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With state’s only hyperbaric chamber inactive, some divers feel uneasy

October 28, 2017 - 11:19pm

KAILUA-KONA — The state’s only public hyperbaric treatment center capable of treating divers with decompression sickness will remain closed through November.

And with the next nearest chamber on Guam and the mainland, officials are hustling to fix the local situation — although a solution hasn’t been established.

The window in which the islands will be without a publicly accessible device used for treating decompression sickness and other ailments is leaving more than a few divers concerned.

“Clearly there’s a huge community of divers here and Oahu and Maui — and I’m going to assume Kauai as well,” said Bo Pardau, a retired dive instructor. “And without a functioning hyperbaric chamber, it just puts us into a terrible situation.”

The University of Hawaii at Manoa announced in a press release on Oct. 20 that the Hyperbaric Treatment Center, the state’s only public facility offering 24-7 treatment for decompression sickness, was out of service “due to unforeseen circumstances.”

Decompression sickness, also known as the bends, is the result of gases like nitrogen forming bubbles in tissue, which can happen as surrounding pressure drops when divers come up to the surface. In the most severe cases, it can be life-threatening.

The treatment center, operated by the university under the John A. Burns School of Medicine and located at Kuakini Medical Center in Honolulu, recorded 57 treatments for 45 divers between the start of July 2016 and the end of this past June.

Since then, the center recorded 17 treatments for seven divers.

It’s not just for treating divers, though. The center has also recorded treatments for non-emergency wound care to 68 patients for a total 1,057 treatments.

The closure followed news that the last physician wouldn’t be available for full-time emergency services.

Hyperbaric chambers operated by the Navy and National Oceanic and Atmospheric Administration aren’t public, said Dave Pence, diving safety officer for the University of Hawaii, and wouldn’t be available anyway for staffing reasons.

And other smaller chambers wouldn’t be suited for treating decompression sickness, given the pressure needed for treatment and the need to accommodate the patient and an attendant during treatment.

On Friday, the university announced the center would remain closed for diving emergencies through November, saying it will have an update on or by the first of December.

The university “is actively pursuing multiple options to reopen the facility as soon as possible,” the release said, such as recruitment of a new director and physician, contact with private entities specializing in hyperbaric medicine and possible partnerships with local medical centers.

The university is also pursuing the resumption of non-emergency treatment during regular hours to maintain current staffing.

“The University of Hawaii is committed to seeking a solution for emergency treatment for diving illness,” said Jerris Hedges, dean of the John A. Burns School of Medicine. “This is a top priority. We know how important the facility is to the dive community and the state and we apologize for the current situation.”

The university advised anyone suffering from decompression sickness should go to the nearest emergency department.

Pence said the nearest options for hyperbaric treatment could be either Guam or the U.S. mainland — both of which are a several-hour flight, which carries its own risks.

“In any direction, it’s a high commercial airplane ride to get there,” Pence said.

Even with the hyberbaric treatment center up and going, Pardau said, if a diver is injured on Hawaii Island, that person still needs to be transported to Oahu on a low-flying plane so that the condition wouldn’t be further exacerbated by a high altitude.

“The mainland’s out of the question,” Pardau said. “It’s the only treatment there is.”

Pardau said local divers already tend to be mindful when out in the water to avoid decompression sickness, but he still stressed how crucial a hyberbaric chamber is for the state.

“We need it,” he said. “Just consider how many tourists come here and go diving. That doesn’t mean that all of them are going to be safe.”

“The local people know what their limitations are and exactly how to deal with these waters,” he added. “There’s a lot of people that are very inexperienced divers; they’ll come to this island and they may go too far and they don’t know their own limitations. And that’s why you need that chamber.”

Keller Laros, a professional scuba instructor with more than 12,000 logged dives, said the closure of the chamber “would be a huge blow to the dive community.”

“Just because you wouldn’t be able to treat the instances where people need recompression,” he said.

“And scuba diving is a huge industry in the whole state, not just in Kona,” he added. “It would have a big negative impact on just the safety of scuba divers.”

And it’s not just the safety concerns that could impact the state’s divers.

Laros also said it could have an impact on insurance for those employed commercially and that some considering a dive vacation to Hawaii might not come here if there’s no recompression chamber.

He compared it to traveling to a remote location without high-quality medical care and noted that the ability to have emergencies attended to is often a consideration for people planning their vacations.

“Now all of a sudden, Hawaii may become like that, because there’s no modern medical facility to treat people should they need emergency recompression,” he said.

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