a "nearby" chamber... certainly not the case. I spent 5 hours in the ER in panama city beach waiting for a hospital (any hospital) to accept me and get a transport. It made me very angry to know there is an active chamber at that same hospital but they won't treat a diver in it.... not profitable enough, too much liability and also expense having a hyperbaric Doc on call. It only took the hospital in panama city beach about an hour to realize they should have had me oxygen from the time I walked in the door. The hyperbaric Docs at Springhill were amazing and have been fighting the battle to get chambers opened to divers throughout florida as they receive almost all cases of DCS that occur in the panhandle and beyond. At the time they had recently taken a patient from the same hospital with catastrophic injuries... a free diver that embolized after holding his breath from depth and free ascending out at Vortex. he was told to go to panama city and received an even longer delay of treatment than I did. I have made a full recovery, unfortunately that young man did not and will be forever crippled by the damage caused. It does ultimately come down to $$$ as Kelly pointed out. Chambers that are willing/open to treating divers have to have a hyperbaric MD on call 24hrs a day which becomes very expensive and of course packing a larger chamber with wound care patients (who "dive" to a much shallower depth) is much more profitable than using the chamber for one DCS patient. Very frustrating and scary for the tens of thousands of divers living/visiting the state of Florida for all sorts of diving activities.
Lesson learned... know where you closest operating hyperbaric facility is and have a plan to get there in case the unexpected happens. Don't rely on any hospital or even DAN to ensure you end up where you need to go. DAN was extremely helpful to me and I am forever grateful for having an active membership since I started diving... never thought I would use it.

DAN and the Springhill Doctors both called the chamber in JAX and confirmed they would treat me if pain returned so I felt safe returning home. I had pain the following day so I went in for treatment. They did a full workup on me, prepped me to "dive", made all sorts of calls to various people (DAN, the insurance people, springhill hospital, other chamber facilities, etc) as I was the first diver they had ever treated and apparently they were the only hyperbaric facility with chambers that could dive deep enough for my treatment. When they finally got all their questions answered the doctor on call was off duty for the day (I got there at 8am and at this time is was around 4pm) and told me he couldn't supervise my "dive" and they would have to look into on another day since he was scheduled to be off for several days. I gave up, frustrated, and went home. I ironically that doctor sent me a nice big bill a few weeks later for "treatments rendered".

What about NEDU in Panama City (Navy Experimental Diving Unit)? Or would they not treat civilian divers?

I understand they don't want civilians, but will take someone in a life or death situation. I don't think they are on DAN's list,but I know if there was a local accident, and Bay Co chamber was offline, they would take you. (or at least used to)

Correct, NEDU *might* take a civilian if the timing was just right and they had time, space and personnel on hand. Same thing with NAMRI in Pensacola. Speaking of Pensacola, Baptist Hospital has a mono place chamber, nothing multi place. They were treating divers for a while, but haven't been for quite some time. There was a really nice multi place facility here, but it has been closed for at least 10 years now. There's an unrelated business in the building, and I have no idea if the chamber is still there or, if it is, if it is functional.

Same is true in Pensacola. The nearest chamber for civilians in a DCS situation is Mobile, Alabama. Remember, the Oriskiny is in Pensacola and is very deep. When diving it you are warned about the danger of DCS and lack of support for chambers.
We have lots of chambers in Florida but not for divers.

[shellmoundal]

Be patient. I am working very diligently in getting a chamber in Gainesville Florida that will be for divers only. This is a very involved task and tons of hoops to jump through. At some point and time I will be calling for volunteers to be trained as techs.
If there is a person out there that has the time and is very serious about this becoming a reality I would like to talk to them. I need a person who is not easily frustrated by the slow actions of the State and the County.

[ARY]

Time to teach in water recompression in full cave class. Given that some cave diving occurs in remote areas it would be a beneficial add to training programs. Also many cave students are not US divers and even if DAN insurance might be available world wide the chambers are not necessarily there. IMHO of course.

[PfcAJ]

Time to teach in water recompression in full cave class. Given that some cave diving occurs in remote areas it would be a beneficial add to training programs. Also many cave students are not US divers and even if DAN insurance might be available world wide the chambers are not necessarily there. IMHO of course.

IWR was part of my GUE Tech 2 course.

[Kelly Jessop]

I am a fan of IWR, but in a reluctant manner,because it may need proper triage to determine if appropriate , and what support is needed. FWIW, not to derail Kate's consolidation post (which I appreciate),perhaps another thread on IWR is needed

[OFG-1]

It is doubtful that most divers have the equipment or the gas to successfully perform IWR, let alone a copy of anything that resembles a treatment table.

Why don't you spend your efforts avoiding needing recompression? Will setting your crutch (computer) for a conservatism of 3 really ruin your day? I have dived with people who's goal was to get out of the water as soon as they could. I have had people exit the water 25 minutes before I did after the same dive, then made fun of me because of my computer settings.

How many of you can calculate ratio decompression on the fly? It is not perfect by any means, but if the ratio method tells you to spend 30 minutes at 10 feet, and your computer says 15, do you really have anything better to do with an extra 15 minutes? How many cut tables for the dives? What conservatism do you use on V Planner?

Do you jump out of the water and start lugging your gear around? Do you surface breathe O2, even for 15 minutes?

If you do get a hit, even a slight one, go and get checked for a PFO. I know several people that have had them repaired, and gone back to serious diving, including a WKPP diver that still dives Wakulla.

Stop bemoaning the fact that the chambers do not want to treat you, and avoid the need to visit one.

[cmint]

Just a thought...

could a scuba tank of nitrox or O2 be used to compress someone in one of these:

http://www.sosgroup.co/in-focus/37

http://www.rehabmart.com/product/sol...FcgjgQodo_sFVA

or if some extra money could be raised to do something like this:

(scroll down and look at the portable chamber being towed behind the truck)

https://whatsupatupstate.wordpress.c...e-rescue-team/

[kensuf]

It is doubtful that most divers have the equipment or the gas to successfully perform IWR, let alone a copy of anything that resembles a treatment table.

Why don't you spend your efforts avoiding needing recompression? Will setting your crutch (computer) for a conservatism of 3 really ruin your day? I have dived with people who's goal was to get out of the water as soon as they could. I have had people exit the water 25 minutes before I did after the same dive, then made fun of me because of my computer settings.

How many of you can calculate ratio decompression on the fly? It is not perfect by any means, but if the ratio method tells you to spend 30 minutes at 10 feet, and your computer says 15, do you really have anything better to do with an extra 15 minutes? How many cut tables for the dives? What conservatism do you use on V Planner?

Do you jump out of the water and start lugging your gear around? Do you surface breathe O2, even for 15 minutes?

If you do get a hit, even a slight one, go and get checked for a PFO. I know several people that have had them repaired, and gone back to serious diving, including a WKPP diver that still dives Wakulla.

Stop bemoaning the fact that the chambers do not want to treat you, and avoid the need to visit one.

Just quoting because there's a lot of gold in this. I'm also highlighting something that is serious and worth doing, having gone through a PFO closure myself and now back to some serious diving, I can attest that it's worth checking.

[renee]

I called DAN a few weeks ago to get a list. I'd post it but it may have changed. Orlando was not on it!