Dealing with emergencies
Medical emergencies that occur during diving are usually caused by adverse pressure effects during rapid ascent (dysbarism or barotrauma) or the formation of nitrogen bubbles in the tissues (decompression sickness, DCS). Both can be avoided by safe diving practices, but when they occur, require rapid intervention to prevent further injury or death. Any acute symptoms on surfacing from a dive should be considered to be dive-related until proven otherwise. Typical symptoms of decompression sickness include:
• limb or joint pain, tingling or ‘pins and needles’
• chest, stomach or back pain
• muscle weakness, often in the legs
• loss of balance
• general weakness
• visual disturbances and confusion
• mottled or spotty red skin rash
• difficulty breathing or breathlessness
• coughing and pink frothy sputum
Round Trip Mozambique Photo Gallery
In all cases, the same basic treatment applies:
• The victim should be reassured, allowed to lie down, kept calm, and kept warm.
• If available, oxygen should be given with a snug mask or demand valve.
• In-water recompression should not be attempted unless expert assistance is available.
• The emergency plan should be implemented and the victim transferred as rapidly as possible to a dive doctor and recompression chamber.
• Gather as much useful information as possible, including: dive history and profile (max depth, duration, safety and decompression stops of all recent dives, history of rapid ascent), time of surfacing, time of onset of symptoms, underlying medical conditions, treatment steps undertaken, medical insurance information, etc.
• Don’t forget to check the diver’s buddy, who is equally at risk!
Recompression chamber facilities in Mozambique
At the time of writing, there are no recompression chamber facilities in reliable operation in Mozambique. Fortunately, healthcare and chamber facilities in neighbouring South Africa are of a very high standard. Evacuation by air to a chamber in Durban (or even Cape Town) can be achieved within a matter of a few hours if logistic and insurance arrangements are in place. There are no medical helicopter services available in Mozambique, although private aircraft (such as resort-owned helicopters) may be used to assist. In the very far south (Ponto do Ouro and surrounds), it may be feasible to move the patient overland to the border, and airlift, to Richards Bay from there. In other areas, an air ambulance will have to be dispatched, which will incur delays with customs and immigration. It is strongly recommended to have specific insurance cover, or membership of an organisation such as the Divers Alert Network, who are well versed in dealing with these challenges (see below).