Newsgroup: it.hobby.scuba
Titolo: report incidente LUNGO





posto questo msg più altro per la completezza delle 
informazioni riportate.


Mi pare un esempio abbastanza utile di gestione (purtroppo 
vera) di un emergenza.


Dive Accident at 
Tubbataha


Victim:
 
        
Larry 
I 
Gallares
Age:
    
        
        
28 
years
Padi DM 
#:
      
        
464666
Experience: 

    
        
In 
his 6 month as full time liveaboard Divemaster. 

Vessel:
 
        
Island 
Explorer 
Accident area: North Tubbataha National Marine 
Park.
Event History:




1
       
Sunday 30 
  April.  During night trip to first dive sites Larry goes to the Boat 
  Manager to say he is not feeling very well and having some slight breathing 
  problems.  After discussion it was decided he would not dive until he 
  feels better and shows improvement.


2
       
Monday 
  1
st
 May and Tuesday 2
nd
 May Larry is still unfit for diving and stays on 
  the Vessel.


3
       
Wednesday 
  3
rd
 May morning Larry does not go on the first 
  2 scheduled dives of the day.  At lunch he tells the boat manager and 
  group 2 Divemaster that he is feeling fine and OK to dive.  After further 
  discussion he convinces both that he is fine and it is decided that he can go 
  on the 3
rd
 dive as a safety diver 
  Only.   He is told to stay above the group and to go up at anytime 
  he does not feel comfortable.


4
       
At 
  approximately 1400 the group consisting of a leading Divemaster, 6 guests and 
  Larry as Safety Diver entered the water to start the dive.  
  


5-6
     
min 
    
    
Group 100 ft 
    
   
        
Larry 
    
  
        
80 
    ft 
    
7-17 
    
   
min
     
Group  
    60 
    ft
    
        
Larry
   
        
50 
    ft 
    
18-24
   
min
     
All 
    divers now at 40 ft


5
       
At about the 
  24-minute mark Larry signals the Divemaster that he is going up.  DM 
  points and gives are you OK and Larry responds with OK signal back.  He 
  hovers as dive guests go past him and DM watches as he does a slow frog kick 
  to surface and resumes diving with guests assuming all is well.


6
       
At the surface 
  Larry signals to chase boat that he is up and two boats head towards 
  him.  First boat arrives within 30 seconds to find Larry now floating on 
  back convulsing with foam coming from mouth. 
  


7
       
They 
    immediately drag him into the boat with assistance from one other boat boy 
    and speed him back to the mother Vessel the Island Explorer.  He was 
    offloaded onto the dive deck and his wetsuit was removed and checked for 
    pulse and breathing by boat crew.  The recall signal was given and 
    first back to the Vessel was Staff instructor Thomas Schack Von Brockdorff 
    who initiated the circle of care and sent for the DAN O2 kit.  At the 
    same time instructions where given to call home base and activate DAN and 
    rescue plan.


All times are approximate due to stress levels at both sites and tough 
  level of communication by marine radio.


Home Base (
HB
) is Scuba World’s Makati Office in Manila City 
  
Island Explorer (
IE
) 
  
Puerto Princesa (
PP
)


14:00 
  
  
        
Enter 
  water 
  
14:30  
 
Found unconscious by chase boat 
  
14:31
   
        
Recall 
  activated and pulse checked 
  
14:40
   
        
Instructor 
  arrives and assumes control of scene. 
  






14:50
   
IE
      
Circle 
        of care established and HB informed of accident via satellite phone from 
        sister vessel Oceanic Explorer 
        
14:55
   
HB
      
Called 
        up Boy Siojo and he in turn immediately contacted Larry’s sister, Pam 
        Gallares-Opus.  She in turn started calling her contacts for 
        possible air evacuation which included Mayor Edward Hagerdorn of Puerto 
        Princesa City 
        
15:00
   
HB
      
Calling 
        DAN Philippines and requests Dr Benjamin Luna for assistance.  
        Informed he is out of country so details of accident given to his 
        secretary.  We ask for emergency plan to be activated and EVAC 
        arranged for victim.  No help is given from this office and no 
        further response is received from this agency. 
        
15:00
   
HB
      
Called 
        up Norman Songco of Island Divers advising him of accident and to alert 
        hospital to be on standby for ambulance service once IE arrives PP at 
        1:00 AM.  Also called  up Mr. and Mrs. Cesar Gabrino of PP 
        requesting for assistance.  However, Mr. Gabrino was in Manila at 
        that time. 
        
