Oxygen treatment and retrieval pathways of divers with diving-related conditions in Townsville, Australia: a 15-year retrospective review

Introduction: First aid for injured divers includes oxygen delivery prior to definitive care. Delay to specialist assessment and/or hyperbaric oxygen treatment (HBOT) may be due to dive site remoteness and limited access to facilities. Townsville has the only hyperbaric facility along the Great Barrier Reef. Analysis of oxygen therapy and retrieval pathways of divers treated in Townsville may assist with establishing future education strategies and resource allocation. Methods: Data were retrospectively collected on divers assessed at the Townsville hyperbaric medicine unit from November 2003 through December 2018. Demographics, dive incident location, oxygen treatment, retrieval platform and pathway, and initial disease grade were reviewed. Data are presented as frequencies and percentages. Results: A total of 306 cases were included (184 males). Divers typically received oxygen therapy (87%, 267/305 known) prior to specialist review. The non-rebreather mask was the most frequently used (44%, 28/63) followed by in-water recompression (24%, 15/63). While 34% of the divers were retrieved from the scene (n = 104), only 11 (11%, 11/104) were retrieved directly to Townsville. Most divers initially classified as severe were retrieved from the scene (82%, 27/33), only two directly to Townsville. Fifteen cases had three retrieval legs (5%, 15/306). Conclusions: Most injured divers received oxygen first aid and were transported to Townsville for definitive care with a variable number of retrieval stages. Continuing education of retrieval physicians should address knowledge of diving related injuries and highlight cases that may benefit from expedited transfer.