潜水意外分享(英语Case Study)。。。

蓝月

刚刚从另一个Forum 看到，在这分享一下，但是英文版。我文笔不好希望哪位‘才子，才女’帮忙翻译下。。

Just for info.


Case Study: It Started on an Open Water Diving Course

By Mel Cefai

Somemonths back, a mother (Sue*) and daughter (Sarah*) were enjoying aholiday together in Malaysia. Living in different countries, this wasan opportunity for mother and daughter to enjoy some time together.Sarah decided to undertake an Advanced Open Water Course and Sue signedup for an Open Water Course.


Getting Started

Sue’sincident took place during the first open water dive on the course. Ittook place at a depth of between 16m-18m when her mask was full ofwater and she couldn't breathe. Although having undertaken basic skillstraining the previous day, in Sue’s moment of panic she simply did notknow how to remedy the situation. She desperately wanted to ascend. Theinstructor kept signalling for her to breathe but she was suffocating.Unfortunately the instructor did not take further control by physicallyassisting Sue in clearing the mask, so Sue surfaced, quickly, becauseshe could not breathe. Sue was choking while exiting the water andimmediately felt pain in her neck and head as well as nausea. Thesesymptoms were relayed to the instructor. The instructor told her tosit, rest, drink a lot of water, and was happy for Sue to take part inthe second dive once she had rested.

Sue could not move, she hadher head in her hands for a while and rested because she could notwalk. Soon she needed to vomit so managed to get to the bathroom. Shejoined the other students for a while and just tried to get throughwhat she was feeling.

Taking Control of the Situation

Feelingno better, Sue decided that there was no way she could do the seconddive so went back to her room. Unfortunately, none of the staff wereconcerned with Sue’s condition. Luckily, Sarah ran into her mum on theway back to her room and witnessed how awful she looked. Sue was intears as soon as she saw Sarah. Once in the room Sue rested on the bedand relayed what happened to Sarah, who immediately ran for help. As adiver, Sarah knew that having ascended so quickly, and exhibiting suchblatant symptoms, which now extended to pain at the base of her skullin the nape of her neck and radiating up the back of her head,indicated that she could very well be suffering from DCI. Once Sarahfound help, the wheels were set in motion. The resort staffadministered oxygen for a short period; however, Sarah noted that thetank was leaking so Sue was not receiving the full benefit of theoxygen.

Sue was referred to the nearest hospital and wastransferred by speedboat to the hospital on the mainland, some45-minutes away. Unfortunately, Sue was not provided oxygen throughoutthis journey.

Chamber Treatment is Not Needed

Sue wasadmitted to the emergency room. She was given oxygen, and had a chestx-ray performed (results all clear). They also tried to administer anIV, but that went totally sour when they couldn't do it properly andcaused Sue further excruciating pain. So Sarah instructed them to stopand instead provided Sue with water consistently in place of the IV.

Theywere then transferred to the inpatient ward, where they had to stay forobservation for 24-48 hours. The doctor suggested that oxygen was thebest treatment. Based on the doctors analysis of Sue he decided thattreatment in the recompression chamber wasn’t necessary at the time.Sarah, as a certified diver was not happy with this recommendation.Based on her previous readings and the superficial checks shepersonally performed on her mum, she knew that treatment in a chamberwas imperative.


So I Called DAN

By this stage, some14-hours had passed since Sue had shot to the surface, following thatfirst open water dive. In a complete state of despair, watching her mumsuffer as she was, Sarah contacted DAN.

DAN AP ExecutiveDirector, John Lippmann and I were in John’s car driving to a meetingwhen we received a call from Sarah. This was a great opportunity for meto witness first hand the work of DAN and the significant role that DANplays in diving emergencies. Sarah was in a highly stressed state, sheclearly felt helpless watching her mum as she suffered in the hospitalbed, feeling that her mum was not being given the level of care sheneeded. She just needed somebody to step in and help her.

Duringthis call, John Lippmann conferenced into the conversation a divingdoctor at the DES Hotline and also a diving doctor in Malaysia. Johnand the DES doctor asked Sarah questions on behalf of her mother inorder to learn more about Sue’s symptoms to facilitate a diagnosis ofSue’s condition. The conclusion to this call? Get Sue into a HyperbaricChamber immediately. This was soon arranged and Sue was admitted to thenearby hyperbaric chamber.


