Year 6 medical student, Mallaika Viswanath provides an insight into her medical elective travelling to Egypt to work in hyperbaric medicine with experts in the field.
This spring, I had the incredible honour of working at the Sharm-El-Sheikh Hyperbaric Medical centre. During my time, I learnt about the physiological changes that occur when divers enter the water and ascend, and how these changes can lead to injuries such as decompression illness if divers do not follow recommended diving procedures.
Additionally, I learned about the signs and symptoms of decompression illness (DCI) and how to examine patients looking for signs of it. I also learned about assessing divers’ eligibility to dive, including how to use hyperbaric treatment tables and first aid measures such as normobaric oxygen, fluids, and temperature regulation. It was an incredible opportunity to learn about the science of the disease, and understand the workings of the chamber, as well as the decompression treatment tables we use, directly from one of the leading experts in the field: Dr Adel Taher.
Dr Adel founded the chamber in Sharm in 1993 and he and his team have been a pillar of the community since. It is a small facility, with only two doctors, but has had a large impact!
Inside the chamber
Whilst there, we had the opportunity to assist with a DCI diving injury that came in late one evening from Dahab. It was a chance to combine our existing medical knowledge (for example, conducting a thorough neurological examination to identify the deficits in our patient) with some of the new skills we had learnt there, as we assisted in driving the chamber and document the patient’s notes. We also learnt about uses for hyperbaric oxygen therapy for non-diving related illnesses such as multiple sclerosis, diabetic foot and wound healing.
I had the unique opportunity to go inside the chamber as a tender for a patient suffering bone marrow oedema in her knee and experience first-hand what it was like to go under (not for the claustrophobic, I must warn you!). Our role as tender is to keep the patient calm and in cases of DCI ensure that they don’t hurt themselves during seizures and such. However, given that my patient was a nurse/ diving instructor with years of helping out at the chamber, her experience far surpassed mine, but it was a great learning opportunity nonetheless.
Once inside the chamber, the airlock is sealed and the chamber driver slowly begins to increase the pressure from the outside. This mimics taking you deeper as you would in diving, and the deeper you go the higher the pressure you experience. Once at about 14 metres depth the patient breathes high flow oxygen for some time with air breaks intermittently; the times for which vary depending on which treatment table you are following. As we begin to rise, both tender and the patient breathe in oxygen to prevent DCI. After just a few treatments, the marvellous effects had kicked in and our patient was already experiencing relief from her excruciating knee pain.
The incredible diving community
One of the things I enjoyed most about working at the chamber was how multicultural the diving community there is. We frequently had visitors coming in for advice, or even just to chat, who all knew the chamber and its doctors for several years. It was thrilling to hear the multitude of languages everyone spoke and the incredible stories they shared. Doing diving medicals on a daily basis on people from all different walks of life and cultural backgrounds helped open up our communication skills and approaches and was a really great opportunity to brush up on some of my dusty Spanish and Italian (no hope for my French or Arabic, I’m afraid).
Adventures in the Red Sea
Of course, I can’t talk about hyperbaric medicine without mentioning the incredible diving opportunities in the Red Sea. Despite having only learnt to dive for the first-time last summer, I spent so much time underwater that I managed to achieve my PADI Advanced Open Water Certificate and feel much more comfortable with my buoyancy control and the underwater environment. Additionally, the advanced diver course taught me skills such as triaging and problem-solving, good communication and organisation skills, and working effectively in a team – all of which are essential in medicine.
The Ras Mohammad National Park in Sharm is famous for its kaleidoscope of corals and tropical fish and the breath-taking clarity of the water means no dive is a dull dive. Even in March, I was able to see plenty of turtles, eagle rays, dolphins and even had my first shark encounter in the straits of Tiran.
It has honestly been the best time of my life and I can’t wait to return one summer when the diving season is in full swing. Diving is a requirement for anyone wishing to be a dive doctor and is considered a part of the elective experience. For anyone nervous about it, as I was my first time, I encourage you to take the plunge and open yourself up to the magical world underwater!
