Diving for dollars is big business along the Gulf Coast of Alabama and Florida as tourism officials market offshore offerings to scuba enthusiasts.

And as Lagniappe reported Aug. 3, local and state governments and private organizations keep adding offshore attractions on the Gulf floor to lure more and more divers to stay in the hotels and condos and eat in the restaurants. Alabama recently announced it will add a 250-foot vessel off the coast of Gulf Shores and Orange Beach this fall or early winter.

But all this worries Julio Garcia, program director at the Center for Wound Care and Hyperbarics at Springhill Medical Center in Mobile.

A hyperbaric chamber is vital to treating divers who suffer from decompression sickness during a dive. What is sometimes called “the bends” occurs if divers surface too quickly after a deep-water dive. It can cause a variety of symptoms from simple limb pain to paralysis or even death.

Just about every hospital along or near the Gulf Coast in Alabama and the Florida Panhandle has chamber facilities. But only two along an approximately 600-mile stretch of the coast — prime diving destinations— use those facilities to treat decompression sickness.

“My hospital here in Mobile, Springhill [Medical Center], and Lee Memorial Hospital in Fort Myers are the two facilities on the Gulf Coast that treat diving emergencies,” Garcia said. “This is a major public safety issue.”

It wasn’t always that way, Garcia said. Back when the aircraft carrier Oriskany was sunk as a diving reef off Pensacola, several hospitals jumped on board to offer treatments in their hyperbaric chambers. But that changed quickly, Garcia said.

“At that time, Escambia County really stepped up to the plate,” he said. “Baptist Hospital in Pensacola said ‘this is what the community wants to do, we’re going to support this by opening up our hyperbaric chambers to the treatment of decompression illness.’

“That was great until about until Dec. 31, 2010, when Baptist put out a letter to the community saying ‘due to internal reasons we are no longer going to do that.’ After they did that there was a domino effect along the Gulf Coast.”

Candy McGuyre of Baptist Hospital said the change in 2010 was made for a variety of reasons.

“Facilities that offer emergency hyperbaric services for critical or unstable patients have dedicated chambers for trauma-level cases,” she said. “Those facilities have specially trained physicians available 24 hours a day, seven days a week. We just didn’t have enough physicians to be able to provide that continuous coverage. We weren’t able to maintain it. It’s a higher level of trauma care.”

That level of treatment, McGuyre said, requires a special chamber and Baptist’s facilities aren’t up to that level.

“They are not trauma-level chambers, where health care providers can enter and exit that chamber in order to maintain vitals, make sure that airway support is maintained,” she said. “We do have a good relationship with Springhill so if we receive anyone here, they are transferred to Springhill.”

Garcia’s facility treats about 12-15 patients a year suffering from decompression sickness and almost all are from Florida. Springhill is the go-to place in about a 200-mile radius if a diver develops symptoms.

“A patient doesn’t find it out until they need our services,” Garcia said. “All of a sudden, they are sitting at a hospital that has a hyperbaric unit, such as Panama City, and they are having to be air-medevaced all the way to Mobile, Alabama, to a small community hospital to get treated.

“This is a national outrage, but it’s even more of an outrage to me in Florida because you’re seeking the tourist dollars. And you are not providing medical services for these individuals. It’s mind-blowing to me.”

Getting treatment takes time. It’s about a six-to-nine-hour time frame for a diver with symptoms in the Gulf to get to a hyperbaric chamber, Garcia said.

“There’s been one fatality, in November of 2016, in Pensacola,” Garcia said. “So far this year we’ve had eight injuries from the Northwest Florida corridor, as far away as Panama City.”

Dive instructor and boat operator Gary Emerson of Gary’s Gulf Divers in Orange Beach said protocol is to treat the symptoms immediately. He’s never had a diver suffer from decompression sickness but he has seen cases on other boats.

“First of all, we put them on oxygen, and we’ve taken classes to be qualified to do this,” Emerson said. “That’s the first line of defense, put them on 100 percent oxygen. You would, of course, immediately start heading in. We get in contact with the Coast Guard.”

The Coast Guard will tell the boat operator where to go and have first responders in an ambulance or a helicopter waiting to transport. In Orange Beach, that usually means the heliport at the Alabama Marine Police facility at Perdido Pass.

Divemaster John Rice also leads dive trips into the Gulf from Alabama. He said the latest incident he can recall was from 2014.

“The diver was transported by helicopter to Springhill and made a full recovery,” Rice said.

Rice said anyone going for dive trips with him is urged to get Diver Alert Network insurance.

“We recommend any certified diver should carry DAN Insurance,” Rice said. “DAN will coordinate emergency evacuation as well as cover the cost of the medical treatment, decompression chamber.”

Garcia said another problem plaguing the dive industry is lack of government oversight of scuba diving.

“Another problem with the industry as a whole is there is not any regulatory agency per se,” he said. “There is no mandate from anyone on the treatment of this industry. You don’t have to have it.”

Yet the popularity of diving and marketing of the dive destinations grows every year, he said, citing the Florida Underwater Trail and state-sponsored lionfish rodeos, where diving spearfishermen round up the invasive species.

Garcia says his facility will continue to provide the service to divers, but lack of other hospitals treating decompression has him concerned.

“My question to the community, and has been for a while, why is a little small community hospital in Mobile taking the brunt of Florida’s tourist industry?” he said. “It’s hard to get a good answer on that.”