Consider this scenario for emergency evacuation
An experienced diver and his partner choose a dive destination they don’t consider remote so in the event of an incident, treatment and evacuation won’t be a problem. The destination is an island off Fiji, which is a relatively short distance from Australia.
As it happens, a serious incident does occur – it involves paralysis of the lower limbs and loss of vision. The divers call DAN to discuss the diver’s symptoms as well as the dive profiles and the location. In this instance, it is quickly determined that the diver needs higher level medical care than can be provided at the local medical centre.
DAN’s preference was to arrange an air ambulance to fly the diver directly to Australia, but that would have taken time to arrange, and there was concern that the oxygen supply at the local medical facility would run out before the flight was available.
Thus, the decision was made to evacuate the diver via a 35-minute helicopter trip to Suva hospital, which had a chamber. There the diver was recompressed, but DAN wanted a more-aggressive treatment plan and as such a decision was made to evacuate the diver by air ambulance to Australia.
Ultimately, the two air evacuations cost in excess of US$110,000, but the diver recovered well and continued to do so in the following months.
Challenges involved in an evacuation
Even though DAN are the experts in dive accident management — with 40 years of experience dealing with emergency medical evacuations all over the world — the unique set of circumstances of each case can and do create challenges. In this case, while the island of Kadavu has a landing strip, the strip is unlit, and therefore night-flight restrictions are imposed. Plus, there was red tape that had to be met for air ambulances to receive permission to enter the country.
When arranging medical evacuations for divers, DAN case managers are often faced with an array of challenges that many people are unaware. These challenges can lead to time delays and frustration for the diver and the case managers.
These challenges can include
- Ensuring the diver is stable enough to be evacuated
- Bad weather preventing an air ambulance from landing or departing
- Meeting entry and visa requirements
- Organising a medical team for an air ambulance to fly in from another country
- Lack of an airport or appropriate landing strip
- Sometimes an air evacuation isn’t possible, and a boat needs to be sent to meet a liveaboard to evacuate a diver
- Sometimes it is quicker for the dive operator to organise local transport, but this must be done in consultation with DAN if the transport cost is to be covered by DAN
As divers travel to more remote locations, they should be aware of the various challenges that may exist and take steps to minimise their risk. Diving conservatively, taking long surface intervals, remaining hydrated, and getting lots of rest are all important in reducing the risks. Divers should also ensure that the operator they choose to dive with is prepared for a medical emergency with plenty of oxygen on board and a suitable emergency action plan to follow.
Finally, having DAN coverage is vital. Evacuations such as these are not easy to organise and are certainly not cheap. For DAN members all this is taken care of - leaving you with much less to worry about.