{"id":11418339,"date":"2025-05-23T12:15:40","date_gmt":"2025-05-23T10:15:40","guid":{"rendered":"https:\/\/alertdiver.eu\/?p=11418339"},"modified":"2025-05-23T12:15:40","modified_gmt":"2025-05-23T10:15:40","slug":"should-i-call-dan-or-ems-first","status":"publish","type":"post","link":"https:\/\/alertdiver.eu\/en_US\/articles\/should-i-call-dan-or-ems-first\/","title":{"rendered":"Should I call DAN or EMS first?"},"content":{"rendered":"<h4><em>Understanding who to contact first in a diving emergency \u2014 and why context matters.<\/em><\/h4>\n<p data-renderer-start-pos=\"231\"><em data-renderer-mark=\"true\">Please note: though this information is generally applicable internationally, its is specifically addressed to DAN Europe members. As some aspects may differ in case management among the various DAN organisations, we advise divers to get in touch with the relevant DAN organisation in their region.<\/em><\/p>\n<p data-renderer-start-pos=\"531\">&#8211;<\/p>\n<p data-renderer-start-pos=\"534\">\u201cIn the event of a diving accident, where decompression illness is suspected, is it better to call 112 (EMS) or DAN Europe first?\u201d This is a question frequently heard among divers, and one that often creates confusion.<\/p>\n<p data-renderer-start-pos=\"754\">First, let\u2019s define <strong data-renderer-mark=\"true\">what a diving accident is in this case<\/strong>: it\u2019s an event that results in a potential risk of illness or death due to inadequate decompression.<\/p>\n<p data-renderer-start-pos=\"915\"><strong data-renderer-mark=\"true\">Decompression Illness (DCI)<\/strong> includes two main conditions:<\/p>\n<ul>\n<li data-renderer-start-pos=\"976\"><strong data-renderer-mark=\"true\">Decompression Sickness (DCS):<\/strong> caused essentially by the persistence of inert gas in bubble form (not dissolved) in tissues or blood.<\/li>\n<li data-renderer-start-pos=\"1112\"><strong data-renderer-mark=\"true\">AGE, or Arterial Gas Embolism:<\/strong> for example, caused by venous gas bubbles crossing to the arterial side or by pulmonary barotrauma.<\/li>\n<\/ul>\n<p data-renderer-start-pos=\"1246\">The risk of DCI during recreational or technical diving, and even during work in pressurised environments, is closely related to the conditions and physical exertion involved in the dive. The estimated frequency is approximately 1 in 10,000 dives for recreational divers and 9.5 in 10,000 dives for technical and professional divers (Mitchell 2022).<\/p>\n<p data-renderer-start-pos=\"1597\">Unfortunately, a number of cases are underreported because divers sometimes self-treat or do not report symptoms, do not seek care in medical facilities, or the care provided is not properly recorded.<\/p>\n<p data-renderer-start-pos=\"1597\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-11418349\" src=\"https:\/\/alertdiver.eu\/wp-content\/uploads\/2025\/05\/diver1_1500.jpg\" alt=\"\" width=\"1500\" height=\"1000\" srcset=\"https:\/\/alertdiver.eu\/wp-content\/uploads\/2025\/05\/diver1_1500.jpg 1500w, https:\/\/alertdiver.eu\/wp-content\/uploads\/2025\/05\/diver1_1500-300x200.jpg 300w, https:\/\/alertdiver.eu\/wp-content\/uploads\/2025\/05\/diver1_1500-768x512.jpg 768w, https:\/\/alertdiver.eu\/wp-content\/uploads\/2025\/05\/diver1_1500-700x467.jpg 700w\" sizes=\"auto, (max-width: 1500px) 100vw, 1500px\" \/><\/p>\n<p data-renderer-start-pos=\"1802\"><strong data-renderer-mark=\"true\">Diagnosing DCI<\/strong> is often challenging due to its several possible symptoms, and it requires a clinical evaluation that considers the nature of the dive(s) and the diver\u2019s personal health history. Any new sign or symptom after a dive should be considered as \u201csuspect DCI\u201d until proven otherwise.