15:00
   
HB
      
Called 
        up Philippine Commission on Sport Scuba Diving (PCSSD) but no 
        answer.  Called up Dept. of Tourism trunkline and was advised that 
        PCSSD was in the process of moving their office within the building and 
        therefore phone lines are out of commission 
        
15:00
   
 IE
  
        
   
Pulse down to 40 bpm, some convulsing, 
        Biting on tongue, serious swelling of eyes and face, and bluish patches 
        on upper chest.  Mucus and clear fluids coming from nose and 
        mouth.  Rescue team clearing fluids and continue to monitor 
        victim.  Dan O2 kit in use. 
        
15:02
   
IE
      
Pulse 
        36, very swollen around face and neck, have to keep mouth and airways 
        open.  Air exchange can be heard from lungs but very weak. 
        
15:04
   
Commence rescue breathing as 
        cannot determine if victim is breathing by himself, nose full of fluid. 
        
15:08/09
        
IE
      
Pulse 
        34-36, swelling around eyes has gone down a little. 
        
15:14
   
IE
      
Victim 
        on pure oxygen at 4 minute intervals.  In-between, oxygen assisted 
        AR was being administered for 1 minute 
        
15:15
   
HB
      
KKP-WWF 
        Philippines has called Navy from ranger station and they monitor radio 
        traffic.


15:18
   
IE
      
Vessel 
        now heading back to Puerto Princesa at max speed.  Due to 
        vibrations hard to count pulse but its there and tissue color is 
        starting to improve. 
        
15:20
   
HB
      
Called 
        505 Rescue Squadron.   Spoke to Capt Natividad and requested 
        immediate medic evacuation of victim.  Response, no asset available 
        as in Manila for servicing.  Advised to make a black and white 
        request addressed to A3 at HQ Philippines Air Force.  Two more 
        check calls later in the afternoon result in no clearance from higher 
        authorities as yet. 
        
15:21
   
IE
      
No 
        more saliva or fluids in the nose.  Swelling continues to decrease. 

        
15:22
   
IE
      
100% 
        sure airway is open, tongue tip is starting to show colour. 
        
15:24
   
IE
      
Jaws 
        relaxed, no more tongue biting, not convulsing. 
        
15:25
   
IE
      
Convulsing 
        and cramping again 
        
15:28
   
IE
      
Pulse 
        clearly there but remains difficult  to count , rescue breathing 
        assistance continues throughout entire process.  Instructor and 3 
        Divemasters are taking turns to do breathing.  They now breathe 
        medical O2 from 400 cf tanks and blow into victim. 
        
15:41
   
IE
      
Pulse 
        43 bpm 
        
15:51
   
IE
      
Pulse 
        48 bpm 
        
15:56
   
IE
      
Pulse 
        48 bpm 
        
16:00
   
HB
      
Calling 
        Palawan looking for Dr Reyes who is trained in hyperbaric trauma.  
        Unfortunately out of town and not  due back prior to 19:00 
        
16:07
   
IE
      
Cannot 
        get pulse, full CPR in progress 
        
16:10
   
HB
      
Calling 
        Palawan Adventist Hospital in search of a doctor to go to the 
        boat.  Getting no response at this time and wasting a lot of time 
        answering stupid questions to nurses etc when we have already declared a 
        medical emergency with victim in critical condition. 
        
16:15
   
HB
      
Called 
        Scuba World Cebu to see if there was an Air Force helicopter 
        available.  Cebu calls back a few minutes later and advised that no 
        chopper and the chamber at Camp Lapu-Lapu not working due to compressor 
        problem. 
        
16:23
   
IE
      
Definite 
        pulse back, 50 bpm 
        
16:25
   
HB
      
Called 
        up Mike O’Farrell from Subic for float plane service but he advised he 
        cannot fly due to registry change in progress for plane 
        
17:00
   
HB
      
Called 
        Lifeline but no night flying, earliest start 06:00 next morning. 
        
17:00
   
HB
      
Contacts 
        have been made in Palawan and Navy on full standby to send fast patrol 
        boat to intercept Island Explorer but still not finding a local doctor 
        to go. 
        
17:06
   
IE
      
Pulse 
        still definite but very faint, rescue breathing still being 
        administered. 
        
 17:15
  
HB
      
Contacts 
        SOS (Supply Oilfield Services) who refer us to International SOS, but 
        once again no night operations so response 06:00 earliest. 
        
