A Traumatic Slip

The protagonist of our “success story” is a 30-year-old diving instructor who traveled to Thailand, a renowned paradise for lovers of marine and underwater environments. It was the 4th of May. As he was getting back onto the boat after a dive, he slipped from the ladder and injured his foot, with an open fracture aggravated by a dislocation, a tear in the tendon of his fourth toe, as well abrasions on his face and nose.

He was taken to the nearest clinic, on the island of Koh Tao, where he was given first aid, however, the facility was too small to offer him adequate treatment or to be able to operate on his foot, which was in a nasty condition. Luckily though, the diver was a DAN member and called our international emergency hotline, which recommended a larger and better-equipped hospital: Bangkok Samui Hospital of Koh Samui. DAN operators immediately began the process of arranging and organising a transfer between the two hospitals.

When the injured man reached his destination, eleven hours had passed since the time of the accident; the injury had a high risk of infection and there was need of an urgent operation. The patient, scared and worried, was comforted regularly by the medics at DAN who were daily evaluating the terms and regulations of the Bankok hospital. In the meantime, he was guaranteed immediate medical assistance, and direct payment of all the medical costs to the facility. Now, he could finally just relax and focus on his recovery.

The foot operation initially seemed to have worked: the patient spent six days in hospital on antibiotics, doing physiotherapy, and was then released. The following control visit, however, detected further problems and a risk of gangrene – making it necessary to procede with a second hospitalisation period of 5 days. The DAN medics, who had been continually following the case and in communication with the Thai hospital staff, were able to arrange discharge from the hospital, allowing the patient to continue his treatment at home. DAN then handled all of the necessary procedures for the return trip; including, ensuring a business class reservation that would allow the patient to keep his limb elevated throughout the journey. DAN medics maintained communication with the patient-diver even after his return home, up until the 26th of May when the situation was finally stable.

A tale with a happy ending, notwithstanding the underwater accident, medical complications and overall cost of €13,000, which was entirely covered by the DAN insurance plan.

Ladder accidents : A problem of misinformation

For the past few years, DAN has been addressing a problem which has been given too little attention, but one of which all divers, boat owners and handlers should be aware: the potential danger of boarding ladders.

What kind of damage can they do?

Potential injuries range from slight bruising – generally to the hands (but not only, as the prior case has shown), to the traumatic amputation of one or multiple fingers.

Furthermore, badly designed ladders that don’t offer a safe and stable support for feet (when wearing flippers, too) make it easy for a diver to fall as he is getting back into a boat. Accidents like this can also cause severe trauma to the divers below.

What does an ideal boarding ladder look like?

The most dangerous part of a ladder are the hinges, used to fold it back onto the boat during navigation.

The positioning of the ladder to the side of the boat is also important. If it is not well fastened or too mobile, particularly if it’s on the side of the boat, it can oscillate and trap the hands or fingers when the rocking of the boat brings it back against the side.

This occurance is less frequent, but still possible, for ladders on the stern, as the boat can pitch forward forcefully. It is even more likely to happen if the ladder is hinged, or if the spacer between the ladder and the side/stern of a vessel is not of an adequate length.

In the case of a diver falling off a ladder, the design of a ladder and it’s construction are both factors to be considered. A ladder that is too narrow or short, is not designed to be climbed with flippers, or is made with slippery materials, can constitute additional risks that could be avoided with a correct design.

Always be careful when climbing up ladders, even on your own boat!