Author Archives: Abbey Dias, 2019 DAN

About Abbey Dias, 2019 DAN

Abbey Dias, 2019 DAN

Thank you, DAN!

My last few weeks here at DAN have been busy wrapping up projects, cramming in as much diving as possible, and saying tough goodbyes.

One of my final projects here was reviewing existing videos and identifying needed changes based on the revised course content from our earlier edits for global use. The next step was to create storyboards for filming updated videos for the Diving First Aid for Professional Divers (DFA Pro) course. Storyboarding is the art of creating an outline for a video or film using illustrations of main scenes and shots for the video.

I learned how to storyboard by researching how Walt Disney developed storyboarding for his films. Disney was the first to use the storyboarding practice, and it is still used today to plan films. Apparently, Disney said something along the lines of not needing to be a great artist to be a great storyboarder, only needing to be able to get a point across. While I enjoy art, I believe I have really embodied that saying in my storyboard work. They aren’t beautiful sketches, but it depicts how we want the films to look and highlights the important changes. This is beneficial in making the filming process more efficient and easier so the videographers and actors know how the scenes should play out. I won’t be around for the video shoot, but I look forward to seeing the changes posted in version 3.0 of DFA Pro in elearning.

My storyboard for relieving a foreign body airway obstruction (severe choking) on an adult.

This image shows the storyboard for the adult foreign body airway obstruction video. Based on the combination of first aid guidelines from various national first aid organizations, we needed to incorporate changes into the videos as well. The new version of DFA Pro will teach three techniques for relieving a foreign body airway obstruction, which includes abdominal thrusts, chest thrusts, and back blows. This can be seen in the storyboard in the last 4 panels.

This week, the other interns and I gave presentations on our work this summer for the DAN Public Lecture Series. I also presented to the DAN staff on my final day, and they even threw me an ice cream party! Well, I am sure they would have had the ice cream party anyway, but excuses always help.

As my time here at DAN comes to an end, I would like to reflect on the things I have learned this summer.

I am grateful for the opportunity to have worked so closely with the DFA Pro course, because with my participation in the course revision process, I feel confident in my first aid skills and hope to expand upon them in the future. I had the opportunity to learn valuable skills on course development through working with Patty and Jim, and I learned how to effectively educate a diverse audience. I know that these skills will take me far as I hope to work with people all over the world in the future.

Simply being around so many accomplished and knowledgeable divers, I learned a lot about diving physics and technical diving while here. Although I only just began my divemaster, learning about the diverse potentials for my diving future is exciting.

As shared throughout my past blog posts, I have added many more tools to my kit of dive knowledge and safety. I am thankful for the opportunity to have participated in the research intern workshops with Dr. Frauke Tillmans and Dr. Allan Uribe, both of whom have been great mentors and friends in addition to my primary mentors, Patty Seery and Jim Gunderson.

Since the training department is currently housed with the medical department, I got to know all the medics and doctors here as well and learned about typical diving-related medical topics and injuries. I also learned what happens when you call the emergency hotline! Everyone here is so nice and knowledgeable, and I feel that I would be in very good hands if I ever need help.

Finally, I learned that DAN is always here for me. Whether I need medical advice, liability insurance, training resources, or friends to talk to ­— I know I can always count on the people here at DAN for their support and knowledge.

I have a new appreciation for all DAN’s resources, including the medical emergency and informational lines, first aid courses, and dive insurance! As long as I am a diver, I will carry DAN dive insurance. (No, they did not pay me to say that!) I look forward to becoming a dive professional and emphasizing safety as part of the training I conduct. For all the instructors out there, did you know that you can register your students for DAN insurance for free during the extent of their training?

I would like to thank everyone here at DAN for sharing their knowledge with me and making this experience valuable and memorable.

I am off to continue my journey back in Washington, where I will lead sea kayaking trips in the San Juan Islands for first-year orientation for my school, Whitman College. I will return to Walla Walla, WA, for my senior year, and write my biology thesis on bone density of deep-sea fishes. Thank you to my new DAN and OWUSS families for providing me with this incredible opportunity to learn and grow.  I look forward to seeing where the future takes me!

The final dives:

Thankful for the friends I made at DAN! Diving the wreck of the Advance with Tess Helfrich.