17:23
   
IE
      
Pulse 
        47 bpm 
        
17:30
   
HB
      
Got 
        in touch with Dr. Jojo Bernardo of the  AFP recompression chamber 
        advising him of accident.  He acknowledged and advised that the 
        chamber is ready to receive the patient anytime. 
        
17:30
   
HB
      
Contacted 
        the Palawan Provincial Hospital and informs doctor in charge, Dr. Nelson 
        Caliuag, of the situation and that an ambulance and trained emergency 
        personnel is needed at the Puerto Princesa Pier at the IE’s ETA of 
        01:00  01:30 the following morning.  
        
17:30/22:30
     
HB
      
Friends 
        of victim and staff calling every person they know to get plane or 
        helicopter to be at Palawan ASAP in the morning for EVAC to 
        chamber.  Several private air charter companies options on standby. 

        
18:00
   
HB
      
Contacted 
        Dr. Enrique Latonio of Divemed and asked him to come to 
HB
 to 
        give medical advise by radio. 
        
18:20
   
PP
      
Local 
        Doctor and Nurse show up at Pier but Doctor forgot something and leaves 
        for 40 minutes.  Advised him that the IE have loads of Oxygen on 
        board 
        
18:28
   
IE
      
75 
        bar left in 1
st  
Tank 
        
18:30
   
HB
      
Contacted 
        KKP-WWF office in Puerto Princesa and was informed that they had been 
        monitoring the situation from the beginning and that arrangements had 
        been made for a Navy patrol boat to intercept the 
IE
 for 
        assistance. 
        
18:30
   
HB
      
Contacted 
        the Palawan Provincial Hospital again and is informed that Dr. Nelson 
        Caliuag had already left with an ambulance. 
        
18:34
   
IE
      
Victim’s 
        jaw locked, having difficulty holding his tongue with rescue breathing 
        
18:35
   
IE
      
Pulse 
        has become more definite, physical appearance has improved. 
        
18:41
   
IE
      
68 
        bar O2 tank 
        
19:00
   
PP
  
        
    
Navy fast patrol leaves Puerto 
        Princesa to intercept 
IE
 with Doctor and Male Nurse onboard. 
        
19:00
   
HB
      
Dr. 
        Latonio arrives in HB and talks to IE by radio and asks for patient’s 
        status 
        
1903
    
IE
      
48 
        bpm 
        
19:15
   
IE
      
60 
        bpm 
        
19:24
   
IE
      
56 
        bpm 
        
19:30
   
HB
      
Dr. 
        Latonio requests to check victim’s pupils.  IE replied that pupils 
        were dilated and not responding to light. 
        
19:44
   
IE
      
90 
        bpm 
        
20:48
   
IE
      
84 
        bpm  O2 Consumption 7 bars/ 13 mins 
        
21:02
   
IE
      
60 
        bpm 
        
21:35 
        
  
IE
      
90 
        bpm 
        
22:15
   
IE
      
Victim 
        turned over to Doctor from Navy patrol Boat


At this time we have still not received the doctors report so facts 
        are based on what eyewitnesses saw happen.


22:16
   
IE
      
Doctor 
        attempts to use hand pump to ventilate victim when this failed he 
        inserted a breathing tube into mouth to open airway and  commenced 
        with hand pump.  He refused to connect  O2 supply to 
        ventilator pump.   Nurse inserts IV into victim’s arm.  
        No pulse so 1 ampoule of pure adrenaline was administered to the victim 
        through the IV.  Doctor attempts one man CPR from above victim’s 
        head while pumping ventilator with one hand and doing chest compressions 
        with the other hand.  After some time, he administers 2 more 
        ampoules of pure adrenaline.  After about 10 minutes maximum, the 
        Doctor declares victim dead.  
        
2230
    
HB
      
Is 
        informed that Doctor has declared Larry dead. 
        
2235
    
IE
      
Captain 
        of IE and Navy Boat confer with permission being received to transfer 
        body to navy boat for transport back to Puerto Princesa.  Three (3) 
        Divemasters accompany body. 
        
23:00
   
HB
      
Arrangements 
        are made for Company Owner and Fleet operations manager to fly to PP on 
        first flight with forms for incident reports and to interview as many 
        eyewitnesses as possible.  These reports and interviews are the 
        basis of this report.


Thursday 4
th
 May


01:30
   
PP
      
Victim 
        and party are met at Pier by Mayor Hagedorn of Puerto Princesa City and 
        party to transfer body to Palawan Adventist Hospital.  Where a 
        Doctor Daniel T. Alfonso administered an EKG and showed the flat line 
        print to the Divemasters. 
        
