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The DAN medical staffers are on call, no matter where you – or they – may be.
DAN Medic Dan Nord had just drifted off to sleep. He was lying next to his 8-year-old son, Jacob, in a pup tent deep in the mountains of North Carolina. All day long father and son had been going full tilt at a Boy Scout Camporee, Jacob busy with knot-tying classes and rides on the zip line, Dan leading events for some of the 200 boys convened for the weekend.
They had both fallen asleep quickly, despite the hard ground and the occasional chatter from nearby tents. And then Dan's emergency pager sounded. He sat up in the darkness and stared at the faint green light of the pager's display.
It was Duke University Medical Center, with a call from DAN's Diving Emergency Hotline - no surprise, really. In fact, the only real surprise was that Dan had not been paged all day long, when, normally, on any given Saturday, he would have been paged at least six or seven times.
He fished his cell phone out of his backpack and dialed the familiar number. The operator, after greeting him by name, patched him through to a DAN member in Baltra, Galapagos Islands.
"I'm on a ship-to-shore radio with one of our dive boats," the man announced. "We've got a divemaster who's got shoulder pain and numbness and tingling throughout his arm [after a dive]."
Every year since DAN's Diving Emergency Hotline began operations in 1981, the number of emergency medical calls to DAN – like the one above – has increased. Three full-time medics now answer the DAN Medical Information Line Monday through Friday, from 9 a.m. to 5 p.m. Eastern Time. These same medics, backed up by a group of senior staff attending physicians at Duke's hyperbaric facility, are also on duty after hours. To date, DAN has answered more than 43,000 emergency calls since the first back in ྍ.
During the same period, DAN has handled more than 196,000 calls to the MedicalInformation Line, and since 1995, DAN has fielded well over 31,000 emails. In addition, DAN's database of dive medical physicians is a resource for the diving community, referring divers to nearly 800 physicians around the world.
After 25 minutes of questions - the questions, of course, had to be relayed from Dan to the ship-to-shore operator and then to the patient and back again - Nord decided that there was indeed good reason to suspect decompression sickness (DCS) in the divemaster. He recommended that the diver receive 100 percent oxygen, fluids by mouth. The boat, which was 18 hours from Baltra, made immediate headway towards home.
Next, Nord set up air evacuation through DAN TravelAssist. He knew that he had at least 18 hours before the boat would make it to shore, but, still, there was a lot to do. First, he had to verify the injured diver's DAN membership. Next, by flipping open his palm-top computer, he retrieved a DAN database listing all of the hyperbaric facilities in South America. A chamber in the Panama Canal Zone initially seemed to be the best choice.
But by now, DAN TravelAssist had contacted an Ecuadorian doctor and nurse - the two who would eventually fly to Baltra to evacuate the diver. The doctor recommended a closer chamber, a military hyperbaric unit in Guayachil, Ecuador. Guayachil agreed to take the diver, and soon the doctor and nurse boarded a Cessna Citation bound for the Galapagos and the incoming boat.
The only thing left to do now was to phone the DAN member in Baltra and let him know that help was on the way. But all phone lines into the Galapagos had gone down. Eventually, the man was able to call out, and when he did, he had more disturbing news: another diver on the same dive boat was showing symptoms of DCS. To further complicate matters, weather and ocean currents were delaying the boat's journey to Baltra. After a series of questions, Dan determined that two DAN members would need to be evacuated. The dive boat finally reached shore 12 hours past its scheduled arrival time and the Cessna Citation, with its medical team, was waiting.
More than three hours after Nord had first been awakened from sleep, he folded up his palm-top computer and his cell phone and sank into his sleeping bag. Though there had been occasional chatter from neighboring tents the first time that Nord had fallen asleep, there were no sounds now. Everyone was asleep: in fact, everyone in the world seemed to be asleep.
And in a few hours Nord would have to get up and pack his tent and head home because he had responsibilities at church the next morning. And Jacob. Well, Jacob had slept through the whole melee of calls and beeps and glowing green lights. He would never know, if his dad didn't tell him, that he had been up most of the night talking to someone thousands of miles away.
Although all of their Hotline calls don't occur in the wee hours of the morning, more than 2,200 critical calls received are dispersed around the clock. Emergency calls have a range of complexity. Some callers may be assured that they are not experiencing symptoms of DCS and directed to his or her family practitioner, while others may lead to a day of complex interaction: with physicians in a far-off land, medical evacuation crews, the destination hospital across an ocean and family members in several locations.
The Diving Emergency Hotline is the flagship of DAN, with quality professionals doing an irreplaceable job. If all they did was talk to those 2,200-plus injured divers, it would be an important and busy job. But in addition to their on-call schedules, our DAN medics put in a standard 40-hour work week, answering an additional 12,600-plus nonemergency information calls this past year. Many of these calls fall into the "ounce-of-prevention-equals-a-pound-of-cure" mode, allowing divers to make informed decisions about their medical issues and their diving futures.
Often we're asked, "What are the benefits of belonging to DAN?" The often-overlooked answer is that your membership dues allow DAN to provide someone to be there for you whenever you need us.
By Robert Huls
Robert Huls is a free-lance writer, baker and full-time father himself, living in Durham, N.C.
This story appeared in the May / June 2006 issue of Alert Diver.
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