Triage and emergency evacuation of recreational divers: a case series analysis.

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Triage and emergency evacuation of recreational divers: a case series analysis.

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Title: Triage and emergency evacuation of recreational divers: a case series analysis.
Author: Zeindler, PR; Freiberger, JJ
Abstract: INTRODUCTION: It is unknown if the benefits of rapid treatment always outweigh the risks of emergency evacuation for recreational divers. To investigate current triage practice, we reviewed a three-year consecutive series of evacuations and analyzed the relationship of evacuation completion time (EvCT) to outcome in the decompression illness (DCI) cases. METHODS: Checkbox-keyword searches of calls to Divers Alert Network (DAN) between 4/06 and 2/09 identified cases for review. RESULTS: Of 24,275 calls, 107 were evacuations. Median EvCT, (defined as time from injury to arrival at treatment facility) was 20 hours (mean +/- SD, 27.3 +/- 27.2). Indications were: DCI 56 percent (60), medical illness 28 percent (30) or trauma 16 percent (17). Twenty-five percent of medically indicated evacuations were for pre-existing conditions. One-third of all DCI air evacuations (17 of 51) were for mild cases (pain or tingling only). EvCT and presentation severity were not significant predictors of DCI outcome; however, early data (less than 6 hours) was sparse. CONCLUSION: More data are needed assess the benefits of faster evacuations. However, in real-world scenarios with EvCTs in the 20-hour range, time did not influence outcome. Risk-benefit analysis of emergency transport is advised, especially for mild cases of DCI with a low probability of symptom progression.
Description: Undersea and Hyperbaric Medicine : Journal of the Undersea and Hyperbaric Medical Society, Inc.
URI: http://archive.rubicon-foundation.org/9490
Date: 2010

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