<\/p>\n<p data-renderer-start-pos=\"2096\"><strong data-renderer-mark=\"true\">Mild symptoms<\/strong> may include unusual fatigue or skin itching.<\/p>\n<p data-renderer-start-pos=\"2156\"><strong data-renderer-mark=\"true\">More serious symptoms<\/strong> include:<\/p>\n<ul>\n<li data-renderer-start-pos=\"2190\">Skin rashes or mottling<\/li>\n<li data-renderer-start-pos=\"2217\">Tingling<\/li>\n<li data-renderer-start-pos=\"2229\">Numbness<\/li>\n<li data-renderer-start-pos=\"2241\">Pain<\/li>\n<li data-renderer-start-pos=\"2249\">Difficulty moving or urinating<\/li>\n<li data-renderer-start-pos=\"2283\">Muscle weakness<\/li>\n<li data-renderer-start-pos=\"2302\">Impaired consciousness, breathing, vision, hearing, speech<\/li>\n<li data-renderer-start-pos=\"2364\">Nausea<\/li>\n<li data-renderer-start-pos=\"2374\">Dizziness<\/li>\n<li data-renderer-start-pos=\"2387\">Reappearance or persistence of mild symptoms after 30 minutes of initial oxygen therapy<\/li>\n<\/ul>\n<p data-renderer-start-pos=\"2481\"><strong data-renderer-mark=\"true\">So, who should be contacted first in the event of a suspect diving accident?<\/strong><\/p>\n<p data-renderer-start-pos=\"2559\">Answer: <strong data-renderer-mark=\"true\">It depends on the diver\u2019s symptoms and location<\/strong>.<\/p>\n<p data-renderer-start-pos=\"2617\">Having DCS in <strong data-renderer-mark=\"true\">Europe<\/strong>, where numerous hospitals with hyperbaric units are available, is one thing. Experiencing it in <strong data-renderer-mark=\"true\">remote locations<\/strong> or regions without a 24\/7 operational hyperbaric chamber for emergencies, is another story.<\/p>\n<p data-renderer-start-pos=\"2617\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-11418358\" src=\"https:\/\/alertdiver.eu\/wp-content\/uploads\/2025\/05\/malditesta_1500.jpg\" alt=\"\" width=\"1500\" height=\"1000\" srcset=\"https:\/\/alertdiver.eu\/wp-content\/uploads\/2025\/05\/malditesta_1500.jpg 1500w, https:\/\/alertdiver.eu\/wp-content\/uploads\/2025\/05\/malditesta_1500-300x200.jpg 300w, https:\/\/alertdiver.eu\/wp-content\/uploads\/2025\/05\/malditesta_1500-768x512.jpg 768w, https:\/\/alertdiver.eu\/wp-content\/uploads\/2025\/05\/malditesta_1500-700x467.jpg 700w\" sizes=\"auto, (max-width: 1500px) 100vw, 1500px\" \/><\/p>\n<p data-renderer-start-pos=\"2847\">In case of <strong data-renderer-mark=\"true\">MILD SYMPTOMS,<\/strong> do not underestimate them. In this situation, there\u2019s usually a little more time for action. <strong data-renderer-mark=\"true\">EMS can be activated<\/strong>, if transport to a health facility is preferable for diagnosis. <strong data-renderer-mark=\"true\">At the same time the DAN Europe hotline should be contacted<\/strong> for 3 reasons:<\/p>\n<ol>\n<li data-renderer-start-pos=\"3129\"><strong data-renderer-mark=\"true\">Reporting the accident<\/strong>: If the diver is an active DAN member, the Alarm Centre, case management and DAN medical staff can open a case and provide remote support, which can be invaluable. The Centre will put local medical or paramedical personnel who arrive at the scene of accident and are typically not familiar with diving medicine, in communication with DAN doctors who <strong data-renderer-mark=\"true\">specialise in diving and hyperbaric medicine<\/strong>, to share information, strategies, recommendations.