The hyperbaric chamber

Posted on July 7, 2018

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The hyperbaric chamber is a place no diver ever wants to be sent. It’s a confined, airtight capsule that is pressurised to a specific depth to try to rebalance a diver who is suffering decompression sickness (DCS).

Last Friday night. (July 29) I watched a colleague go through this ordeal for five hours. We were evacuated by helicopter to the US Virgin Islands and with an oxygen mask still clamped to his face. He was examined by a doctor on arrival and given the green light for treatment immediately. It was a surreal experience to be witness to and scary and emotional to be part of. Something I hope I never have to repeat.

DCS affects the body in different ways. Some divers break out into a rash, others suffer pain in their joints, tingling, headaches, loss of sensation in their limbs and others suffer blurred vision. The symptoms don’t always surface immediately because it can take up to 48 hours. Usually it’s brought on due to surfacing from depth far too quickly, breaking standards of depth limits or if you’re not in good physical shape repetitive dives it seems can also impact your health.

The night before this incident a teenager in our fleet who’d been diving earlier that day started to complain of dizziness, a headache and a severe pain behind his eye socket. His condition started to deteriorate while we were docked at Nanny Cay. I was asked to interview him and see what I thought.

We were sent on a med run that night to the local hospital to check it out. At first his symptoms confused doctors who ordered a full blood count to ensure it wasn’t dengue or chikengunya, both mosquito spread diseases that are currently present in this area. His platelet count came back healthy. Mild DCS now looked the culprit.

The kid told me was born with “essential tremors” a condition that he doesn’t take medication for. He told me his hands shake in the morning and when his blood sugar is low or when he’s stressed or nervous. It’s a neurological condition. I relayed this to the doctor.

On learning this the experts were now convinced it was DCS. He was given 100% oxygen to help alleviate the symptoms. His blurred vision was the most concerning. I had to fill out his paperwork, call his father in the States numerous times. He’s since been banned from further diving. I’ve told him to see a dive doctor when he gets home if he wants to dive again. I stayed five hours with him in hospital updating his family and my boss. He was kept in overnight and by the time I headed back to the boat it was past 10pm. I promised to come back in the morning and to give his father an updated condition check after the doctors had done their morning rounds.

It was a worrying situation for one so young. I had no idea that the next day while my young teen had made solid progress thanks to continuous oxygen, in a room two doors down my colleague had checked himself in at 3am.

As soon as I saw him lying upright in the bed, he burst into tears.

“Thank god you’re here Asha,”he said blubbering through the tears reaching one hand out. I gave him a tight hug and squeezed his hand.

He was breathing rapidly and his right hand had a cannula inserted into it. They we’re giving him fluids to help rehydrate him too.

“I’m just glad you’re here,” he said shaking. “They just don’t know what they’re doing here. I need your help. They won’t give me my dive documents. I can’t feel my arm mate.”

“It’s ok love, I’m here now,” I said reassuring him. “Don’t stress. I’ll deal with whatever you need to get this fixed.”

Over the space of another three hours, I called his PADI insurance in Australia to get them onto activating a claim. Emailed his mother, filled out paperwork in the hospital, was the go between the head doctor and my superiors. Rang Divers Alert Network to get them to make sure the chamber in St Thomas was staffed. All paperwork had to be verified and insurance processed before we could get a medical evacuation. I called the office to get our passports and ETSA forms for the trip across to US soil. My colleague had to have a CT scan and chest X-ray as procedure. He was panicking and trying to get involved which took some persuasion to tell him to step back and to trust me. His heart rate was all over the place.

We left the hospital, picked up an oxygen cylinder for him to breath from as we approached the airport. Waiting for us was the hyperbaric chamber operator. Another oxygen cylinder was ready for him as we got onto a small chopper with just four seats.

We flew low and fast across the ocean. The wind pushing us. We landed softly and without drama, were processed by customs and got back in the chopper. Twenty minutes later we landed at the helipad at the hospital emergency department.

More paperwork, I can’t tell you how many times I wrote out his DOB and address that day. I handed over a disc with his chest X-ray and CT scan to the doctor there along with paperwork from Tortola. Within 40mins he was locked in the chamber.

He started at a depth of 18m (60 feet) and each hour the depth inside the chamber changed as he was slowly brought up. I went out to get a food run and bring back his dinner. Halfway through the session one hatch is opened and food left inside for him to take. He gets a 15 minute break to eat inside before it continues. He was only allowed to wear cotton clothing because anything else can give off toxic fumes at pressure. I rummaged through his backpack for suitable clothes. The chamber temperature was chilly and by the end of it he looked like a badly dressed teenager wearing several layers desperate to stay warm.

Being stuck in a chamber can challenge anyone’s mental state let alone feeling pressure on your airways. He had to equalise constantly and experienced a reverse squeeze. Pressure building up as the depth gets shallower as he’s “brought back up”. I was able to talk to him through the whole process via an old antiquated talkback button. The chamber was donated by NASA in the 1960s and has had a who’s who of famous divers visit it for publicity photos as well as treatment.

I’ve no idea what was going through my friend’s mind but he coped pretty well can considering. When he finally staggered out of the capsule five hours later, he was exhausted but deliriously happy. “Asha thank you,”he said gripping me tightly getting emotional, I’ve no idea what I would have done without you mate. Thank you.”

It was the craziest Friday night I’ve spent in years. “It goes without saying,”I replied. “I’m just glad i could help.”

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