If you are planning a dive expedition and will be diving deeper than 100 meters please follow guidelines before submitting your application for approval.

Our self-contained underwater breathing apparatuses are only useful as long as the cylinder contains sufficient breathing gas. Scuba equipment allows us to breathe underwater, extending our ability to explore. Without breathing gas, our time is limited by the dangers of asphyxia and drowning.

As a member, DAN recommends that you notify the DAN hotline service of your travel plans prior to departure. A travel notification is to ensure that DAN knows when members travel abroad or locally and to add this note on our emergency management system. With the information provided DAN would be able to be prepared for potential evacuation procedures and to advise you on the availability of appropriate treatment facilities where you will be diving. As a DAN member you are welcome to request emergency plans for specific dive sites from the DAN hotline via email (danmedic@dansa.org) or by calling the DAN office on +27 11 266 4900. This is not to be confused with your own on-the-ground emergency plan. The DAN emergency plan is to provide members with a realistic expectation regarding the availability of emergency services and the challenges regarding evacuation procedures.

As an extreme diver, DAN-SA requires that divers submit an emergency plan (first aid equipment; initial stabilisation; access to emergency vehicles or aircrafts; nearest recompression facility; nearest accident & emergency department; nearest ICU; etc.), dive trip details (depth; time; gas mixtures; etc.), dive equipment that will be used (open circuit; rebreathers; oxygen decompression; shot-line or buoy-line; etc.) and the details of the divers participating in diving activities when diving beyond 100 meters. The intent is not to critique dive plans or to “police” divers in anyway. Rather, it is to partner with divers who are willing to plan such dives meticulously. In this way, problems may be avoided as far as possible but, even if they were to occur, the first aid by the divers and emergency response by DAN can complement each other so as to be both expedient and appropriate. We also inform the hyperbaric facilities capable of treating extreme diving injuries to be on standby and have the necessary gas mixes available in the event of a diving injury. The dive plans also need to be approved by the DAN medical director to ensure that all the DAN benefits remain intact when divers dive beyond the 100-meter depth.

Few people enjoy perfect health for their entire lives. Adopting a healthy lifestyle early in life can help postpone ailments associated with ageing. Prior to diving, you should take an honest assessment of whether you are medically fit to dive. Be vigilant for signs of acute illness (like congestion) and familiarize yourself with the risks and essential precautions associated with any chronic diseases.

For more than 20 years DAN has been assisting divers within its region and internationally with emergency evacuations. Many of these evacuations have been extremely complicated, which at times can lead to unfortunate misinformation about alleged unwillingness of DAN to evacuate people by air or road from remote dive locations. Although such a perception may exist, the allegations are simply not true.  To avoid any misunderstandings regarding evacuation, it is important for you and your group of divers to avoid problems as best possible and to work with DAN in the case of an emergency to ensure the fastest, most appropriate response to an emergency.
 
Medical Evacuation is the process of transporting a person suffering from a medical emergency or injury to a place of medical assessment and care or more advanced medical care. This may be achieved by using dedicated aeromedical evacuation, commercial airlines, watercraft or road transport. It may even include using the injured person’s own means of transportation depending on the circumstances. The ultimate objective is to move the person to the intended destination while ensuring necessary safety of the patient (and others involved in the evacuation); providing the appropriate best care available; and achieving this within a time frame that will minimise the consequences of the injury or emergency. Medical decisions balance these complex factors in an effort to offer the best solution in a real world filled with many challenges including weather conditions, terrain, loss of daylight, limited access, and – most importantly – reliable communication. As long as communication is maintained it is possible to consider alternatives, manage difficulties and offer advice – this should always be a priority.  
 
Each emergency is unique. DAN cannot predict the most appropriate solution to every situation in advance. This is where experience and judgment comes into play and that is why DAN partners with experienced service providers both locally and across the globe to assist with these decisions. We also rely on the medical, logistic and environmental information provided by local dive operators who are on site.
 
