By Michael Menduno. Images courtesy of Scubapro and David Rhea
See accompanying table: THE EVOLUTION OF SCUBAPRO INNOVATIONS
Now in its 60th year of operation, Scubapro, arguably one of the most iconic brands in scuba, has decided to up its tech game. Though it is not known as a tech brand per se, its iconic Jet Fins and its reputation for making some of the best regulators in the world have assured Scubapro a place in tekkie gear bags. But now, the innovative equipment maker has completely rethought and redesigned its legacy X-Tek line from the 1990s—remember that?—including redesigning the tried-and-true backplate, harness, and wings! Hello S-Tek! They’ve even come out with a new S-Tek Fin. Is nothing sacred?!?
Fortunately, there’s arguably no one better to help explain Scubapro’s tech re-entry than underground veteran David Rhea, who’s worked as a Scubapro sales representative for nearly 30 years and has been actively involved in the development of their tech products. A former training director and board member for the National Association of Cave Divers (NACD) Rhea, who was also one of Global Underwater Explorers’s (GUE) earliest instructors and instructor evaluator who was instrumental in forging a relationship between Scubapro and then tech and cave diving equipment start-up, Halcyon Dive Systems, in the late 1990s—a relationship that is still going strong today. More recently, he was a part of the team that developed and christened Scubapro’s new S-Tek line.
InDEPTH sat down with Rhea to discuss Scubapro’s re-entry into the tech market and some of their new creations designed to better address tekkies’ needs. Here’s what the man had to say.
InDEPTH: David, when we met in 1990, I was taking my full cave diving course with Steve Gerrard who was the NACD Training Director at the time. You owned a dive center and were also teaching. We met up while the two respective classes worked on line drills before getting in the water. We go back quite a ways. That was before you joined Scubapro. How and when did that come about?
David Rhea: Back then, the Scubapro sales rep for my shop—Rhea’s Diving Inc. in Maryville, Tennessee—was a guy named Guy Miller. He was not only my rep, but he became a really good friend. That’s how I feel about a lot of the relationships in my Scubapro territory, where I’m really close friends with my dealers.
By way of background, I had worked with SeaQuest on their buoyancy compensator devices (BCDs) and also got to work on SeaQuest’s Black Diamond BCD and other diving products. In fact, I had flown out to Seaquest and met with Mario Valenzuela, who later came to work for Scubapro, and he offered me a job.
When I got back to Tennessee, I told Guy. He said, “No way. If you’re gonna work for anybody, you’re gonna work for Scubapro.” I had to agree. I told him the only way I would sell my dive store would be if I had a chance to work for Scubapro because I had always been proud of the brand. Then Guy explained that there were several openings for sales reps. “Why don’t you go up to Wisconsin and apply?” At the time, I was going through a divorce and life changes. So, it felt like, “Maybe this is what I’m supposed to do!”
Making a life change. What year was that?
It was 1996. I went to Scubapro headquarters and met with Robert Stoss who, at the time, was the president of Scubapro North America. He explained that they had several territories; the Northeast, the Midwest, or Miami and the Caribbean. And I said, “In the Northeast, I probably won’t survive long as a redneck, and I’d probably starve in the Midwest. I’ll take Miami, the Florida Keys and the Caribbean.”
Long story short, I took the job and sold my store to the guy who owns it to this day. I taught him how to dive when he was 18 years old, got him into cave diving, and eventually made him a NAUI instructor—I was a course director. He’s now 54. I can’t imagine anyone else who could have better represented my vision. He’s done a great job.
That’s terrific. So, you’ve been with Scubapro for almost 30 years. You actually helped create some of Scubapro’s original tech line, the X-Tek, back in the 1990s. Tell me about that.
Correct. I worked on the original X-Tek with a man named Dave McLean, who was an engineer at Soniform. In addition to Scubapro, Johnson Outdoors acquired Soniform, which made buoyancy compensators primarily for OEM sales, the same year (1997) it purchased Uwatec.
So we looked at the rudimentary wing that Scubapro originally created in the 1970s and what was on the market at the time. Dive Rite, of course, had a wing, and English Engineering, and others. And with Soniform onboard, we could build whatever we wanted, which was great. So, we designed and created the original X-Tek wing. Dave brought more from the manufacturing side, and I brought more from the tech instructor and explorer side of things.