Diving safely! 🙂

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“Almost Heaven”—not John Denver’s idea of West Virginia

What does John Denver have to do with scuba diving? Nothing, really. Yet somehow, I ended up singing four hours of “Take Me Home, Country Roads” in the car as I made the trip from Durham, North Carolina, to Beckley, West Virginia, last week.

This was in part because I was curious about the Blue Ridge Mountains John sings about, but mostly because I was on my way to the 24th World Scout Jamboree. I wonder if John still would have considered it “Almost Heaven, West Virginia” if he made it to Summit Bechtel Reserve where the 44,000 scouts gathered for two weeks.

This is an international event that draws scouts from all over the world, and this year, more than 165 countries were represented. The main goal of the experience is to bring young people together to promote peace and the development of life skills and leadership.

The reserve covers over 10,000 acres of wilderness and has some of the largest outdoor-activity facilities in the country, including zip lines, climbing walls, and lakes. Additionally, there were multiple large, four-foot-deep inflatable pools in the center of all the booths at the Jamboree. The pools were outfitted with tons of BCDs, regulators, masks, scuba cylinders and an onsite compressor so the scouts could try scuba diving for the first time with a divemaster. I even had the chance to take a dive! (Can I log that?)

Large inflatable pools for scuba diving. Picture by Rhett Hendrickson. The DAN booth is located to the right in white tents. Campsite can be seen below the scuba center in the upper right corner.

Since the scuba diving experience is one of the largest events at the scout Jamboree, DAN sends staff members there every year to promote dive safety and coach scouts in CPR. The Jamboree is two weeks long; I attended the first week of the event accompanied by Jim Gunderson, Reilly Fogarty, and 4 CPR manikins to run our “CPR challenge” activity. Reilly, DAN research intern Andrea, and her husband, James ran the second week.

The goal of attending the Jamboree each year is to empower scouts to seek training and gain skills that can save lives in or out of the water. While we were not providing anyone with a full CPR class or official trianing, we did demonstrate 30 chest compressions and 2 rescue breaths. After the demos, we let the scouts have a try on the manikins for two minutes while we coached their technique.

Demonstrating 30 chest compressions with two rescue breaths to a group from Chile.

Coaching students as they practiced two minutes of CPR with a group from the United States.

 

 

 

 

 

 

It was interesting to see how many people were new to CPR versus those who already had training. I learned that many European countries teach CPR in school! We observed a wide range of skill levels, but everyone was enthusiastic about learning and improving.

Most scouts that attended our booth on the first day were English speakers, but we did meet one group from Argentina. I asked where they were from and if they were familiar with CPR. A girl in the front admitted that they did not know English and started to walk out of the tent. On the fly, I dug way back into my brain to recover something from the four years of Spanish classes I took in high school (with a wonderful teacher I might add), but it had been three years since I last spoke it. I did not want the scouts to walk out of our tent because they did not understand English, so I told them, “Uno momento! Yo hablo Español, pero no es muy bueno.” They laughed and agreed to come into the tent for a lesson.

It took a minute for my brain to switch into Spanish mode, but once it did, I was able to demonstrate CPR in Spanish to the group. Speaking Spanish may not be a skill I would put on a resume, but I was very surprised at my ability to successfully communicate with the group. That night, I went back to my hotel and studied up a few key words I didn’t know, like “compressions” (apparently, it’s just “compresiones”!), so I could be better prepared to speak with future groups.

DAN patches and coins awarded to scouts who came through our tent and successfully completed 2 minutes of quality CPR.

Over the next few days at the Jamboree, I believe I spoke in more Spanish than I did English! Scouts were very patient with my efforts and they enjoyed teaching me new words. It was a humbling experience to ask scouts, “¿Inglés o Español?” and see the relief and excitement on their face knowing someone could cater to their own language. This allowed us to open our tent to a much broader audience, as I was able to coach scouts from Colombia, Peru, Chile, Spain, Argentina, and Mexico.

A new friend from Peru! I was very grateful for his patience with my Spanish speaking, and he really appreciated the introduction to CPR and one-on-one time I gave to coach him. We exchanged gifts, I gave him a DAN patch and coin and he gave me a bracelet from Peru!