<\/li>\n<li data-renderer-start-pos=\"3603\">In the event of accidents in remote locations, the diving centre or boat staff are put in touch with medical personnel to receive <strong data-renderer-mark=\"true\">immediate assistance<\/strong> on what is best to do\/not to do following a diving accident. This is how the DAN Alarm Centre implements assistance mechanisms locally.<\/li>\n<li data-renderer-start-pos=\"3893\">The DAN Alarm Centre is <strong data-renderer-mark=\"true\">available 24\/7<\/strong> for telephone conversations with everyone, both active (insured) DAN Members and non-Members, as well as with lay and healthcare personnel for discussion and advice.<\/li>\n<\/ol>\n<p data-renderer-start-pos=\"4101\">DCI should be suspected if the symptomatic individual has been scuba diving (open or closed circuit, recreational or technical) or freediving, especially if they have been repeatedly diving to deep depths.<\/p>\n<p data-renderer-start-pos=\"4308\">Usually the first rescue manoeuvres are carried out by the diving buddies, instructor, diving guide, or surface assistants. The ideal conditions for a correct management of an accident are: <strong data-renderer-mark=\"true\">adequate training<\/strong> of all divers, the presence of secure means of communication and emergency management material (Oxygen Unit, First Aid Kit); the planning of an accident protocol in case of particularly demanding dives, including phone numbers of the closest facilities equipped with a Hyperbaric Chamber.<\/p>\n<p data-renderer-start-pos=\"4308\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-11418340\" src=\"https:\/\/alertdiver.eu\/wp-content\/uploads\/2025\/05\/calldan_1500.jpg\" alt=\"\" width=\"1500\" height=\"1000\" srcset=\"https:\/\/alertdiver.eu\/wp-content\/uploads\/2025\/05\/calldan_1500.jpg 1500w, https:\/\/alertdiver.eu\/wp-content\/uploads\/2025\/05\/calldan_1500-300x200.jpg 300w, https:\/\/alertdiver.eu\/wp-content\/uploads\/2025\/05\/calldan_1500-768x512.jpg 768w, https:\/\/alertdiver.eu\/wp-content\/uploads\/2025\/05\/calldan_1500-700x467.jpg 700w\" sizes=\"auto, (max-width: 1500px) 100vw, 1500px\" \/><\/p>\n<p data-renderer-start-pos=\"4809\"><em data-renderer-mark=\"true\"><strong data-renderer-mark=\"true\">Summing up: <\/strong><\/em><strong data-renderer-mark=\"true\">What should you do in case of mild symptoms?<\/strong><\/p>\n<p data-renderer-start-pos=\"4867\">One person should contact the <strong data-renderer-mark=\"true\">DAN Europe Hotline<\/strong> for advice, while others should:<\/p>\n<ol class=\"ak-ol\" start=\"1\" data-indent-level=\"1\">\n<li>\n<p data-renderer-start-pos=\"4952\">Perform a 5-Minute <a class=\"_mizu1p6i _1ah31bk5 _ra3xnqa1 _128m1bk5 _1cvmnqa1 _4davt94y _4bfu18uv _1hms8stv _ajmmnqa1 _vchhusvi _syaz14q2 _ect41gqc _1a3b18uv _4fpr8stv _5goinqa1 _f8pj14q2 _9oik18uv _1bnxglyw _jf4cnqa1 _30l314q2 _1nrm18uv _c2waglyw _1iohnqa1 _9h8h16c2 _1053w7te _1ienw7te _n0fxw7te _1vhvg3x0\" title=\"https:\/\/www.daneurope.org\/en\/-\/on-site-neurological-assessment-course\" href=\"https:\/\/www.daneurope.org\/en\/-\/on-site-neurological-assessment-course\" target=\"_blank\" rel=\"noopener\" data-renderer-mark=\"true\"><strong data-renderer-mark=\"true\">Neurological Check<\/strong><\/a>:<\/p>\n<ol class=\"ak-ol\" start=\"1\" data-indent-level=\"1\">\n<li>\n<p data-renderer-start-pos=\"4952\">Ask the diver how they feel, where they are, the day and time.<\/p>\n<\/li>\n<li>\n<p data-renderer-start-pos=\"4952\">Check eye tracking with a finger.<\/p>\n<\/li>\n<li>\n<p data-renderer-start-pos=\"4952\">Ask the diver to whistle, show teeth, or stick out the tongue symmetrically.<\/p>\n<\/li>\n<li>\n<p data-renderer-start-pos=\"4952\">Test balance and motor coordination.