Wednesday, Jun 01, 2011
Following incidents on diving sites around the globe, a number of Client companies are now requesting that the Diving Contractor must provide ‘written confirmation that arrangements have been made with a registered, approved medical practitioner for the provision of medical support for situations which are beyond the capabilities of the on-site diver-medics.’
The National Hyperbaric Centre has now established a 24 hr on-call diving medical information and advice service to support small and medium sized diving companies around the world.
The service is in conjunction with an efficient 24/7 emergency response coordination company which transfers the calls directly to the on-call doctor.
“This service enables the on-site medical personnel, such as the Supervisor or Diver Medic to speak to a qualified and experienced diving doctor at any time of day or night, all year round.” confirmed David Smith, Managing Director.
“A team of diving doctors has been assembled and we are pleased to say that we are bowled over by their knowledge and enthusiasm.
Ongoing professional development is also a key part of the plan to enable the doctors to develop the NHC’s service to be the very best in the world. We have a program of teaching planned from doctors worldwide to continue to develop the knowledge and skills of the team.
We also include practical exercises involving the medical staff experiencing the confines of air chambers, bells and even hyperbaric lifeboats so that they immediately understand the conditions in which the advice may be utilised, along with the equipment likely to be available.
Air diving sites are simulated using a team of divers and the diving tank at the NHC in which various scenarios can be enacted, which all leads to a realistic appraisal and awareness by the doctors”.
The National Hyperbaric Centre has been in discussions with companies involved in commercial diving regarding this situation and uncovered that many commercial diving companies rarely have in place a formal contract for Diving Medical Support.
This is mainly due to:
a. A lack of awareness of a legal requirement to have adequate provision for such industrial healthcare
b. A belief that, in the event of an emergency, local Government owned emergency services will intervene. This may include the Coastguard, Navy or local hospitals.
The companies often rely upon ‘not being turned away’ and in the past have frequently cited the NHC as their ‘provider’ of such a service even when there is no contract in place, but until recently the NHC was not even set-up to offer this service.
In the UK the Diving at Work Regulations also place a specific duty on the diving contractor to have in place adequate, and demonstrable, emergency procedures.
When might we need Diving Medical Support?
Most people’s immediate response is to cover decompression illness, but this is a very small percentage of the actual real incidents occurring on dive sites. The ability for a doctor to comprehend the possible effect of diving on a number of ‘industrial’ types of injuries is key part of the provision of the support service offered, as most doctors are unaware of the possible implications, effects and limitations of treatments if diving is involved.
This service is not a substitute for competent on-site medical personnel.
The variety of diving operations adds to the need for a flexible, encompassing service.
The companies which we have identified as users of this service may be involved in many diving operations in many different locations around the clock and throughout the year. They may be inshore diving contractors or operators of one or two mobile saturation systems. Diving may be taking place in a variety of conditions and in locations ranging from harbours, canals, reservoirs, piers, oil terminals and offshore construction projects.
The nature of the contracts is that they can be from a few hours with a small team of divers plus support crew on, say an inspection operation, through to a civil engineering construction task building a new harbour lasting several weeks with a team of maybe 12-20 divers working around the clock.
The larger occupational health companies who provide this service for the major diving companies, are not set up to get involved with the myriad of specialist smaller diving companies to whom a total Occupational Health service is not yet affordable. However, these smaller contractors still need a professional diving specialist support service.
Gone are the days when it was acceptable to ‘contribute’ to the local hyperbaric doctor’s ‘holiday fund’ on a non-commercial basis. Gone also is the haphazard nature of such a service with no 24/7 cover and also the nagging concern as to the level of knowledge of such an individual.
Non-Urgent Diving Medical Support
Non-urgent Diving Medical queries are also part of the service and dealt with during office hours. This can relate to subjects as varied as confirmation of diving tables, emergency procedures (ERPs), rotation of biocides in chambers, acceptable hyperbaric medical equipment, and what equipment is needed as a requirement on diving sites in remote locations.
An audit will be conducted on subscribing companies which will include Emergency Response Procedures, on-site Medical staff and Equipment. Advice and training can be given to assist companies in the establishment of acceptable ERP systems.
The service is offered on a 24/7 emergency response system via a dedicated ERP control centre. Two doctors are on call at any time which provides a robust system which operates 24 hours per day permitting contact from anywhere in the world and at anytime.
It is intended that the new service will result in raising the standard of Diving Medical Support for commercial diving contractors worldwide. A number of contracts have already been signed.