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Hyperbaric assistance provided to a scuba diver

31/08/2012 - Giglio Island

The Titan-Micoperi divers team provided hyperbaric medical assistance to a scuba diver that had decompression disease after a recreational dive.

At 14:13, a rubber tender with 3 men on board approached to the red pier close to the hyperbaric chamber installed by the Titan-Micoperi for hyperbaric emergency response in the work site.

Two person on board the tender were screaming for help while the other one was lying down on the deck unconscious. In the same time, some Titan-Micoperi divers that were checking dive equipment on the red pier, seeing the happening, immediately made available a stretcher in order to pick up the injured person. 

The injured diver was unconscious and showed clearly the signs of decompression sickness: froth from mouth , tremors, gasp, upside eyes and light nosebleed. Immediately the dive master of Titan-Micoperi that was also on the red pier ask information to the companion of the injured diver about the causes of the decompression disease.
It was reported that the injured diver made the following series of dives without decompression phase: 1) 51mt -23min - 2) 43mt for 16 min - 3) 56.7 for 13 min and a deco phase at 9mt for only 3 min The dive master Mr. Antonio Gianfreda staying in touch by phone with the Micoperi Hyperbaric doctor of Ravenna Hyperbaric Center started at 14:17 the medical treatment using the hyperbaric chamber. In the mean time the salvage room was alerted and the HSE dept immediately informed the Coast Guard about the happening and through them required the medical assistance. Also the Client has been informed. Three people got inside the hyperbaric chamber: the injured diver on the stretcher, his companion and one diver medic. Mr Antonio Gianfreda seeing the condition of the injured diver and the decompression missed proceed to hyperbaric chamber treatment using the Table n°6.
After a few minutes of treatment the diver was again conscious. At 14:25 the doctor of the local 118 first aid facilities arrived. Mr. Antonio Gianfreda, that was maneuvering the chamber, required to the 118’s doctor the intervention on site of an hyperbaric doctor. Immediately the doctor called for hyperbaric assistance by phone but it seems that no hyperbaric medic were available to come on Giglio Island in order to provide direct assistance. In the mean time the Micoperi hyperbaric doctor continues to give medical assistance by phone to Mr Antonio Gianfreda.
At 14:50 the 118’s doctor on site received instruction by phone to give direct assistance to the patient entering in the hyperbaric chamber. The doctor, escorted by one diver, tried to reach the patient in the hyperbaric chamber but , when inside the first compartment he had problem in the ear equalization. Only the diver medic inside the chamber continued to give assistance to the patient.
Seeing that no hyperbaric doctor arrived, at 15:20 the undersign called by phone the Director of Sanitary facilities in the Region of Tuscany in order to report the happening and to speed up the hyperbaric doctor request.
At 16:00 an helicopter departed from Massa Carrara in order to pick up an hyperbaric doctor in Grosseto hospital and to bring him in Giglio Island.
In the mean time the Coast Guard alerted a SAR vessel in order to transferred ashore the injured diver after the hyperbaric chamber treatment.

At 17:05 the helicopter Pegaso landed in Giglio Island. At 17:32 the hyperbaric doctor Dr Paolo Tanasi arrived in the red pier. He decided to stop the hyperbaric treatment one hour and an half before the end of the treatment as per the Table 6 (see attached the letter of assumption of responsibility).
At 17:35 as per instruction of the hyperbaric doctor, Mr Antonio Gianfreda started the cycle of decompression to bring back the patient to the atmosphere pressure.
At 18:07 the patient went out of the chamber standing up on his legs and immediately picked up by an ambulance for further transport by helicopter in Grosseto Hospital.

The dive equipment of the injured diver has been seized by the Coast Guard for further investigation. Further investigation will follow in order to clarify the delay of the intervention on site of the hyperbaric doctor. The detailed page of the Hyperbaric chamber log book is available for further analysis.

Paolo Di Blasio
Site Safety Coordinator