Every diving activity shall maintain emergency medical equipment that will be
available immediately for use at the scene of a diving accident (Figure 21-2). This
equipment is to be in addition to any medical supplies maintained in a medical
treatment facility and shall be kept in a kit small enough to carry into the chamber,
or in a locker in the immediate vicinity of the chamber.
Primary Emergency Kit. Because some sterile items may become contaminated
as a result of a hyperbaric exposure, it is desirable to have a primary kit for immediate
use inside the chamber and a secondary kit from which items that may
become contaminated can be locked into the chamber only as needed. The lists of
contents presented here are not meant to be restrictive but are considered the
minimum requirement. Additional items may be added to suit local medical
preferences.
Emergency Kits. The Primary Emergency Kit is described in Table 21-7; the
Secondary Emergency Kit is described in Table 21-8a.
Primary Emergency Kit. The primary emergency kit contains diagnostic and therapeutic
equipment that is available immediately when required. This kit shall be
inside the chamber during all treatments.
Secondary Emergency Kit. The secondary emergency kit contains equipment and
medicine that does not need to be available immediately, but can be locked-in
when required. This kit shall be stored in the vicinity of the chamber.
Portable Monitor-Defibrillator. Only commands having recompression chambers
with a medical officer attached shall maintain a portable monitor-defibrillator and
those drugs listed with an asterisk (*). These drugs need to be in sufficient quantities to support an event requiring Advanced Cardiac Life Support. These
drugs/equipment are not required to be in every dive kit when multiple chambers/
kits are present in a single command.
Use of Emergency Kits. Unless adequately sealed against increased atmospheric
pressure, sterile supplies should be resterilized after each pressure exposure, or, if
not exposed, at six-month intervals. Drugs shall be replaced when their expiration
date is reached. Not all drug ampules will withstand pressure. Stoppered multidose
vials should be vented with a needle during pressurization and then discarded if
not used.
Modification of Emergency Kits. Because the available facilities may differ on
board ship, at land-based diving installations, and at diver training or experimental
units, the responsible Diving Medical Officer or Diving Medical Technician will
have to modify the emergency kits to suit the local needs. Both kits should be
taken to the recompression chamber or scene of the accident. Each kit is to contain
a list of contents. Each time the kit is opened, it shall be inventoried and each item
checked for proper working order and then re-sterilized. Sterile supplies are to be
provided in duplicate so that one set can be autoclaved while the other resides in
the kit. The kits on-hand are inventoried, unopened, at four-month intervals.
Normally, use of the emergency kit is to be restricted to the medical personnel.
Concise instructions for administrating each drug are to be provided in the kit
along with current American Heart Association Advanced Cardiac Life-Support Protocols. In untrained hands, many of the items can be dangerous. Remember
that as in all treatments YOUR FIRST DUTY IS TO DO NO HARM.
