For more than 20 years DAN has been assisting divers within its region and internationally with emergency evacuations. Many of these evacuations have been extremely complicated, which at times can lead to unfortunate misinformation about alleged unwillingness of DAN to evacuate people by air or road from remote dive locations. Although such a perception may exist, the allegations are simply not true. To avoid any misunderstandings regarding evacuation, it is important for you and your group of divers to avoid problems as best possible and to work with DAN in the case of an emergency to ensure the fastest, most appropriate response to an emergency.
Medical Evacuation is the process of transporting a person suffering from a medical emergency or injury to a place of medical assessment and care or more advanced medical care. This may be achieved by using dedicated aeromedical evacuation, commercial airlines, watercraft or road transport. It may even include using the injured person’s own means of transportation depending on the circumstances. The ultimate objective is to move the person to the intended destination while ensuring necessary safety of the patient (and others involved in the evacuation); providing the appropriate best care available; and achieving this within a time frame that will minimise the consequences of the injury or emergency. Medical decisions balance these complex factors in an effort to offer the best solution in a real world filled with many challenges including weather conditions, terrain, loss of daylight, limited access, and – most importantly – reliable communication. As long as communication is maintained it is possible to consider alternatives, manage difficulties and offer advice – this should always be a priority.
Each emergency is unique. DAN cannot predict the most appropriate solution to every situation in advance. This is where experience and judgment comes into play and that is why DAN partners with experienced service providers both locally and across the globe to assist with these decisions. We also rely on the medical, logistic and environmental information provided by local dive operators who are on site.
The following is a guide to these decisions that may be made when (1) the nature of an emergency specifically requires aeromedical evacuation, and (2) there is insurance (e.g., cover related to DAN membership) that offers the service provider a guarantee of payment. The most common reasons for delayed or aborted evacuation are (1) inadequate communication; (2) loss of daylight which disqualifies many airstrips for purposes of night time access; (3) lack of insurance; (4) poor reporting of information required to determine medical necessity for evacuation. Accordingly, every effort should be made to think of an evacuation as a partnership and every effort should be made to facilitate this.
Even under ideal conditions, some delay is to be expected. Dive operators and resorts must realise that they may need to provide assistance to an injured person for up to 24 hours before help is able to arrive in remote dive destination. An injured person’s chances of recovery or survival are dramatically improved if proper first aid and oxygen administration can be provided. Persons or groups traveling to remote destinations should enquire what services and equipment are available at the various resorts and dive operations. When in doubt, be independent and take your own equipment and supplies. Importantly make sure that there is an emergency response plan in place and that the management and staff know what to do in an emergency. Don’t leave this to chance.