                                                                                                                                                                                                                                                                                                        

蓝月

Finally, relief

I could hear the relief in Sarah’s voice.Clearly it was of value for Sarah to be speaking to people who had agreat understanding of diving-related illnesses and their associatedsymptoms in order to be able to identify the treatment Sue required.Sarah was very grateful for DAN’s involvement after having felt soalone and scared for so many hours since the incident first occurred.

WhatI haven’t mentioned is that Sue was not a DAN Member. So while DAN wasthere to assist Sarah with advice, we were not in a position toorganize or pay for the evacuation/treatment. Had she been a Member andimmediately called DAN, it is highly likely that Sue would have alreadycommenced her treatment in the chamber, rather than still trying to getthe attending physician to recognise the symptoms and acknowledge howserious the situation actually was.

The only downside to thisconversation is that it messed up John’s navigation and we became lostfor a while, but still managed to get to the meeting on time! However,it really does show the reality. DAN and its Hotlines receive calls forhelp at all hours of the day, and often the middle of the night. When acall is received the DAN Team stop whatever they are doing to give thecaller the attention required to effectively deal with a situation. Andseeing the organisation in action, and the level of care that isprovided, really highlights how beneficial a support network like DANreally is.

On the Way to Recovery

The patient received analmost five-hour treatment in the chamber at the Semporna NavalHospital and was notably in better condition afterwards, much toSarah’s relief. Sue was more alert, conversational and in much lesspain. The following day, Sue still had pain in her neck, a sore lowerback and some occasional shooting pains in her head. The doctorsconducted neurological tests and Sue was much more stable on her feet.She could stand with one foot in front of the other with her eyesclosed for one minute, as well as complete the heel to toe test steadyon her feet with no problem. Just 24-hours earlier Sue could notachieve either.

John Lippmann continued to stay in contactwith Sarah via phone and email for the coming days and weeks to makesure Sue was recovering well and to monitor her after various homewardflights. Many months later we are delighted to advise that Sue has madea full recovery but is not looking to complete her Open Water courseany time soon.

Thank you to all involved


Sue and Sarah pass on the following thanks:

Thankyou for all your help and support John! You’ve been truly wonderful. Iappreciate the advice and concern of Dr Suzy Szekely (from the DES), DrTony Lee and yourself, despite us not being members. I was justcompletely alone with no support, little information and no propermedical support/attention for 14 hours prior to receiving your call(despite being in hospital), so I took matters into my own hands byreaching out to anyone who could provide me with sound advice andsecond opinions with regards to diving issues/treatment. DAN seemedlike a good place to start. You've been more than helpful. I assure youI wouldn't have been nearly as comfortable with the situation had I nothad your guidance. There's nothing worse than feeling helpless,especially when it involves the health of your family in a foreigncountry, and you were a huge factor in keeping me productively involved

蓝月

一位潜水教练的感想。。。
I'm a firm believer in prevention rather than cure.

Firstly, why is the first dive in an OW course at a depth of 16 - 18m???

from PADI instructor manual standards:

You must conduct the Open Water Dives at a dive site with conditions
and environment suitable for beginning divers. The maximum planned
depth for Open Water Dives 1 and 2 must not exceed 12 metres/40 feet.

During the pool sessions, I let my students practise coughing while holding the regulator in place. This gives them the confidence that in the unlikely event they do get some water in their mouth/throat and start coughing, they need not accend to the surface. On the surface, we also discuss circumstances when an emergency accend to the surface would be likely and clear all their doubts about "shooting to the surface". (A major no no!!)

Exercises such as mask removal and the no mask swim further elaborates to the student how they can handle a mask problem in water.

As the incident indicates, many countries, including ours, are not fully equipped to handle diving related problems or injuries. (This includes stings from potentially lethal animals such as the blue ring octopus, etc.)

The good work by DAN could have saved the day for the person involved here but it is best to prevent yourself, your friends or your students from getting into similar situations.

anelva

谢谢分享~~

GeoLink

太长了, 懒惰翻译啊..
事情发生在SIPADAN一带啊?

蓝月

太长了, 懒惰翻译啊..
事情发生在SIPADAN一带啊?
GeoLink 发表于 10-7-2010 12:20 AM

看来是。。。也会有可能是Layang layang 那一带吧？不懂那边有多少个Chamber facilities。。。