Category Archives: 2019 DAN

Abbey Dias

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! 🙂

Behind the scenes of dive safety: Hyperbaric chambers and cylinders

Leave a reply

“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.

Taking a bite out of DFA Pro

2 Replies

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!

The Omnipresent Divers Alert Network