The first five minutes
Five actions. In this order. Before anything else.
When a dive incident occurs, the actions taken in the first minutes have a direct bearing on medical outcome. The sequence below is not a checklist for later. It is the immediate response — while the diver is still in or near the water.
1
Abort the dive
Any diver showing symptoms of a possible dive injury exits the water immediately. Do not complete the dive. Do not wait to see if symptoms resolve. The dive is over. Get the diver out of the water.
Immediate
2
First aid
Keep the diver calm and still. Lay them in a comfortable position. Do not give food. Offer fluids only if the diver is fully conscious, alert, and able to drink safely. Monitor their condition. Note any symptoms — when they appeared, what they are, whether they are changing.
Immediate
3
Administer surface oxygen
If oxygen equipment is available — and on any properly equipped dive boat, it should be — administer 100% surface oxygen immediately. This is the single most important pre-treatment intervention in decompression sickness. Oxygen administration significantly improves outcomes and changes what follows medically. Continue until the diver reaches medical care or oxygen supply is exhausted.
Critical — do not delay
4
Call local emergency services — if the situation is life-threatening
If the diver is unconscious, not breathing normally, severely injured, or otherwise in immediate danger — activate local emergency services first. Do not wait. DAN can coordinate alongside local responders. For life-threatening situations, local EMS takes absolute priority.
Immediate — life-threatening situations
5
Call DAN
Contact the DAN emergency hotline as soon as practically possible — while first aid and oxygen are being administered, or immediately after the diver is stable. Anyone can call. You do not need to be a member. A dive medicine physician will guide what happens next and can coordinate alongside any local emergency response already activated.
As soon as practically possible
Why oxygen matters
Surface oxygen is not a comfort measure. It is pre-treatment.
Breathing 100% oxygen at the surface after a suspected dive incident accelerates the elimination of nitrogen from the body's tissues, reduces bubble size, and improves oxygen delivery to affected areas. A diver who receives surface oxygen promptly arrives at the hyperbaric facility in measurably better condition than one who does not. Every dive boat should carry oxygen. Every diver should know where it is and how to use it.
Calling DAN
What happens when you call — and what to have ready
The DAN emergency hotline connects you with dive medicine expertise. The physician who responds will ask structured questions to assess the situation, advise on immediate care, and begin coordinating what needs to happen next — whether that is local treatment, evacuation, or both. If local emergency services have already been activated, DAN coordinates alongside them.
You do not need to have all the answers. You need to be on the phone. DAN will guide the conversation. Having the following information ready helps the call go faster — but do not delay calling while gathering it.
If you cannot make a phone call
DAN Europe offers two alternatives when voice calls are not possible.
The DAN Europe App includes an SOS button that sends your GPS location and triggers an immediate callback — useful in remote locations with limited voice signal. DAN Europe also offers an internet-based VoIP call at emergencycall.daneurope.org — reachable wherever data connectivity exists, even without a phone signal. Download the DAN App before your trip. Save the VoIP address.
What to have ready when you call DAN
Information that helps DAN respond immediately
Your location — as precisely as possible. GPS coordinates if available. Name of dive site, vessel, island, or nearest town.
The diver's symptoms — when they appeared, what they are, whether they are getting better or worse.
The dive profile — maximum depth, bottom time, number of dives that day, any recent flying.
Whether oxygen is being administered and for how long.
DAN membership number if available — but do not delay calling if you do not have it. Anyone can call.
A call-back number in case the connection is lost.
DAN does not only provide medical guidance on the call. They coordinate. They identify the nearest appropriate hyperbaric facility. They arrange or advise on evacuation. They communicate with local medical personnel if needed. They stay with the situation. A diver with DAN activated from the first call has a physician and a logistics team working alongside them — not a claims department they will speak to after.
Documentation — collect it before you leave
The paperwork that matters is the paperwork you collect at the time.
In the chaos of a dive emergency, documentation is the last thing on anyone's mind. It should not be. The records that support a claim are almost always collected — or not collected — in the hours following the incident. Once you leave the treating facility, what was not collected may be very difficult to recover.
This is not about distrust of insurers. It is about giving any insurer — DAN included — what they need to process a claim completely. A claim form with gaps requires follow-up. Follow-up takes time. The documentation collected at the time eliminates most of that delay.
One important note: if the diver is incapacitated and cannot complete documentation at the time, DAN will still provide assistance. Documentation can be completed by someone on the diver's behalf. Do not let the diver's condition prevent the call to DAN — assistance begins from the first contact, not from the completed paperwork.