<\/p>\n<\/li>\n<\/ol>\n<\/li>\n<li>\n<p data-renderer-start-pos=\"5219\">Administer <a class=\"_mizu1p6i _1ah31bk5 _ra3xnqa1 _128m1bk5 _1cvmnqa1 _4davt94y _4bfu18uv _1hms8stv _ajmmnqa1 _vchhusvi _syaz14q2 _ect41gqc _1a3b18uv _4fpr8stv _5goinqa1 _f8pj14q2 _9oik18uv _1bnxglyw _jf4cnqa1 _30l314q2 _1nrm18uv _c2waglyw _1iohnqa1 _9h8h16c2 _1053w7te _1ienw7te _n0fxw7te _1vhvg3x0\" title=\"https:\/\/www.daneurope.org\/en\/-\/advanced-oxygen-first-aid-scuba-diving-injuries-course\" href=\"https:\/\/www.daneurope.org\/en\/-\/advanced-oxygen-first-aid-scuba-diving-injuries-course\" target=\"_blank\" rel=\"noopener\" data-renderer-mark=\"true\"><strong data-renderer-mark=\"true\">100% normobaric oxygen<\/strong><\/a> for at least 30 minutes, at the highest available concentration (15 L\/min), regardless of the gas mixture used, and ideally using a demand valve or non-rebreather mask if the diver is conscious. Although administration may start before contacting DAN, we remind that oxygen is a drug and, in this case, its use should be supervised by a physician.*<\/p>\n<\/li>\n<li>\n<p data-renderer-start-pos=\"5606\">Hydrate the diver: at least 1 liter of water in an hour, monitoring urination and\/or other symptoms.<\/p>\n<\/li>\n<li>\n<p data-renderer-start-pos=\"5710\">If vomiting or loss of consciousness occurs, place in the recovery position.<\/p>\n<\/li>\n<\/ol>\n<p data-renderer-start-pos=\"5793\"><strong data-renderer-mark=\"true\">In case of DCS with SEVERE<\/strong> <strong data-renderer-mark=\"true\">SYMPTOMS<\/strong>, <strong data-renderer-mark=\"true\">immediately alert EMS<\/strong> (<strong data-renderer-mark=\"true\">112<\/strong> <strong data-renderer-mark=\"true\">in<\/strong> <strong data-renderer-mark=\"true\">Europe<\/strong>). EMS manages the emergency by sending an ambulance on site, providing cardiopulmonary resuscitation (CPR) and\/or other life-saving measures as needed. <strong data-renderer-mark=\"true\">The DAN team <\/strong>is then activated and liaises with the local rescue team, to ensure that the diagnostic and therapeutic procedure is correct. DAN follows the case and remains available throughout the period of necessary treatment &#8211; also for all those aspects linked to reimbursements.<\/p>\n<p data-renderer-start-pos=\"6302\">From personal experience I can guarantee that the DAN Medical team often provides helpful assistance, even in serious cases, through telephone support, mediation, and education &#8211; e.g. supporting colleagues who may not be familiar with underwater medicine, and would not diagnose a diving pathology correctly.<\/p>\n<p data-renderer-start-pos=\"6612\"><strong data-renderer-mark=\"true\">In case of serious symptoms, <\/strong>while someone calls <strong data-renderer-mark=\"true\">EMS<\/strong> and clearly states a <strong data-renderer-mark=\"true\">\u201cdiving accident\u201d<\/strong>, others should:<\/p>\n<ul>\n<li data-renderer-start-pos=\"6723\">Perform CPR if needed.<\/li>\n<li data-renderer-start-pos=\"6749\">Administer 100% oxygen at 15 L\/min using bag-mask ventilation. As previously mentioned, oxygen is a drug and should be used under medical supervision. *<\/li>\n<li data-renderer-start-pos=\"6905\">Call the DAN Europe hotline.<\/li>\n<\/ul>\n<p data-renderer-start-pos=\"6937\">DAN <em data-renderer-mark=\"true\">cannot in any way<\/em> replace an equipped First Aid centre or a clinic nearby where we would like everything to work 100% in the best case scenario.