10:00
   
Plane from Manila arrives with 
        company staff and friends and relatives of the victim.  During the 
        next 30 hours we interviewed all own staff and talked to Navy and 
        Hospital with the help of the Mayor’s office 
        


Later in the day the body is moved to a local funeral parlor so 
        transportation can be arranged to return Larry to his Parents on the 
        Island of Bohol.  


Friday 5
th
 May


14:00 
  
While at the airport waiting for 
        plane back to Manila we received a copy of the deaths certificate which 
        states the following. 
        


Cause of death:
 
Cardio-pulmonary Arrest 
          secondary to unknown cause. 


Time:
   
        
02:00 
        4
th
 May, 2000 
        


Attding 
          Physician:
      
Dr 
          Alfanso.  Adventist Hospital Doctor not Doctor on the Navy 
          Boat


8.
      
While we as Dive 
    Instructors and Divemasters are not certified doctors we are highly trained 
    in Medic First Aid and CPR procedures.  We are still waiting for the 
    Official reports from the Hospital, Doctor and Navy for their version of 
    events as they happened.  We are not trying to point the finger of 
    blame at any individual but would like to be in possession of all reports so 
    we can all draw our own conclusions based on facts and not 
    speculation.


9.
      
There was no 
    autopsy done as per request of the family of the victim


10.
     
While this unfortunate 
    tragedy can no longer be avoided there are some very disturbing and serious 
    questions to be asked and answered so this does not happen 
    again.


11.
     
We at SCUBA WORLD will 
    be only too happy to answer any questions that anyone has regarding this 
    most sad accident that has resulted in a Fatality.  We can be contacted 
    at : 
    




Phone
   
        
(63) 
        2 895 3551 
        
Fax
     
        
(63) 
        2 890 8982 
        
Email
   
        
swidive@i 
        
manila.com.ph


12.
     
We would also like at 
    this time to express our condolences to all the Family and friends of Larry 
    Gallares.  


13.
     
We would like to thank 
    the crew and dive staff involved for what was a superhuman effort that kept 
    Larry alive for more then 7 hours.  In particular are Thomas Schack von 
    Brockdorff (instructor), Casty Pambid (DM), Oye Peralta (DM) and Allan 
    Agustin (DM from the Oceanic Explorer who transferred to the IE to 
    assist).


14.
     
We would also like to 
    thank all the people who helped and gave assistance:  
    


a.
      
Dr. Jojo Bernardo 
      of the AFP Recompression Chamber 
      
b.
      
Dr. Enrique 
      Latonio of DiveMed 
      
c.
      
Norman Songco of 
      Island Divers 
      
d.
      
Naval Forces West 
      under the command of Commodore Rodolfo R. Rabago, AFP 
      
e.
      
Dr. Nelson 
      Caliuag of the Palawan Provincial Hospital 
      
f.
      
Mr. and Mrs. 
      Cesar Gabrino of Puerto Princesa City 
      
g.
      
KKP-WWF 
      Philippines staff field office at Puerto Princesa City 
      
h.
      
Mayor Edward 
      Hagedorn of Puerto Princesa City and his staff 
      
i.
      
Mel Segarra and 
      Boy Siojo 
      
j.
      
All individuals 
      who contributed whom we may have omitted 
      unintentionally


15.
     
We would also like to 
    thank all the friends and fellow divers who called their own contacts for 
    air evacuation through private parties and who kept vigil at HB until the 
    early morning hours of May 4, 
  2000


John 
Wee
        
        
        
        
        
        
        
        
Paul 
Voice
President
       
        
        
        
        
        
        
        
Marine 
Operations
SCUBA 
WORLD
     
        
        
        
        
        
        
SCUBA 
WORLD






-------------------------------------------


Anthony Co


Systems Administrator at-large


Email: 
as...@info.com.ph


Handphone: 
+63917-5265189


Voicemail: +63917-280


"Yesterday it worked. Today it is not working. 


Windows(TM) is like that" - Computer Haiku




 



Vessel:         Island Explorer=20
Mamma mia che ansia mi ha messo questo articolo!!!!!, spero di non
trovarmi mai ne dentro ne vicino ad una situazione cosi.
Ciao Andrea 



posto questo msg più altro per la completezza delle 
informazioni riportate.


Mi pare un esempio abbastanza utile di gestione (purtroppo 
vera) di un emergenza.


Dive Accident at 
Tubbataha


Victim:
 
        
Larry 
I 
Gallares
Age:
    
        
        
28 
years
Padi DM 
#:
      
        
464666