At the treating facility
Medical report stating diagnosis and treatment
Ask the treating physician to provide a written report stating why hyperbaric treatment — or any other treatment — was indicated. A chamber log without a clinical justification is not sufficient on its own.
Without this: the insurer cannot verify why the treatment was necessary.
At the treating facility
All invoices and receipts
Request itemised invoices for every charge — chamber sessions, physician fees, medication, facility fees. Keep every receipt. If you pay anything out of pocket, record it at the time.
Without this: specific charges cannot be verified or reimbursed.
From the dive
Dive computer profile
Download and save the dive profile from any computer involved in the incident immediately — before the device is reset, lost, or the data is overwritten. The profile documents depth, time, ascent rate, and any warnings triggered.
Without this: the circumstances of the dive cannot be independently verified.
From the incident
Incident report from the dive operator
Ask the dive boat captain or dive centre to complete a written incident report at the time. Record witness names and contact details. Note the time, location, and what was observed.
Without this: the incident record exists only in memory, which fades and varies.
Transport
All transport documentation
Keep documentation for every transport leg — boat, ambulance, aircraft. Names of services, costs, dates, and times. For evacuation, ask for written confirmation of the service provided.
Without this: transport costs cannot be attributed to the covered incident.
Claim process
Completed claim form — all sections
Complete the claim form in full. Every question. Ask the hospital and physician to complete their section before you leave. Attach all supporting documents when you submit.
An incomplete form will be returned — and that takes time.
What slows a claim
Claims are not typically denied. They are delayed by documentation gaps.
The most common reason a legitimate claim takes longer than it should is missing paperwork — not bad faith on the part of the insurer. A claim that arrives complete, with all supporting documents attached, is processed significantly faster than one that requires follow-up for missing items.
📄
Medical report without clinical justification
A chamber log shows the diver was treated. A medical report explains why. Both are required. The most common single documentation gap is a treatment record without a written diagnosis from the treating physician.
💻
Missing dive computer data
The dive profile documents the circumstances of the incident. A diver who cannot produce their computer data — because it was not downloaded before the device was reset — creates a gap in the incident record that is difficult to fill retrospectively.
📋
Incomplete claim form
Unanswered questions on the claim form require follow-up before processing can continue. The physician or hospital section left blank is the most common example — it requires contacting the treating facility, which may be in another country and time zone.
🧾
Missing invoices for specific charges
A total bill without itemisation cannot be fully verified. Charges for which no invoice exists cannot be reimbursed. Request itemised documentation at the treating facility before payment is made.
⏱️
Late notification to the insurer
Many evacuation and repatriation benefits require coordination or authorization before transport is arranged, whenever circumstances permit. Contact DAN as early as possible — they can arrange or coordinate transport and ensure coverage applies. The earlier DAN is involved, the smoother the process.
The documentation that supports a claim is almost always collected — or not collected — in the hours following the incident. What is not collected at the time is very difficult to recover later.
What not to do
Five things that make a dive incident significantly worse.
Knowing what to do matters. So does knowing what not to do. These five are the most consequential errors — the ones that turn a manageable incident into a more serious one, or a straightforward claim into a complicated one.
✕
Do not re-enter the water
A diver showing any symptoms of a possible dive injury does not dive again — not that day, not the next day, not until medically cleared by a physician with dive medicine knowledge. Re-entering the water before clearance risks serious harm.
✕
Do not fly until medically cleared
Flying after a dive incident — particularly after decompression sickness — can cause serious deterioration. Reduced cabin pressure at altitude affects nitrogen bubble behaviour in ways that can worsen the injury significantly. No flying until a dive medicine physician has explicitly cleared the diver for air travel.
✕
Do not assume symptoms will resolve on their own
Symptoms of decompression sickness — joint pain, fatigue, numbness, tingling, dizziness — can be mild at onset and worsen significantly without treatment. Any symptom that appears after a dive should be treated as a potential dive injury until a physician says otherwise. Waiting is not a conservative response. It is a risk.
✕
Do not arrange major evacuation without contacting DAN when possible
Where circumstances permit, contact DAN before arranging evacuation or transport. DAN can identify the nearest appropriate facility, coordinate the transport, and ensure the chain of care is continuous. In a life-threatening situation, local EMS always takes priority — but where there is time to call DAN first, do so.
✕
Do not leave the treating facility without documentation
The medical report, the invoices, the physician's section of the claim form — all of this is collected at the treating facility, in the hours following the incident. Once you leave, recovering missing documentation from a foreign facility may take weeks. Do not leave without it.