Scubapro obviously brought a lot to the table.
For sure. X-Tek was a cool name and Scubapro had some cool products. We were famous, of course, for our regulators and Jet Fins. Scubapro BCDs had always been strong—they created the first jacket-style BCD. They also invented the balanced inflator. While Scubapro didn’t necessarily have as much expertise in designing technical equipment, we had expertise in other areas, including the best hoses, dump valves, power meters, and things like that—the functioning portions of the BCD as well.
I think it’s fair to say that many people don’t think of Scubapro as a tech brand. Though they are an old, highly respected brand with high quality, innovative products. In fact, it’s their 60th anniversary! Amazing!!
I never really thought of them as part of the tech world in the beginning, but they were, of course!
Yes, they were.
Their hallowed Scubapro Jet Fins, along with the knock-offs that followed, have long been the standard among tekkies—and, of course, Scubapro regulators. And they were also instrumental in working with Halcyon Dive Systems in the early days. You were one of GUE’s earliest instructors and involved with Halcyon. Didn’t you help broker the relationship between Halcyon and Scubapro back in the day?
Yes, I did. As you know, I have been passionate about diving my entire life. I mean, I love diving, and I’ve been blessed to do what I love for a living. But you know the one area that keeps me going—the drug that keeps feeding me—is the cave diving side of things, and with that the exploration side of things: the “going where no one has ever gone” exploration side.
So, understand, from the very beginning, I was trying to push them into technical diving. ”We’ve been around all these years, we’ve created all these products, we should get into technical diving!”
And working with Halcyon was a way to do that.
Halcyon had just started and was coming on really strong. They were friends of mine, of course; they are still friends of mine, and Scubapro had a lot of things they needed. Halcyon was creating harnesses and backplates, but they needed to have waist buckles—the stainless steel buckles. At the time, everybody had plastic buckles, but if the tanks fell over or you dropped anything heavy on them, you could break them. However, we always had this really classy metal belt buckle. So, for a while we provided them with belt buckles.
Then of course, as X-Tek was getting started, we needed a spring heel, which was originally developed by Bob Hollis, and Halcyon was making them in-house. So, they started making heels for Scubapro. Meanwhile, we provided them with manifolds, which they used in the early RB80; and, of course, pressure gauges and some other things. Sο, we had and still have a symbiotic relationship to this day, as we manufacture their regulators.
Both brands benefited!
It has definitely been a good relationship for both organizations. Halcyon, which is affiliated with GUE, was looked at, of course, as representing premier explorers around the world. As a result, having the best regulator that money can buy made by the best manufacturer of regulators on Earth was kind of a no-brainer from them.
And, from our [Scubapro’s] perspective, it was like, “Hey man, if these people are gonna go out to do these unbelievable wreck and cave dives all over the world, it would be awesome if they were using our regulator versus a regulator from one of our competitors.”
Because, you know, without sounding arrogant, I truly believe in my heart and soul that we make the best regulators that you can dive with. So, I wanted to make sure that my friends at Halcyon had the safest, best equipment out there.
And you certainly went out and spread the love. I mean legendary explorers Sheck Exley and Jim Bowden, training pioneer Hal Watts, and even the Woodville Karst Plain Project (WKPP)—you got a lot of explorers engaged with and diving Scubapro regulators to support their exploration work.
Guilty as charged! [Rhea grins.] Early on, the WKPP used Scubapro almost exclusively from the start, though it changed a bit later. Jim Bowden and I were good friends. I got him and his partner Ann Kristovich on Scubapro regulators. Hal Watts, aka Mr. Scuba, and I are still very dear friends to this day. Mr. Scuba will jokingly say he’s Mr. Scubapro because he’s always been super passionate about Scubapro. And, he’s done some incredible deep air dives, which is his passion and what he’s famous for. And our regulators have—as far as I know—performed flawlessly for him for years.
Of course, there’s all kinds of scientific, military, and commercial groups that have been using our products for years and have trusted them all over the world in all kinds of extreme conditions.
So, now Scubapro is making an exerted push, a new push, into the tech market with new products. Talk to me a little about that. Why now? Why the push to up their tech game?
