We got underway at once after aggressive CPR and O2 restored breathing and heart function but later the patient became combative in her terror and tore out her IVs that delivered both fluids and sedatives to her while we masked her with O2. Luckily, I had an old friend and M.D. (radiologist) Gregg Gaylord aboard and we decided to, esssentially, induce near coma with IV demerol and valium to knock her out so we could maintain the patent airway for O2. Divemaster Miguel Sanchez of the crew then joined our around-the-clock vigil. After nearly 30 hours of oxygen and fluids, the patient regained vision and we were able to write messages on a clipboard that explained what was happening. When we arrived off Panama after almost 36 hours in transit at sea, the patient had nearly fully recovered and walked off the ship on her own… but with no memory of the accident. She was air-lifted to the U.S. for continued treatment and she fully recovered. But the unprecedented aggressive use of 100% O2 (that was really the only tool we had in the field), was what saved her life. Frankly, most of us thought it was a miracle that she survived at all, much less with no mental deficits.

Oxygen is an extraordinary drug. Always be certain that any liveaboard you go on has plenty and can deliver it via a 100% mask. And never give up on the therapy until you either run completely out or the patient dies.

In my nearly 40 years as a professional diver (that included 25 years running recompression chambers as the supervisor), I have learned that oxygen physiology in diving operations and subsequently in treatments is a subject that few physicians and even fewer lay persons have much familiarity with. There are good reference materials on this esoteric subject including case histories to review. I have gone to great pains over the years to publish a series of articles, formal papers, and as a contributing editor to medical texts on the subject. We need more input from field cases that achieved success so divers can benefit from “real world” patients, not just those in hospital settings. Send any information you may have acquired on your own to Dr. Dick Vann at DAN. He’s one of their primary researchers and a committed professional who would welcome the input. (email: rvann@dan.org)

Bret Gilliam
bretgilliam@gmail.com