The following is a guide to these decisions that may be made when (1) the nature of an emergency specifically requires aeromedical evacuation, and (2) there is insurance (e.g., cover related to DAN membership) that offers the service provider a guarantee of payment. The most common reasons for delayed or aborted evacuation are (1) inadequate communication; (2) loss of daylight which disqualifies many airstrips for purposes of night time access; (3) lack of insurance; (4) poor reporting of information required to determine medical necessity for evacuation. Accordingly, every effort should be made to think of an evacuation as a partnership and every effort should be made to facilitate this.
 
Even under ideal conditions, some delay is to be expected. Dive operators and resorts must realise that they may need to provide assistance to an injured person for up to 24 hours before help is able to arrive in remote dive destination. An injured person’s chances of recovery or survival are dramatically improved if proper first aid and oxygen administration can be provided. Persons or groups traveling to remote destinations should enquire what services and equipment are available at the various resorts and dive operations. When in doubt, be independent and take your own equipment and supplies. Importantly make sure that there is an emergency response plan in place and that the management and staff know what to do in an emergency. Don’t leave this to chance.

From simple cases of swimmer's ear to the serious and sometimes lasting damage of barotrauma, divers are vulnerable to ear problems because the delicate mechanisms that govern our hearing and balance are simply not designed for the rapid pressure changes that result from diving.

In case of an emergency in remote areas emergency service providers such as Netcare 911 will need to be informed at least 3 hours (best case scenario) PLUS the flight time to the location before sunset to mobilise their staff and land in daylight as most airstrips are not illuminated in remote areas. Emergency service providers cannot land their aircrafts after dark on runways that don’t have runway lights. Motor vehicle lights and lanterns are unacceptable as they put the aircraft and air crew at risk. However, aircrafts can take off after dark, so the key is getting in before sunset. Therefore it is imperative to phone the DAN hotline as soon as possible when a problem arises. Delay in notification may cause up to 18 hours delay before medical assistance is able to arrive – so notify early: Calling off a flight is better than calling it too late. The most important element in the event of an accident or emergency is to secure good communication. It does not matter whether it is done by telephone, cell phone or radio. As long as the rescuer making the call can talk to a qualified medical person that can provide advice and coordinate the medical response effort. By doing this the injured diver has a better chance of receiving timely care. The second most important element is gaining access to the injured diver. Therefore the rescuer making the call needs to provide the call centre with as much information about the injured diver and the location as possible.
 
Air evacuations is a factor that DAN-SA has no control over. This applies to medical aid and travel insurance companies as it does to DAN-SA. It is important to note that aeromedical resources, such as helicopters and air ambulances, cannot be dispatched unless the need for them has been confirmed and authorised by the DAN Diving Medical Officer, as well as the medical officer responsible for the evacuation. Importantly, and contrary to popular belief, it may take longer to activate an air ambulance than it would take to mobilise emergency medical services via a ground ambulance. In addition, there are several factors, aside from costs, that influence the ultimate decision to make use of aeromedical evacuation, namely:
 
(1) The availability of transport: Is an air ambulance or a helicopter available?

(2) The nature of the injury: How urgently does the patient need advanced life-support and should they be moved to intensive care?

(3) The location of the patient: What are the optimal logistical considerations for efficiently and safely moving the patient to a place where they can receive medical assessment and appropriate medical care, with appropriate medical support during the transfer?

(4) Various aspects regarding the landing zone or airport: Are these appropriate for a helicopter or a fixed-wing air ambulance; are these open, particularly at night; what are the customs or immigration requirements; and what are the implications of getting the patient to the landing zone or airport or the crew to the patient?

DAN must be contacted in the event of a medical emergency to access benefits in the event of any diving injury. You must advise DAN if you are travelling outside your country of residence for longer than 90 days, as international cover is limited to 90 days from the date of departure. If you are a non-working diver and require a limited extension, you must contact DAN-SA in order to ensure that you qualify. DAN benefits are secondary coverage. Wherever possible, DAN will arrange for expenses to be covered firstly by any other travel or medical insurance(s) you may have. Lost or damaged diving gear is only covered if it was lost or damaged as a direct result of a valid, DAN registered accident or evacuation. To ensure cover, DAN must be contacted in the event of any covered emergency or loss. As with insurance companies, there are specific conditions and exclusions which apply. Please make sure that you understand these and have read the benefits of your membership discussed in the Annual Membership guide.