It’s funny because it does come across as, “Why now?” But from my perspective, S-Tek has actually been in the works for a long time.
So Scubapro has changed the name of their tech line from the original X-Tek to S-Tek?
That’s right. It’s funny, when we created X-Tek—Dave might have been an influence there—it was the 90s and the letter “X” was hot, like X-Games. It seemed a bit more technical and radical. Your magazine aquaCORPS had christened the sport “technical diving,” so X was just part of the “cool.”
Elon Musk still thinks it is!
You gotta point there. We talked about S-Tek at the time. In fact, we did some logos and stuff. I liked the S better, just because I thought it made it obviously Scubapro, especially with our iconic S, where X didn’t. So, when we decided to revitalize the line, we decided to brand it S-Tek. We wanted to keep the family name and use the Scubapro logo on all of it. Also, we didn’t want any negative stigma of X-Tek. Don’t get me wrong; there wasn’t anything wrong with it. But it never really got the traction that we wanted. Back in the day, X-Tek also expanded into things like ‘bondage wings,’ which I’ve never endorsed in my life. Scubapro still has the X-Tek line along with some of the legacy wings and harnesses, but their focus now is on the S-Tek line.
Ha! Well I have to say, I’m glad the company chose the T-E-K option, the original designation. So Scubapro has decided to have another go at the tech market with S-Tek!
That’s right. It’s been many years in the making, and we are now just pulling the trigger! In fact, Scubapro’s global group vice president Joe Stella and Rhys Couzyn (who invented the Hydros BCDs and our NOVA and new Go Fins, a brilliant engineer) and I got together a few years ago, and Joe said, “Let’s make this happen.”
So I flew to South Africa and spent a couple of weeks there, and we basically looked at every aspect of the technical diving market—within reason. We’re not going to go into rebreathers or anything like that. But we said, “How can we do it the Scubapro way?” which means we innovate, we redesign, we don’t just copy.
Wow! I understand that Scubapro has actually reinvented the backplate, harness, and wing which got my attention. Who knew that they even needed to be reinvented. Talk to me about that!
Well first, kudos again to Rhys. He is arguably one of the top engineers in the diving industry, and a technical diver. He began by looking at how backpacks fit for hiking, military use, and all the ways people use backpacks. And then we started looking at backplates. How is it going to fit when you’re walking to the water with a set of 120s on? How’s it going to fit when you’re spending hours in trim in the water swimming or scootering through a cave, and how’s it going to feel for hours decompressing?
As a result, we were able to identify—I wouldn’t necessarily call them weaknesses—but rather, areas for improvement, with the existing backplate technology. So together, we decided to do something different.
Fascinating. So, what did you do?
Instead of using a break and taking the metal and basically creating a channel down the back, we use a 100-ton press and actually press the stainless into a shape that’s more like your true back. There’s no channel down the back.
Of course, the channel was created to make space to bolt the wing and backplate to the tanks, so the wingnuts could be tightened down without poking a hole in your drysuit or wetsuit. So, after the metal is pressed, we hydraulically punch sockets into the backplate. By doing that, we ended up creating a plate that is not only completely shaped to your back, but also has these sockets, which is where the wingnut goes.
We then went a step further and created these easy-to-tighten ergo nuts. The nut forms a little case that holds either a metric or imperial wing nut, which you can drop right in. It’s got a little door that you pop open, drop your wingnut in, and go. So instead of trying to tighten down a stainless wingnut with your cold hands, you have this large plastic surface area with an opening, with all of the strength of the stainless steel. Using the press, we were also able to build the handle into the stainless, so you can pick up your rig directly from the backplate.
That makes a lot of sense,
It does. Finally, we went back, looked at them, and rethought the slots in the backplate. The slots in classic backplates are such that they have your harness coming over your shoulder in a way that they naturally want to slide off your arms and or cut into your neck. It’s the same way with your waist strap. The typical waist strap usually creates a V. That’s not how our belts work on our pants, you know? They go around our waist.
So, we redesigned the angles of these slots so that everything is coming over your shoulders properly as it should. And then in the waist, we made it so that it actually comes around your waist the way it should. So, it’s not in a V; it’s actually going to go perfectly around your waist at your waistline. We created two versions of the backplate, Pure and Pro, and offer them in both lightweight black, anodized aluminum and stainless.
