• the location of the diver/emergency   (GPS coordinates, if necessary and available)
• the diver’s current status, particularly:
  

1. Is the diver conscious?
2. Is the diver breathing?
3. Does the diver have a heartbeat?
4. What are the patient’s vital signs (if taken)?
5. What are the other signs/symptoms which resulted in the need for medical attention?
   

• the cause of the emergency.
• the emergency care being provided.
• the destination and ETA, if the vessel will be transporting the patient to shore.

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• Suspect a diving emergency any time the patient developing signs/symptoms has dived within the past 24 hours.
• Don’t rule out other causes of signs and symptoms, e.g. allergic reactions, heart attacks, etc.
• Perform initial assessment and institute any necessary resuscitative measures.
• Administer oxygen via non rebreather mask, demand valve, or other method that provides a good mask seal and a high concentration of oxygen.
• Remove the patient’s dive gear and suit as carefully as his or her condition permits.
• Prevent heat loss and rewarm as appropriate.
• Evaluate the patient’s condition frequently, paying particular attention to changes in level of consciousness and respirations.  Changes should be documented for later use by medical staff.
• Obtain and record information on patient’s dive profile.
• Transport diving equipment with patient.  The diving equipment should be left in the condition in which it was found.
• Transport the patient level, in a left lateral recumbent position, by ground, in an aircraft pressured to sea level, or by aircraft flying at lowest safe altitude (less than 1,000 feet, if possible).
• The Divers Alert Network may be contacted by on-scene medical personnel or by the physician remotely managing the case.
• Be prepared to provide personnel investigating the dive with detailed information about the events and your observations

Acutely sick dive emergency patients

• Rapid transport to a medical facility should be a primary concern.
• Oxygen should be continued until patient reaches the medical facility.
• An IV should be started and a 500 ml bolus of normal saline, or other balanced salt solution should be administered, followed by an infusion of 250 ml/hr.
• The rescuer should document changes in the patient’s signs, symptoms, and vital signs which occurred en route.
• Seizures should be anticipated and treated promptly by protecting the patient during the seizure and resuming the administration of oxygen as soon as possible.

Stable dive emergency patients

• If the patient is not receiving IV fluids, give the patient warm, non-alcoholic fluids if this can be accomplished without interrupting the delivery of oxygen.  Plain water is best.  Fluids containing large amounts of sugar or caffeine should be avoided because of their diuretic potential.
• Oxygen should be continued until the patient reaches the medical facility.
• Perform a baseline neurological examination which tests at least orientation, eyes, facial movement, hearing, sensory perception, and balance and coordination, if possible.
• Transport to a medical facility for further evaluation and treatment.