A fun group from Chile! They were excited to be taught in Spanish.

My new friend from Taiwan.

 

 

 

 

 

 

 

I had the pleasure of meeting many other people from all over the world at this event, including a young boy from Taiwan. He was so eager to learn and worked really hard to have a conversation in English while we waited for the rest of his troop to arrive. He had never seen a CPR manikin before, but after a bit of coaching, he was able to perform wonderful compressions. We also exchanged gifts, I gave him a DAN patch and coin and he gave me a scout logo that he had 3D printed!

Over the week that I was there, we had more than 1,200 scouts come through our booth. I am very thankful for this opportunity to share life-saving first aid with these intelligent youths. I hope that they continue their first aid education and seek official training, but for those who may not have this option in their home countries, the challenge gave them a great introduction to the process. While I hope no one has to experience a situation that warrants CPR, it is comforting to know these kids have a new tool in the box to help others.

As if the diving in the four-foot pool was not exciting enough, I also decided to attend a boat dive this weekend when I returned to North Carolina. This photo was taken on the wreck of The Hyde off the coast of Wrightsville Beach in Wilmington, NC—it was great to see a few adult sand tiger sharks! Thanks to Aquatic Safaris for the trip.

   

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Behind the scenes of dive safety: Hyperbaric chambers and cylinders

“The bends” — or decompression sickness (DCS) — can be a serious dive-related injury that results from inadequate elimination of accumulated inert gases (like nitrogen) from body tissues. The body absorbs more gas from breathing while diving than it does at the surface in attempt to equilibrize gas concentrations in tissue with the increasing ambient pressure of the surroundings. Therefore, to reverse this process and eliminate the accumulated gas, the reduction in ambient pressure must be slow and controlled. For this reason, it is recommended that divers do not exceed an ascent rate of 30 feet/9 meters per minute and they perform a safety stop to wash out as much remaining gas that was accumulated under pressure as possible. In the event of a rapid ascent, inert gases are not properly washed out from the body tissues and the person becomes “bent.”

If a person is suspected to have DCS, they will be sent to the nearest medical facility to be evaluated by a physician, and then DAN will contact the nearest available hyperbaric facility for treatment.

A common misconception about hyperbaric treatment of DCS is that it causes bubbled nitrogen in the body to re-dissolve back into the blood. The real benefit to hyperbaric treatment is that the act of breathing oxygen at increased pressure and concentration creates a pressure gradient. This gradient allows for more effective removal of other gases in the body (like nitrogen) through exhalation and addresses the inflammatory response to aid in healing as well. Hyperbaric medicine is not just for scuba divers, because the benefits of high concentrations of oxygen can be used to treat serious infections and heal wounds resulting from diabetes or radiation treatment, as well as treat other indicated conditions.

The entrance and inside of the chamber “Charlie.” Operating lights are visible hanging from the ceiling because the chamber was originally intended for use as an operating room for open-heart surgeries. Since the invention of the heart and lung machine (at the same time as the chamber was finished), this is no longer needed.

 

 

 

Duke’s hyperbaric medical facility has an interconnected multi-place chamber system, and recently the other DAN interns and I received a tour of the facility from Eric Schinazi, a hyperbaric chamber specialist at Duke. He shared with us the history of the chambers, how they were built, how they’re controlled, and how air is compressed.

The control panel station for all the chambers at Duke. Pressure gauges are visible (large round circles) and are very similar to the pressure gauge on scuba cylinders.

While we were touring the chamber, there was a research project being conducted on oxygen toxicity. We got to peek into the research chamber to see how the research subject was preparing to exercise while breathing compressed gas in the chamber.

Looking into the small pool in the research chamber. The research subject is preparing to exercise on a bike sitting under the water. He is connected to various sets of electrodes and a respirometer for monitoring outside the chamber.

A big thanks to Eric for such a wonderful tour! I hope to stay out of hyperbaric chambers during my diving career, but it was a great experience to learn what hyperbaric treatment involves.

Cylinders:

Speaking of compressed gas, last week DAN employees and interns also had the opportunity to visit the Luxfer aluminum cylinder manufacturer where we learned how the cylinders are made and tested — it was like an episode of “How It’s Made”!