The Pure system is basically a “Doing it Right” (DIR) configuration. It’s a single, continuous piece of webbing that has incredible strength with the normal five D rings: your right, left shoulder, left hip, front crotch strap, rear crotch strap. So that is completely GUE DIR.
Conversely, the Pro harness has stainless steel skydiver buckles that allow you to loosen and tighten, but they’re not quick release. In other words, they’re just exactly like what’s used in skydiving. It’s not a continuous piece of webbing—there’s a left and right because you need that adjustability without having to adjust the entire system. It allows users to get in and out of it quickly and make adjustments easily, so it’s ideal for rentals.
That’s one of the things that Halcyon and others ran into early on when dealing with rentals. It was difficult for a dive store to have backplates and wings in rental without having to spend a lot of time adjusting. Rhys came up with a simple design to be able to do that.
Clever. Wow, and wow! So, the end result is a backplate and harness that fits much better? I mean, it hugs your back and does all the things you want it to do.
Yeah. We made a backplate and harness that is better designed for comfort for the human body and based on studying backpacks and rucksacks. The weight is distributed properly, it actually is shaped to your back, and it’s substantially more form-fitting than what you would have in a standard channel-style BC. There are no gaps at the top nor a big channel going down your spine. And the harness fits properly.
So, it’s not crazy rocket science, but we basically ended up redesigning the whole thing. We even rethought the holes, and intelligently made every hole to serve a purpose.
How many holes does it take to fill the Albert, err Ginnie Springs?
Right? We even designed a brand new K-style power inflator just for the S-Tek—because that’s what the market wanted—which is what’s typical on a Halcyon, Apex, or whatever Wing. We have had a number of our own unique inflators over the years that were custom-made by us, but we wanted a K-style inflator to complement the S-Tek line because that’s what technical divers are used to.
The wing is pretty cool, too. We used our sidemount, low profile shoulder attachment and lower dump. It has a 1,000 denier (a density unit) outer bag, and a 500 denier inner bag. Of course, you can replace the bladder. And our numbers are 100% true numbers. A 60 is truly 60 pounds of lift; super low profile back dump, our own inflator, reinforced 11-inch centers. It’s easy to change out the bladders, and we actually put a grommet at the top of the wing to make bubble checks easier, and two on the bottom to be able to let the water out between the bladders so it’s not in the back of your car. So really strong, heavy duty, streamlined design. Of course, we made it so that when you’re swimming, it wraps up around the cylinders.
I’m really impressed with the thoughtfulness that has gone into these designs. I am going to give the S-Tek system a try. It does look like it’s very comfortable and may indeed fit better than a traditional backplate and harness. I look forward to trying one out.
Yeah, they really are amazingly comfortable. And when you’re wearing the kit for a long time, for example in the WKPP, there are lots of times we have a good walk with equipment on to get to the dive site. I find the difference amazing after diving all the other ones for years—and just how well it fits. And of course, in the water, it just feels more stable.
Again, nothing crazy revolutionary, but we were determined to make it better and not knock others off. Number one, that’s not Scubapro. And number two, I’m definitely not copying my friends. Lamar Hires of Dive Rite is a friend of mine, plus Jarrod Jablonski [Halcyon co-founder] and I go way, way, way back. Yeah, I’m not knocking off my friends. X-Tek existed before Halcyon, so it’s not like we just decided to jump in the game. But we knew that we needed to be there. It’s just taken us a while to get back into it.
Of course I have to ask you about fins before we wrap up. Obviously, Jet Fins are iconic and are arguably still the dominant fin in the tech market. But Scubapro has now come out with the S-Tek Fin. Cannibalizing your children? Talk to me about that?
Again, Rhys, in all his genius, has worked for many, many years to come up with a modular fin. It has a blade that works just like a trailer hitch with a pin and locking mechanism, which makes it great for travel and gives you the ability to go from an open heel fin to a foot pocket fin. Most importantly, it was designed specifically for tech kicking (i.e., frog, helicopter, and back kicks), and has a vented, 30º pre-angled blade, which adds power while reducing drag, and the ability to add ballast making the fins neutral to heavy.
Cool. How do they perform?
