Re: ...actually, i had a slightly different q...

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Posted by Karl E. Huggins - USC Catalina Hyperbaric Chamber on August 25, 2000 at 19:47:56:

In Reply to: ...actually, i had a slightly different q... posted by kelphead on August 25, 2000 at 11:03:40:

Was this a doctor who actually works at DAN or was it one of the physicians that DAN refers divers to?
There can be different perspectives at work.
However in both cases most of the local cases that get routed through a physician at DAN are delayed cases.
These are the cases where the diver ignores a problem during the dive trip, or the problem crops up a couple hours later, and is ignored until they are back home or even a couple days later.
For these non-emergency cases they would more than likely be sent to one of the mainland chambers like Northridge because of ease of transport and expense.
In fact if you look at our cases here, over the last 25 years that we have been treating divers, the number of decompression sickness (DCS) cases (and re-treatments) treated here dropped dramatically in 1985, which is when Northridge Chamber opened.
This was due to the fact that the non-emergent DCS cases on the mainland went to Northridge instead of being transported to the island.
For follow-up treatments it was easier for the patient to be taken back to the mainland and taken care of there.
However the numbers of air embolisms cases we got remained about the same.
This is because we get almost all of the emergency diving accident cases in this area.
These are the cases that are worked up by the local EMS (Lifeguard, Coast Guard, 911, etc.) and never get called into a national network like DAN.
If they do get called into DAN the medic on-call will get the caller to activate the local EMS, and a physician at DAN might not get into the loop.
Because we only treat divers, are on-call 24 hours a day - 365 days a year, and are considered an extension of LAC+USC Medical Center's Department of Emergency Medicine, we are set up to handle these emergencies.
If you had an emergency diving accident in Southern California where the EMS was activated you would generally go to one of four chambers.
* In the Monterey area you would be taken to the Pacific Grove Chamber
* From the Northern Channel Islands area you would generally be taken to Pleasant Valley Chamber although we get divers from that area occasionally (for those of you who do not know, the Los Robles Chamber closed at the end of February)
* From Santa Barbara Island, San Nicholas, the northern part of San Clamente Island, and Catalina Island you would come to the USC Catalina Hyperbaric Chamber
* From the southern part of San Clamente Island and south you would go to UCSD Medical Center's Chamber
There are of course other chambers that occasionally will get emergency cases, like Northridge Chamber.
So for this local area we are the primary chamber for emergency diving accidents and Northridge was a primary chamber for non-emergency cases.
That being said I am sad to report (for those of you who did not see the LA Times article) that as of July 31st the Northridge Chamber also closed.
It is unknown at this time if they will ever open up again.
It is possible that the UCLA Chamber be taking over the non-emergent cases and re-treatments since they also have a large multi-place chamber set-up.
So far we have only treated one non-emergency case this summer that would have normally gone to Northridge so we may not have an increase of non-emergency cases.
However this summer seems to be keeping some of the chambers hopping.
UCSD Medical Center Chamber had either 5 divers in 7 days or 7 divers in 5 days (can't remember exactly but that is still an awful lot of hurt divers)
The Catalina Hyperbaric Chamber has had at least one diver brought in each week since the middle of July with our last treatment lasting 12 hours (from 11:30 pm to 11:30 am - this is what 24 hours a day means).
So as the water continues to warm up and beckons all you divers, just remember the words of Sergeant Esterhaus from Hill Street Blues... "Let's be careful out there!"

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