Cylinders are created from one piece of metal and formed into their shape through heating and pressure manipulations. Pictures were not allowed in the factory, so to get an idea of what the process looked like, you can check out this YouTube video of steel cylinders being created. It is generally the same process, except for minor differences between steel and aluminum cylinder production and details unique to each processing factory.

A ruptured cylinder. Cylinders are designed to split like this in the event of an explosion, to avoid fragmenting and shrapnel. This proves how essential it is to take good care of gear.

While at the facility, we also had the opportunity to take a visual cylinder inspection course from Mark Gresham, CEO of PSI-PCI (Professional Scuba/Cylinder Inspectors).

All cylinders need to have a visual inspection at least once per year (and hydrostatic testing every 5 years), but visual inspections should be done more often if there is reason to believe the cylinder may have sustained damage. This could be from dropping a cylinder, running the cylinder dry (because this greatly increases the risk of water getting into the cylinder), heat exposure, or after it’s been stored for a long period of time. In the event of an explosion, cylinders are designed to split down the middle (photo to the left) to avoid fragmenting and shrapnel.

Mark also was very generous to meet with us at DAN earlier this week to continue educating us on Oxygen cleaning and cylinder valve inspection. I took my first valve apart, and then put it back together! Let’s hope it still works!

 

A special thanks to Mark for his generous time and for sharing loads of knowledge with us.

I am very thankful to this opportunity from OWUSS and DAN to gain so much exposure to all the different fields that play a role in making diving functional and safe, as well as the opportunity to learn from people at the top of their fields.

This week underwater:

“Stop polluting our water!”—A message from the fish.

 

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Taking a bite out of DFA Pro

Diving can take individuals all over the world, and it is becoming increasingly accessible to people, including those with diverse backgrounds. This calls for the ability of critical safety materials to be available globally and meet the needs of the growing diver profile.

If you are a dive professional, you may have had the opportunity to take DAN’s Diving First Aid for Dive Professionals (DFA Pro) course. It is a comprehensive course focused on diving and non-diving related injuries. Content includes emergency O2 first aid, CPR with AED, and marine life-related injuries to provide basic training for those who use diving as part of their jobs or volunteer activities. The first version of this course was created in 2006 at the request of aquariums needing to track a variety of staff and volunteer divers to maintain their accreditation. After many years of research and revision, the course is now on version 3.0 with release expected in 2020.   

DAN is a global leader in scuba diving safety resources and has locations all over the world, including Asia Pacific, Brazil, South Africa, Europe, and headquarters in Durham, North Carolina. However, all the course materials and guidelines come from the DAN headquarters here in the U.S.

As a member of DAN and a dive professional-in-training, I had the opportunity to take this course both for my own benefit and for part of my internship. This past week, I finished the skills portion and completed the course. I definitely improved my emergency response skills and become more confident with each time I practice!

A humorus break—not so funny! Camilo was a great patient. Picture by Tess Helfrich.

Instructor Jim writing on Instructor Tess’s forehead to demonstrate part of proper tourniquet usage. Congrats, Tess, on earning your DFA Pro Instructor status!

 

 

 

 

 

 

 

 

 

 

Behind the scenes of the classroom, Patty Seery, Jim Gunderson, and I have been working together to reassess and rewrite the course materials as needed to fit our global audience. This includes comparing guidelines from organizations that are part of the International Liaison Committee on Resuscitation (ILCOR) such as the American Heart Association (AHA), Australia and New Zealand Committee on Resuscitation (ANZCOR), Canadian Heart Association (CHA), and the European Resuscitation Council (ERC).

Practicing CPR with rescue breaths, 30:2. Picture by Jim Gunderson.

 

While most of the guidelines are consistent across the board, there are a few differences in recommendations that need to be addressed and considered. For example, there are 3 methods proven to be effective in responding to a foreign body airway obstruction (FBAO), commonly referred to as severe airway obstruction or choking, in adults. The ERC says no single technique alone is effective in resolving an FBAO, but the best method is multiple techniques used together, including back blows (or “slaps”), abdominal thrusts, and chest thrusts. The ANZCOR guidelines suggest chest thrusts and back blows are effective but abdominal thrusts are not. The AHA recommends abdominal thrusts be used first in rapid sequence for simplicity, but acknowledges multiple methods in combination may be needed. Of course, not one organization offers better guidelines than another—the guidelines are created based on research that can be interpreted in multiple ways, and thus, discrepancies exist. We are working to reconcile these conflicting methods because of the locations of our courses.