I was just diving them in St. Croix to get more time on it. I love the fin and have been testing it for a while. But the thing we want to make sure everybody understands is this is in no way, shape, or form meant to be a replacement for the Jet Fin. The Jet Fin is iconic. I still love it. I’m still going to dive it on all my cave dives forever.
But we have a lot of people that are diving shipwrecks; say, in the Philippines, where the water’s 30º C/86º F and they are diving wetsuits. So, if you’re wearing a wetsuit, the weight of a Jet Fin is pretty heavy to maintain your trim for a very long time and keep your legs up. Especially at a hundred feet or much deeper when your suit is completely compressed. The S-Tek is our lighter fin alternative.
We made it out of monprene. It is an extremely aggressive blade. You can do backwards kick, helicopter turn and, of course, frog. But on a flutter kick—I would put this blade up against any fin in the world for the flutter kick. I would almost bet you that the S-Tek is sustainably faster than the Jet Fin. And that’s hard for me to say, okay?
I can see a lot of thought has gone into other S-Tek components as well. Your new catch-proof, colored SMB spools are very innovative and of course, you have new computers as well. I’m guessing that a lot of tech divers don’t know that Scubapro also has a real depth in computers. They go way back to the first SOS analog computers. They bought market leader Uwatec back in the 1990s, and then in 2015, its parent company Johnson Outdoors acquired SeaBear, founded by innovative engineer Arne Sieber, who now runs Oxygen Scientific.
Scubapro came out with the G2 Tek a year or so ago, and I understand you’re coming out with a watch version, the G3, which can handle eight gases and air integration (AI). Of course, you have your work cut out for you in the tech computer market, Shearwater is such a dominant player. Good luck with that.
In wrapping up, perhaps you could share your vision going forward. What is your hope for S-Tek, and where do you see it going?
That’s a great question. I mean, obviously, S-Tek is kind of my baby. Though, of course, it was Rhy and I working together; it was certainly more his engineering prowess than my exploration experience that made these children.
But as a guy who’s just super passionate about technical diving, I want people to know that Scubapro is Scubapro. We don’t step out to lunch and do a half job on anything. We do it as well or better than anybody. Because we’ve been doing this for 60 years and because we engineer it, we design it, we build it, and it is done right. So, everyone can have confidence in these products.
I think it’s also fair to point out that just because someone has been selling technical products for a long time doesn’t mean that they are better. In fact, most manufacturers do not make their own backplates, or wings, or inflators. We do. Okay, so 100% of this is made by Scubapro in South Africa and Italy. Engineered, designed, and built. So that’s a big plus.
You heard it here tech brands! There’s a new, err…there’s that kid on the block again!
Finally, I would love to see more people outside of technical diving give our S-Tek gear a try. As an underwater photographer and a technical diver, I still think a backplate and wing is the most streamlined and cleanest way to dive. Of course, like anything, it’s probably not for everyone. But dive masters, instructors, photographers—there are a lot of people that aren’t technical divers that really should try diving the S-Tek.
I agree. I always thought that, at some point, the entire industry would move to the backplate and wing! We’re still waiting. Haha. Thank you for educating us on S-Tek, David. I’m definitely gonna try it out, and I am guessing others will, too.
InDEPTH: The RB80 Semi-closed Rebreather: A Successful Exploration Tool by David Rhea
Michael Menduno/M2 is InDepth’s editor-in-chief and an award-winning journalist and technologist who has written about diving and diving technology for more than 30 years. He coined the term “technical diving.” His magazine “aquaCORPS: The Journal for Technical Diving” (1990-1996) helped usher tech diving into mainstream sports diving, and he produced the first tek.Conferences and Rebreather Forums 1.0 & 2.0. In addition to InDEPTH, Menduno serves as an editor/reporter for DAN Europe’s Alert Diver magazine, a contributing editor for X-Ray mag, and writes for DeeperBlue.com. He is on the board of the Historical Diving Society (USA), and a member of the Rebreather Training Council.