<\/p>\n<p data-renderer-start-pos=\"6937\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-11418367\" src=\"https:\/\/alertdiver.eu\/wp-content\/uploads\/2025\/05\/murena_1500.jpg\" alt=\"\" width=\"1500\" height=\"1000\" srcset=\"https:\/\/alertdiver.eu\/wp-content\/uploads\/2025\/05\/murena_1500.jpg 1500w, https:\/\/alertdiver.eu\/wp-content\/uploads\/2025\/05\/murena_1500-300x200.jpg 300w, https:\/\/alertdiver.eu\/wp-content\/uploads\/2025\/05\/murena_1500-768x512.jpg 768w, https:\/\/alertdiver.eu\/wp-content\/uploads\/2025\/05\/murena_1500-700x467.jpg 700w\" sizes=\"auto, (max-width: 1500px) 100vw, 1500px\" \/><\/p>\n<p data-renderer-start-pos=\"7093\"><strong data-renderer-mark=\"true\">So, \u201cDAN or EMS \u2013 who\u2019s better?\u201d<\/strong><\/p>\n<p data-renderer-start-pos=\"7127\">In the best-case scenario, the two entities will work together synergistically. Sometimes only EMS will be alerted, possibly resulting in a successful intervention. Other times, DAN will be contacted by NHS personnel for specialised guidance on how to proceed, or even directly by the injured diver after calling EMS first. It\u2019s not about choosing \u201cwho is better\u201d \u2013 it\u2019s about understanding the context and adapting the response to the specific situation.<\/p>\n<hr \/>\n<p data-renderer-start-pos=\"7127\">*When a doctor \u2013 ideally specialised in underwater and hyperbaric medicine \u2013 is not available on site, assistance can also be provided remotely, under supervision. Our approach is that first responders, who are not doctors but have been properly trained and certified through DAN <a title=\"https:\/\/www.daneurope.org\/en\/education\" href=\"https:\/\/www.daneurope.org\/en\/education\" target=\"_blank\" rel=\"noopener\" data-renderer-mark=\"true\">first-aid courses<\/a>, can intervene promptly to administer oxygen to divers in difficulty. In such cases, our team of experienced doctors provides remote support to ensure effective and safe assistance.<\/p>\n<hr \/>\n<p data-renderer-start-pos=\"8098\"><strong data-renderer-mark=\"true\">References:<\/strong><\/p>\n<p data-renderer-start-pos=\"8111\">Mitchell SJ, Bennett MH, Moon RE. Decompression Sickness and Arterial Gas Embolism. N Engl J Med. 2022; 386(13):1254-54.<\/p>\n<hr \/>\n<p data-renderer-start-pos=\"8258\"><strong data-renderer-mark=\"true\">About the Author<\/strong><\/p>\n<p data-renderer-start-pos=\"8276\">Lara Lambiase is a Medical Doctor specialised in Infectious Diseases and in Diving &amp; Hyperbaric Medicine. Passionate about scuba diving and freediving since 2016, she transformed an ancestral fear of the sea into a true passion. During a vacation in the Maldives, she decided to overcome the fear that had prevented her for years from even swimming offshore. Since then, the sea has become an essential part of her life.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Understanding who to contact first in a diving emergency \u2014 and why context matters. Please note: though this information is generally applicable internationally, its is&#8230;<\/p>\n","protected":false},"author":9,"featured_media":11418376,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[261],"tags":[427],"authors":[395],"class_list":["post-11418339","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-articles","tag-features","authors-lara-lambiase"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v24.2 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Should I call DAN or EMS first? - Alert Diver Europe<\/title>\n<meta name=\"description\" content=\"Unsure whether to call DAN Europe or EMS first after a diving accident? 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