Now for the underwater adventures:
The Carolinas are known for the sharks that live off the coast—and this reputation dates back about 30 million years! Megalodon sharks, which are thought to have reached lengths exceeding the size of a school bus, are the equivalent of underwater T-Rexes. Although these giants lived way before our time, we can still occasionally find their teeth. I decided to test my luck and take a trip to South Carolina’s Cooper River to dive for these prized artifacts with some friends here at DAN.

Showing off my best teeth. Photo by John Cercopely.

Shout out to my awesome dive buddy, Tess! Photo by John Cercopely with Cooper River Dive Charters.

 

 

 

 

 

 

 

 

The conditions were harsh: below 7 feet it was completely dark, visibility was 10 inches at best, and we fought a current with screwdrivers stuck into the clay bottom. It was an incredibly challenging couple of dives, but I improved some valuable skills such as performing successful safety stops with no reference points. Above all, though, our efforts were greatly rewarded! I returned with a mouthful of awesome teeth.

 

The day’s finds! Size shown relative to my hand. Large tooth is about 5 inches and is from a megalodon. Other teeth might be from bull sharks, lemon sharks, tiger sharks, sand tiger sharks, and one alligator tooth (bottom right). Thanks to Cooper River Dive Charters!

 

 

 

 

 

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The Omnipresent Divers Alert Network

Whether you are new to scuba diving or an experienced scuba instructor, you’ve probably heard “DAN” mentioned more than a few times.

Most of us know that DAN plays an important role in dive safety, probably from purchasing some form of dive insurance from them throughout the years. One of the best-known perks of DAN is the 24-hour availability to speak with dive medical specialists (For DAN’s emergency hotline: +1 (919) 684-9111).

But DAN is much more than answering phones and dive insurance! It wasn’t until I walked through the doors of the headquarters that I began to understand the true scope of its services. DAN is a global leader in dive safety education, research, products, and services like providing emergency medical assistance — and not just limited to diving!

Figure 1. Patty Seery, Director of Training at DAN and PADI Course Director, Jim Gunderson, Assistant Director of Training at DAN and NAUI Course Director Trainer.

This summer, I am the 2019 OWUSS/DAN Dive Safety Education Intern working with Patty Seery and Jim Gunderson. Like Patty and Jim, the many people I have met here at DAN are incredibly passionate about dive safety and accident prevention through education. From the medical professionals to the masters of IT, everyone plays an important role in making DAN accessible to divers across the world. I started my time here meeting with the head of each department: research, communications (including writers of Alert Diver), marketing, insurance, membership, IT, warehouse, and risk mitigation. DAN requires all the essential elements like any company, including marketing devices, a mail room, and lots of Krispy Kreme doughnuts.

Since a large goal of DAN is safety education, my work this summer involves revisions to DAN’s first aid courses for international utilization. Because DAN is a globally recognized organization, it is important that all materials continue to match guidelines for first aid in different countries and are understandable, accessible, and inclusive to partners across the world.

Aside from my position, DAN offers summer research internships. I had the opportunity to serve as a practice patient for their studies.

Figure 2. My heart! Frauke Tillmans, Ph.D., using an echocardiogram. Research interns are practicing using these procedures as part of their studies to look at bubbling in divers.

Although we work hard in the office, we like to have fun outside, too. On the weekends, the best place to find me is underwater.

Figure 3. DAN crew diving at Blanch quarry. From left to right: Hannah DeWitt, Tess Helfrich, Caitlyn Ruskell, Jim Gunderson, Andrea Filozof, Frauke Tillmans, Alex Romfoe, Chloe Strauss, George Anderson, Abbey Dias (me), Shelli Wright. Interns testing out waterproof EKG leads during the dive for research.

I am looking forward to helping make our dive community increasingly safer and more accessible to people across the world!

Figure 4. Me, feeling like a saltwater fish in freshwater, learning to be euryhaline at Fantasy Lake (NC). Photo by Tess Helfrich.

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