THE EVOLUTION OF SCUBAPRO INNOVATIONS:
- 1963: MK2 is introduced and is considered one of the most reliable first stages in diving
- 1965: The Jet Fin is introduced, bringing a new approach to efficient underwater propulsion
- 1971: SCUBAPRO releases the dive industry’s first Stabilizing Jacket, known as the “Stab” Jacket, which combines front- and back-inflation for superior comfort
- 1972: The Quick Disconnect Inflator enables divers to use the air from their tanks to fill their BCDs
- 1974: Buoyancy Control Pack combines the buoyancy compensator, automatic inflator, tank, backpack, and regulator into one functional, easy-to-handle system
- 1979: AIR2, the first alternate inflator regulator, integrates the BCD inflator with the octopus regulator
- 1981: Super Cinch Tank Band cam action buckle system redefines tank security
- 1986: The aviation-inspired Sea Wing Fin is the first of its kind to utilize lift force vs. drag and displacement for propulsion
- 1986: G250 enters the diving scene,\ and quickly becomes one of the most imitated second stages in diving
- 1987: SCUBAPRO/Uwatec’s first dive computer, Aladin Pro, becomes a favorite with its convenient wrist-mount design and easy-to-read screen
- 1990: Diving’s first frameless mask becomes a favorite with professionals the world over
- 1996: Seahawk becomes SCUBAPRO’s first weight-integrated BCD
- 1998: SCUBAPRO introduces the Venus, its first back-inflation BCD designed specifically for women
- 2007: Galileo line of technologically advanced wrist-mount dive computers is introduced
- 2009: A700 second stage is introduced, offering effortless inhalation and easy exhalation in a precision-crafted, full-metal package
- 2010: Award-winning Seawing Nova fin quickly becomes the industry standard for fin performance
- 2015: Patented Extended Thermal Insulating System (XTIS) along with other freeze inhibiting internal components and coating transform the MK25 EVO into diving’s premier high-performance, cold-water regulator
- 2017: HYDROS PRO, diving’s most modern, innovative BCD, is introduced. Full-color G2 wrist-mount computer marks the birth of a new generation of advanced dive computer technology
- 2018: G2 Console offers advanced G2 technology in a streamlined console design. SCUBAPRO launches its first wetsuit made with Naturalprene, a neoprene blend sourced primarily from renewable rubber trees
- 2019: Galileo HUD, our most innovative mask-mounted, heads-up display dive computer radically transforms the way the world goes diving
- 2020: The HYDROS X is our first front-adjustable BCD to offer a fully injected Molded Monprene® thermoplastic back pad and shoulders that conform to the body like a tailored fit
- 2022: Seawing Supernova is introduced as an innovative step up from the popular Seawing Nova in design, performance, fit, and versatility. Everflex YULEX® line of divewear is an environmentally friendly upgrade to the best-selling Everflex wetsuit, offering award-winning thermal protection that’s 100% neoprene-free
Hyperbaric Chambers Are Turning Away Divers. Will There Be One Nearby When You Need It?
Unfortunately, it’s hard to make a business case for treating divers versus wound and burn care victims. As a result, many hyperbaric chambers no longer treat divers, leaving fewer facilities available for divers in need and increasing their post-dive time to treatment. InDEPTH editor Ashley Stewart reports on this growing crisis in the US and what can be done!
By Ashley Stewart
Steven Wells was diving on the scuttled wreck of the USS Oriskany off the coast of Florida in 2016 when a problem with his buoyancy compensator caused a rapid ascent to the surface.
Wells’ dive buddies followed the emergency action plan for the Oriskany listed on the Florida Fish and Wildlife Conservation Commission’s website at the time and brought Wells straight to Naval Air Station Pensacola, the nearest facility with a hyperbaric chamber. The facility turned him away because there was no one there to run it.
Wells was taken 30 minutes away to Baptist Hospital, which also has a chamber capable of treating his injuries, but the hospital had years earlier decided only to use it for wound care. Doctors there decided Wells would be taken by ambulance more than an hour away to Mobile, Alabama, the nearest facility that accepts divers.
By the time Wells arrived at the only chamber that would help him, it was too late.
“I got a call from the hospital saying, ‘Your husband is on life support. You need to get here now,’” Rachel Wells said of her late-husband of more than 23 years.
Julio Garcia — the program director of Springhill Medical Center’s wound care and hyperbaric facility where Steven Wells was to be treated — told InDEPTH that while no one can be certain how sooner treatment would have affected the outcome of Wells’ case, it would have given him the best chance for a full recovery.
