Rural practitioners probably come across diving emergencies more often than other medical professionals. Reasons for this include
- participation in local rescue teams (including lifeboat and coastguard teams)
- requests to attend incidents in a BASICS capacity where divers have surfaced – but too quickly
- emergency or delayed presentations to the surgery or community hospital, often when signs are more advanced
There are some specific recommendations when dealing with diving emergencies. One of the most important conditions to be aware of is ‘the bends’ or decompression illness – caused by formation of nitrogen bubbles in the blood stream, which can lead to neurological problems including stroke.
If someone presented to your local A&E unit, would you know what to do? There are a number of sources for assistance.
- The Emergency Medical Retrieval Service (EMRS) have a specific guideline for dealing with diving emergencies, and as ever, this contains extremely succinct and relevant information, along with useful contact numbers.
- The Scottish Diving Medicine website contains some useful background information on the facilities available in Scotland, along with some useful checklists for assessment of diving emergencies.
In summary, emergency management of a diver presenting with symptoms of the bends should include:
- keep the patient lying flat to avoid bubbles migrating to the brain
- high flow oxygen
- management of hypothermia and dehydration, common especially after prolonged dives
- early expert advice and rapid transfer to a hyperbaric facility, if advised that this is necessary
This video from the Diving Diseases Research Centre in Plymouth explains more about the condition.