Diving Medical Emergency Course in Tasmania puts Doctors in the Deep End
“Hundreds of metres underwater, divers work far from sunlight in the cold and alien world of the deep sea. Their voices rise to a high-pitched squeak as they breath helium, and they rely on hot water pumped around their suits to stay warm.
Saturation divers stay confined to their tanks, leaving for construction and maintenance work on oil infrastructure, salvage work and other projects. It can take many days to walk freely at surface level once their work is finished, as they stay in their chambers readjusting to normal pressure and avoiding decompression sickness. Their work on deep water projects puts them at risk. The materials they work with are heavy and pressure levels are high.
Diving medicine specialists receive diver medic training
Their hands can get jammed, they can break their bones, have their gas supply cut off, or get caught in explosions. The diver’s partner will have to rescue them and bring them back to the chamber. But at such depths, the need to decompress means doctors can’t easily reach them physically, Hobart-based specialist in diving medicine Dr David Smart said. “They’re actually further away from earth than the astronauts on the moon.”
A group of 19 diving medicine specialists travelled to northern Tasmania to learn how to treat saturation divers despite the barriers. Between April 10-16, Dr Smart and three other instructors led diver medic training for the doctors at The Underwater Centre, which trains commercial divers in both air and saturation diving at Beauty Point and Lake Cethana.
Visiting doctors, travelling from as far as the United Kingdom, Germany, Canada, Portugal and Indonesia, saw the saturation diving system the Centre uses to train divers. The training is the first of its kind in Australia and New Zealand to receive international accreditation.
The Underwater Centre‘s Operational Director, Allan Brown, said there was an element of prestige involved in the project. “These are very qualified people already who are coming to learn more in Tasmania.” The Centre’s equipment, which includes an easily-accessible saturation diving system at Lake Cethana, enabled the training to take place in the state.
Only two other diving facilities outside the United States are equipped to host the course. Drills gave doctors experience in managing deep water medical emergencies. “It’s a different way of practising to what you’d normally expect,” Dr Smart said. The helium that divers breathe saps heat from their bodies 30 times more than normal air, making them vulnerable to body temperature changes. “Divers can get very cold or hot very quickly.” They’re at peril without heating in their wetsuits and chambers, which are warmed to tropical levels of 28-32 degrees Celsius. “That can be a very serious emergency.”
Reliant on the diving team medic
Stakes are high on expensive projects underwater. A whole team can stop functioning if one of its members is injured or becomes unwell underwater, Dr Smart said. “It could cost millions of dollars if a diving operation has to be aborted.”
Saturation diving creates an alien environment. Doctors need to learn the limitations it imposes, he said. In medical emergencies doctors sometimes can’t see the diver needing help, unless they have a video link. They rely on a diving team medic to describe what they see, and perform treatment needed. “They are initially our hands, eyes and ears inside the hyperbaric chamber.” Doctors have to direct the divers in managing their colleagues’ trauma with first aid.
Responding to underwater medical emergencies
Medics pack injuries with disinfectant, and give antibiotics. At rare times, doctors have to go into the chamber themselves to perform life support procedures or conduct surgery. The distortion of voices helium causes can make divers unintelligible to doctors directing the response. Someone accustomed to the divers’ high-pitched tone at times has to translate. Electronic devices can also unscramble their speech.
Responding to underwater medical emergencies can be extremely stressful, Dr Smart said. The increased heat inside saturation chambers puts injured divers at higher risk of infection. Doctors have to juggle the risk of prolonging patients’ exposure to these conditions against putting them in danger of the bends by speeding their decompression. “We know every minute the diver is in the chamber adds to the risk.”
A previous lack of training in medical assistance for saturation divers
Dr Smart joined three other internationally-renowned colleagues, Britain’s Dr Phil Bryson, Canada’s Dr Debbie Pestell and Melbourne’s Dr Ian Millar, in devising the course after they found five years ago there was a lack of training in medical assistance for saturation divers.
“It’s important I get the next generation of doctors having the sort of knowledge I’ve been able to acquire throughout my career,” he said.
Western Australian diving medicine specialist Dr Neil Banham completed mock rescues during the course. Divers receiving instructions needed to stay calm, he said. The doctor, who works at Fiona Stanley Hospital, Perth, joined colleagues from overseas, and every Australian state and territory except the Northern Territory, in the mock drills. There were few people with the expertise and experience to provide saturation diving medical support, he said.
An increase in offshore projects around Australia’s coast would probably enlarge demand. “It’s a very niche area and we often get calls from diving companies that do employ saturation divers to be around in case assistance is required,” he said.
Dr Smart plans to run another training program for doctors next year.”
This article about the training – Medical Support of Occupational Offshore and Saturation Diving Level 2 Course, approved by DMAC – originally appeared in The Examiner on 20th April 2016. If you are interested in finding out more about the diverse range of diver training at The Underwater Centre in Tasmania please get in touch with Jen by calling +61 3 6383 4844 or emailing [email protected]