Each year in the US, there are about 400 serious cases of decompression illness (DCI) — a category including both arterial gas embolism and decompression sickness — in divers, according to one 2020 paper. The Divers Alert Network (DAN) hotline dealt with 587 cases annually over the past five years.
The availability of hyperbaric chambers to treat decompression illness is something many divers take for granted. We try to avoid dive-related injuries through training, but expect treatment to be available when we need it.
The reality — as Steven and Rachel Wells tragically learned — is that only a minority of divers are close to care for diving-related injuries, according to medical professionals in the field. The estimates vary, but it’s generally believed there are about 1,500 hyperbaric medicine facilities in the US and only 67 are currently treating diving accidents, according to DAN.
The estimates vary, but it’s generally believed there are about 1,500 hyperbaric medicine facilities in the US and only 67 are currently treating diving accidents, according to DAN.
“The problem is only getting worse, not better,” Garcia, the Springhill Medical Center program director, said. Garcia has been sounding the alarm about this problem for more than a decade. His hospital takes patients from as far away as Florida cave country and treated 20 DCI cases in 2022. Those patients had an average transportation time of 11.5 hours, according to an InDEPTH analysis of Garcia’s records.
Florida stands out because it’s a popular diving destination, DAN Research Director Frauke Tillmans said, but the situation is not much better across the US. Many of the 1,500 hyperbaric medicine facilities, like Pensacola’s Baptist Hospital, have transitioned to treating wound care only for economic reasons. Emergency hyperbaric services are expensive to train and staff, and come with increased liability.
Time to treatment can be important in DCI cases
Time is of the essence when treating DCI. Divers Alert Network Director of Medical Services Camilo Saraiva told InDEPTH time to treatment is a “pivotal determinant” when it comes to outcomes for DCI patients. “Swift intervention significantly influences the effectiveness of therapeutic recompression,” Saraiva said.
Decompression sickness, for example, results from rapid changes in pressure and can form gas bubbles in body tissues. Initiating recompression therapy minimizes bubble size and number, Saraiva said, enhancing their elimination and reducing the risk of further vascular obstruction and tissue damage.
“The timely provision of hyperbaric oxygen therapy not only aids in bubble resolution but also mitigates the potential for neurological deficits and other severe complications, highlighting the critical role of early treatment in optimizing outcomes for DCI patients,” Saraiva said.
The 2018 paper “In water-recompression” stated delays to recompression in military and experimental diving are typically less than two hours and more than 90% of cases are completely resolved during the first treatment.
Frank K. Butler and Richard E. Moon, hyperbaric medicine experts, wrote in a 2020 letter to the Undersea and Hyperbaric Medicine journal editors suggesting a minority of patients who need life-saving hyperbaric oxygen treatment (HBO2) are close to a major hospital with a 24-hour emergency hyperbaric facility.
“Despite the urgent need for treatment, most hyperbaric chambers will decline to accept emergent patients at present,” Butler and Moon wrote. “Patients may eventually receive HBO2 but after a significant delay and a transfer of several hundred miles. Many never receive indicated HBO2, often resulting in poorer patient outcomes.”
Patients who are delayed treatment, they wrote, face the possibility in some cases of “death, permanent neurological damage, permanent loss of vision, or loss of an extremity, most of which would have been readily preventable had emergent HBO2 been administered.”
Why fewer chambers treat dive injuries
As recently as two decades ago, according to Butler and Moon, the majority of hyperbaric treatment facilities were available 24/7 to treat emergency patients. The percentage of those facilities now treating emergency patients is unclear, but it’s universally agreed the number has fallen significantly.
The reasons for the loss of emergency HBO2 facilities, Butler and Moon suggest, include “a better economic return when chambers focus on wound care patients as opposed to emergencies; the greater legal liability involved with treating high-acuity emergency patients; and the increased training and staffing requirements that would be required to manage critically ill patients — especially diving injuries and iatrogenic gas embolism patients.”
A letter from an administrator at Baptist Hospital — which sent Steve Wells to Springhill Medical Center — viewed by InDEPTH shows the hospital discontinued hyperbaric emergency services in December 2010, citing lack of staffing for specialty trained hyperbaric physicians who can provide 24-hour patient care. Baptist has yet to respond to InDEPTH’s request for comment.
