Photo by Mark B. Hatter, Airport Strip Cagayancillo Island, Located between the Visayas and Tubbataha, Philippines.
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FROM THE PUBLISHER
200 Days to the DEMA Show... Do You Have a Roadmap for Success?
PAGE 7
SAFETY
Dan Orr: The Crisis Continues in Emergency Hyperbaric Treatment Availability
PAGE 11
RETAILING
Shelli Hendricks, Ph.D.: Three Strategic Tips for Building A Stronger Customer Base
PAGE 12
ECO PRO
Alex Brylske, Ph.D.: A Diver’s Guide to Responsible Seafood
BUSINESS EDU
Wayne B. Brown: Turning Problems into Opportunities
PAGE 17
PHOTO PRO
Amos Nachoum: Behind The Lens: Capturing the Great White Shark Breach
PAGE 18
BUSINESS EDU
Al Hornsby: Direct Supervision – When Definitions Really Matter
PAGE 20
BUSINESS EDU
Cathryn Castle Garcia: Using a Strong Hook to Stop the Scroll
Cover Photo by Mark B. Hatter: This spectacular wall is located between the Visayas and Tubbataha. The Philippines Aggressor stops at Cagayancillo Island so divers have another full day of diving on the transition. The location boasts excellent visibility and lots of triangle butterflyfish. Nikon D850 in a SEACAM housing, 13mm Lense Nikonos RS, ISO: 200, F-18, 1/100, Twin Ikelight DS230 Strobes. Diver is Kevin Kurtz. Special thanks to Mark & Aggressor Phillipines.
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TRAVEL
Carlos Lander: Cartagena, Colombia –A Timeless Blend of History and Coastal Splendor
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RETAILING
Jeff Cinciripino: Travel Insurance - A Win-Win for Your Customers and Your Dive Shop
PAGE 29
BUSINESS EDU
William Cline: 5 Ways Resorts Can Attract Dive Travel Sellers
PAGE 33
TRAVEL
Peter Symes: Geopolitics - The Water’s Still Fine in Europe
PAGE 36
TRAVEL
Gil Zeimer: Part III: How to “Blue” Your Business Beyond Green Eco Resorts
2 & 3 Aggressor Adventures
6 Diver’s Alert Network (DAN)
7 ScubaRadio
10 Aggressor Adventures
14 Make A Difference Contest
15 Neal Watson’s Bimini Scuba
16 Stream2Sea Reef Safe Products
16 Sea Experience, Ft. Lauderdale, FL
18 DRYFOB Key Containers
19 ScubaWeather.com
19 Barefoot Cay Resort, Roatan
21 Blue Force Fleet Liveaboards
22 Take Our Subscriber Survey & Win
23 Clear Story Coach
23 Reef Smart Guides
25 Sau Bay Resort & Spa, Fiji
27 All Star Liveaboards
28 SeaCure Custom Mouthpieces
30 Wayne B. Brown Book
31 Scuba Do Rag Diver’s Apparel
32 Books by Dan Orr/Best Publishing
32 Big Animals Global Expeditions
33 X-Ray Magazine
34 & 35 DIVO By Scubatech
38 The Scuba Show, Long Beach, CA
39 Explorer Ventures Liveaboards
BACK COVER DEMA
41 Level Up Podcast
42 Article Index
FROM THE PUBLISHER
200 DAYS TO THE 2025 DEMA SHOW... DO YOU HAVE A ROADMAP FOR SUCCESS?
As you read this, we're roughly 200 days away from the DEMA show - do you have a strategic plan to maximize your investment?
Studies from the Center for Exhibition Industry Research reveal that exhibitors who initiate their promotion over six months before an event typically experience 30–50% more booth traffic and higher-quality meetings, leading to increased post-show sales. Similarly, insights from Salesforce.com's Dreamforce team reinforce that early planning significantly boosts exhibitor success. As they put it, "When they owned the pre-show conversation, they owned the floor."
Here's a condensed roadmap to ensure your success at DEMA:
Phase 1 (200–150 Days Before): Launch your strategic marketing founda-
tion. Secure a media plan with Scuba Diving Industry Magazine, design print ads that tease your presence, and consider our sponsored email campaigns.
Phase 2 (150–60 Days Before): Generate pre-show buzz. Highlight your
brand's value proposition clearly, introduce booth specifics, and utilize targeted ads with calls to action, such as QR codes for lead generation and online meeting scheduling.
Phase 3 (60–0 Days Before): Final marketing push. Promote exclusive
booth-only specials and testimonials. Upgrade your ad presence for maximum impact.
Phase 4 (Showtime): Execute with precision. Drive booth traffic through
ads and real-time social media coordination. Mention your ads prominently at your booth to reinforce your marketing efforts.
Phase 5 (0–30 Days After): Follow-up effectively. Recap show highlights
and maintain momentum through ads, QR-linked resources, case studies, and podcast appearances. Especially in our November and December issues. Start your planning now as owning the conversation early is the key to maximizing your success at DEMA.
