Physicians from the Division of Hyperbaric Medicine, Department of Emergency Medicine at Upstate now provide medical oversight to Jefferson County’s dive rescue team. The physicians are board certified in Undersea and Hyperbaric Medicine.
That means if one of the rescue divers is injured – as happened during a drill this past spring – an Upstate doctor is immediately available for emergency response. The dive team has a portable Hyperbaric Oxygen Chamber, but using it for hyperbaric oxygen treatment requires physician oversight. Depending on the circumstance, the Upstate doctor may respond to the scene by helicopter, or the doctor may ask that the patient be brought to Upstate in Syracuse for treatment.
“In the past, we crossed our fingers a lot,” dive commander Mark Knowles says. Knowles is a physician assistant at Watertown Urgent Care who volunteers as leader of the STAR Team, short for Special Tactics And Rescue.
When it began decades ago, the team offered specialized rescues for wilderness, confined spaces and high angles. Now it focuses on water rescue, including ice rescues in winter. The team responds to an average of three calls per week, year round. It comprises nine volunteers, all experienced divers, some from the military and some civilians.
Several of the physicians who will be on call are also dive certified. Three of them attended a STAR Team drill on July 31 in Cape Verde including Marvin Heyboer, Monica Morgan, and Shane Jennings. Jennings is doing a fellowship in Undersea and Hyperbaric Medicine at Upstate, one of fewer than 20 programs in the country. The hyperbaric medicine physician on call will respond if a team member experiences decompression sickness or any other problem related to a dive. They also plan to provide medical evaluations for members of the dive team in the future.
When a diver descends to 33 feet, he or she doubles the atmospheric pressure. With the pressure of the nitrogen in his or her air increasing, the nitrogen dissolves into the body tissues. This continues as the diver goes deeper.
When a diver makes his or her ascent, the pressure decreases, and nitrogen seeps from the tissues to revert back to a gas. If this happens too quickly, nitrogen bubbles can develop in the blood and tissues. Medical texts say decompression sickness, or the bends, is like shaking a can of carbonated soda, then opening it to a gush of bubbles.
“The sooner you begin treatment, the more successful the outcome,” Heyboer says. Decompression sickness is treated in a hyperbaric chamber where the diver breathes 100 percent oxygen at higher-than-atmospheric pressure, causing the gas bubbles to dissolve.
During a STAR Team drill in the spring, one of the divers ran out of air 60 feet below the surface of Lake Ontario. Rather than seek air from his partner, he panicked, held his breath and shot to the surface. He was treated at Upstate, recovered well and has since rejoined the dive team.
That situation demonstrated for the dive team and the Upstate physicians a need to form a partnership.
Upstate University Hospital already is the hospital of choice for treatment of decompression sickness and other dive related injuries in Upstate New York, because Westchester County is the next closest Hyperbaric Oxygen Chamber. The formal agreement between Upstate Hyperbaric Medicine and STAR Team allows the physicians to provide immediate medical direction and oversee on-sight treatment in the portable multi-place chamber when necessary.
Hear Dr. Heyboer’s radio interview about the new partnership.
Hear Dr. Derek Cooney’s radio interview about treatment of scuba diving injuries.
Learn more about hyperbaric oxygen therapy at Upstate.