There’s also the issue of pay. Garcia, the Springhill program director, said the current rate of pay for doctors who administer hyperbaric treatments regardless of length is around $150. A typical hyperbaric treatment for other conditions is about two hours. Diving treatments are usually six or seven, he said. “What doctor wants to get paid $150 to be up all night for seven hours, at that point making less than the technician?” Garcia said. “The fix is that healthcare payers need to pay more for the supervision of the treatment for diving injuries. Make it something that’s worth a doctor’s time besides the goodness of their hearts.”
Silence from lawmakers
Medical and diving organizations in 2020 sent a letter to the House and Senate, federal government agencies, governors of Florida and California, and the American Hospital Association expressing concerns about the lack of availability of chambers to treat diving injuries.
“There are approximately three million recreational scuba divers in the US,” the letter stated. “In the unlikely event that they suffer a diving-related injury, they trust that the US medical system will provide state-of-the-art care for their injuries, but the steadily- decreasing number of hyperbaric treatment facilities in the US willing to treat them emergently for decompression sickness or arterial gas embolism often places them at much greater risk than they realize.”
Garcia has on his own contacted lawmakers, reporters, medical systems — even private space companies like SpaceX because his facility is also the only one nearby treating altitude decompression sickness from space and air travel.
Little has changed, Garcia said.
Garcia showed InDEPTH a 2014 letter from a Defense Health Agency director who said, while there are three Undersea and Hyperbaric Medicine Society-accredited clinic hyperbaric medicine facilities and two additional facilities that can treat civilian emergencies, they are not staffed 24/7 and not designed for patients with other medical illnesses. Garcia at the time requested the creation of a federal grant to support the expansion of 24/7 hyperbaric services, but the director said that was outside of the agencies’ purview.
Two years after this exchange, Steven Wells was taken to and turned away from one of these facilities — the NAS Pensacola, listed on the Florida Fish and Wildlife Conservation Commission’s (FWC) emergency action plan at the time.
The Florida Fish and Wildlife Conservation Commission website now shows a map of the nearly 4,000 artificial reefs across Florida’s 1,350 miles of coastline. Two chambers, one in Mobile, Alabama, and one is Orlando, cover 500 of those miles densely packed with dive locations, according to Garcia.
The FWC website now shows a map of the nearly 4,000 artificial reefs across Florida’s 1,350 miles of coastline. Two chambers, one in Mobile, Alabama, and one is Orlando, cover 500 of those miles densely packed with dive locations, according to Garcia. A report from the University of West Florida estimated the sinking of the Oriskany, scuttled in 2006, generated nearly $4 million for Pensacola and Escambia County in the next year alone.
An FWC spokesperson said the agency provides diver safety reminders and recommended actions on its website “as a courtesy” and is not intended for emergency response. FWC and Visit Florida did not respond to inquiries about how much Florida’s government spends on advertising the artificial reefs and other diving activities, or whether any effort to expand the availability of hyperbaric facilities to treat the divers who show up as a result.
“My question is what is my husband’s life worth compared to your chambers,” Rachel Wells, Steven Wells’ widow said. “Why did he have to die?”
DIVER: A Crisis in Emergency Chamber Availability by Dan Orr (April 2022)
Divenewswire: A Crisis Lurking Below the Surface Emergency Hyperbaric Treatment Availability by Dan Orr (August 2021)
Undersea and Hyperbaric Medicine (2020): Emergency hyperbaric oxygen therapy: A service in need of resuscitation – an open letter by Frank K. Butler, MD, and Richard E. Moon, MD
InDEPTH: A New Look at In-Water Recompression (IWR) (2019) by Reilly Fogarty
Diving and Hyperbaric medicine (2018): In-water Recompression, Doolette DJ and Mitchell SJ
InDepth Managing Editor Ashley Stewart is a Seattle-based journalist and tech diver. Ashley started diving with Global Underwater Explorers and writing for InDepth in 2021. She is a GUE Tech 2 and CCR1 diver and on her way to becoming an instructor. In her day job, Ashley is an investigative journalist reporting on technology companies. She can be reached at: firstname.lastname@example.org.