“Planning a dive trip: What to look for in an operator”
Medical facilities in remote locations
Divers should also be aware that the medical facilities in developing countries are often relatively basic and this generally becomes increasingly the case the more remote the location. For this reason, it is important to dive more cautiously and conservatively as there can be considerable delays before evacuation to a suitable facility, often distant and possibly in another country, can be achieved. It is also important to call a DAN Hotline as soon as possible if any symptoms develop after a dive. Prompt, appropriate and sufficient delivery of oxygen first aid can sometimes reduce or even clear some symptoms of decompression illness (DCI) but this should be done under appropriate diving medical guidance.
A shared responsibility
Safe diving is a shared responsibility between the diver and, to some extent, the dive operator with whom he or she dives. The diver needs to refrain from diving if concerned that the conditions are beyond their capabilities, or if they are not feeling well enough, or comfortable enough, to dive. Diving medical health and fitness is an essential part of safe diving and divers should regularly monitor their health and fitness. The diving environment can be stressful, both physically and mentally, and is relatively unforgiving. For example, a person who becomes unconscious on land may often be managed successfully, depending on the circumstances, whereas a diver who becomes unconscious in the water is at a high risk of drowning. Divers also need to follow appropriate advice from the operator and conduct their dives in a manner that is likely to ensure their safety.
However, divers often need to rely on the dive operator to provide important information about the dive sites and conditions. In addition, divers are often reliant on the functionality and safety of certain equipment provided by the operator, the purity of the breathing gas supplied, and safe and suitable transport to and from the sites. The operator is also expected to provide its services in a professional manner that should not endanger the diver. This includes having systems to reduce the chances of divers being unknowingly put into dangerous situations that could well have been foreseen by the operator with their local knowledge. This could include areas with treacherous down-currents and circumstances where the divers could be left at sea after the dive, among other things. The dive operator also has an obligation to provide ready access to suitable oxygen first aid equipment and an appropriate oxygen supply, as well as someone at the dive site who is trained and competent in its use.
Considerations for divers and dive operators
Below are some points to consider for both divers and dive operators alike:
Is the dive operator affiliated with a reputable dive-training organisation?Such affiliations can provide some, level of overview of the services provided. However, this cannot guarantee the safety of an operator\as it is difficult for agencies, to monitor operations, especially in distant places.
This issue is often overlooked. There have been some serious accidents, some fatal, as a result of contaminated breathing gas. In developed countries, there are often stringent standards and testing requirements. However, this is not the case in some developing countries where such requirements do not exist. This can be an expensive exercise but not impossible for the operators to do. It is an important safety measure and should be done. Safe diving is a shared responsibility between the diver and, to some extent, the dive operator with whom he or she dives.
The recommended test period varies between countries, from about one to five years. Visual inspections for corrosion and cracking are required more frequently. On rare occasions, cylinders have exploded and have killed or maimed nearby persons. Are the cylinder valves in good condition? Do they operate smoothly and are they free of leaks?
Infections can occasionally be transferred between users of such equipment and it should therefore be cleaned and sterilised using appropriate procedures after each use.
Appropriate oxygen equipment should be capable of supplying near -100% oxygen to a breathing diver by both a demand valve and a high concentration constant flow mask (e.g. non-rebreather mask). It should also be capable of supplying at least 50% oxygen to a non-breathing diver.
Can the oxygen delivery system provide oxygen to more than one diver at a time?
It is important that oxygen equipment and a trained oxygen provider are available where the diving is taking place. This often means on the dive boat. In a serious case of decompression illness (e.g. an arterial gas embolism), it is important that the victim begins breathing high concentration oxygen as soon as possible.
This needs to provide near-100% oxygen to a diver or divers for the likely period required before an evacuation team arrives. In some places, this means a supply that will last more than 24 hours of constant oxygen administration.
There should be staff available who is trained and currently competent in oxygen provision, basic first aid and CPR. It is not enough to simply have had basic training. The staff must practice to maintain familiarity and competency in these skills. This is more essential in remote locations without prompt access to good medical care. DAN offers appropriate training, often at a higher level than many others.
This should include a prompt call to a DAN hotline for advice, provision of basic life support and first aid, and knowledge of the local medical centres and suitable chambers. Be aware that most medical personnel have little or no knowledge of diving medicine, and may therefore find it very difficult to diagnose and provide correct management for some potentially serious diving injuries. By calling a DAN hotline, expert diving medical advice is accessible 24 hours a day for a diving emergency.
This is important anywhere, but especially important when distant from land. Do they provide adequate, clean drinking water on the dive boat?
Adequate hydration is important to reduce the potential risk of DCI, as well as conditions such as heat exhaustion, a common potential problem in warm climates. Divers should be actively encouraged to hydrate sufficiently. Clear or nearly clear urine can provide a rough indication of adequate hydration.
This is important in warmer climates and even more important if the dive sites are distant from the base.
Divers can easily be injured entering the water if the entry point(s) are not suitable. Exertion on exiting the water should be minimised to avoid precipitating DCI or cardiac stress after the dive.
Such arrangements should allow comfortable decompression for a group of divers and should be appropriate to the level of difficulty of the dives, the number of divers, and the decompression obligations that might be expected.
If compulsory decompression is expected, a more complex system will be required which may need to incorporate decompression stations at multiple depths.
Travelling divers have a widely varying range of expectations when it comes to being led underwater.
Some prefer to be left alone, while others prefer to have the dive closely monitored by the dive guide. It is helpful to know if the dive operator’s procedures will match the needs and expectations of your group.
If the latter, it is essential to obtain prior knowledge of local conditions and to ensure that divers have adequate experience for this.
Enjoy your diving but be responsible and prepared!
Article by John Lippmann and reprinted with the permission of the Divers Alert Network Asia-Pacific