SCUBA DIVING INDUSTRY™ MAGAZINE APRIL 2025 VOL. 2, NO. 4
William Cline, Publisher
Patty Cline, Associate Publisher
Amber Wagenknecht, Executive Editor
Betty Orr, Copy Editor
Neal Watson, Sr., Editor-at-Large
Britain Cline, Advertising Sales Manager
Gavin Young, SE Asia Ad Sales
Carlos Lander, Latin America Ad Sales
Walker Cline, Digital, Social & SEO
Contributors:
Wayne B. Brown, Augusta, GA
Alex Brylske, Ph.D., Avon Park, FL
Mark B. Hatter, Lake Mary, FL
Shelli Hendricks, Ph.D., Sun City West, AZ
Jeff Cinciripino, Rocky Hill, CT
Cathryn Castle Garcia, Azores, Portugal
Al Hornsby, Singapore
Carlos Lander, Caracas, Venezuela
Amos Nachoum, Pacific Grove, CA
Dan Orr, Driggs, ID
Peter Symes, Denmark
Gil Zeimer, San Rafael, CA
Reach out to myself, Britain, Gavin (Asia) or Carlos (Latin America) and let us show you a roadmap for success to the 2025 DEMA Show in Orlando, FL!
The Crisis Continues in Emergency Hyperbaric Treatment Availability
– by Dan Orr , President, Dan Orr Consulting
A variation of the following article was originally published in two other media sources with the goal of alerting the recreational diving community to an issue that can certainly have serious implications for the safety and wellbeing of those wishing to enjoy dive locations that rely on medical facilities in the U.S. Unfortunately, since this issue was brought to the attention of the diving and medical communities, there has been no improvement in this situation that could have potentially, catastrophic implications for those injured in a diving accident. In fact, there are now even fewer hyperbaric facilities available 24/7.
There are millions of recreational scuba divers in the U.S. and hundreds of thousands of traveling divers from countries around the world making tens of millions of enjoyable recreational dives each year in unique dive locations all over America. In the unlikely event that any of these divers would suffer a pressure-related diving injury, they trust that the U.S. medical system will provide stateof-the-art care for their injuries, especially in an emergency situation. As these divers are preparing to enjoy a pleasurable dive in some of the world’s most popular dive locations in this country, little do they know that if a pressurerelated injury were to occur while diving that would necessitate treatment in a hyperbaric chamber, they may experience a delay in treatment that could adversely impact their chances for a successful and residual-free outcome.
were aware that there were five hyperbaric treatment facilities in the Pensacola area. These facilities had been providing hyperbaric oxygen therapy for a variety of non-diving medical conditions, but the divers were totally unaware that not one of these facilities would provide the emergency care this severely injured diver badly needed. Instead of being treated at one of these treatment facilities only minutes away, this diver had to be transported to a treatment facility in Mobile, Alabama, which was willing to treat injured divers 24/7.
The reality is that this facility in Mobile, Alabama, was one of the very few treatment facilities in the U.S. that had continued to offer emergency care for injured divers 24/7. The most recent information regarding this facility indicates that, unfortunately, it is no longer available on a 24/7 emergent basis for the Gulf Coast diving community.
The injured diver in this example was fortunately treated successfully with no residual symptoms, despite the treatment delay. As accident data from Divers Alert Network (DAN) has shown, treatment delay, such as occurred during this diver’s care, is one of the most significant risk factors for a negative outcome when treating divers with decompression sickness or arterial gas embolism.
Unknown to most divers, there is a steadily decreasing number of hyperbaric treatment facilities in the U.S. willing and able to treat them, even in a life-threatening emergency, for decompression sickness or arterial gas embolism. This situation places all divers at a much greater risk than any of us have realized.
For example, in May of 2020, a recreational diver made a dive off the coast of Pensacola, Florida. After surfacing, he experienced serious neurological symptoms that were indicative of a pressure-related diving injury. Divers in that area
This reduced capability to provide emergency treatment for diving accidents also impacts local fire and police forces, many of which have diving rescue teams; federal law enforcement agencies; fish and wildlife services; park services; and other state and federal agencies with dive teams, as well as military divers conducting training operations in areas away from the location of their unit chamber.
There are approximately 1,300 hyperbaric treatment facilities (each of which has one or more hyperbaric chambers) that currently provide hyperbaric oxygen therapy in the United States. As recently as two decades ago, the large majority of hyperbaric treatment facilities were available to pro-
vide emergency treatment on a 24/7 basis. Today, however, few of these facilities offer emergency treatment 24/7, and some of those facilities do so only intermittently. Non-diving patients being treated for wound healing therapy dominate hyperbaric chamber usage.
The Undersea and Hyperbaric Medical Society (UHMS) identifies hyperbaric facilities based upon the level of care that can be provided. For example, Level One facilities have a hyperbaric program that offers a full scope of services for the hyperbaric patient. They are typically hospital-based facilities that cover all recognized indications, including 11 emergency life- or limb-threatening injuries, and are available for treatment of the emergent patient 24/7. Level Two facilities have a hyperbaric program that provides a reduced scope of service for the hyperbaric patient (does not treat emergency patients). They are typically in hospital settings and not available 24/7. These programs provide high quality care to outpatients Monday through Friday and are not equipped or staffed for emergency indications. Level Three facilities have a hyperbaric program that offers appropriate hyperbaric therapy in the non-affiliated setting (non-hospital-based nor affiliated with a hospital). Level Four facilities are in international locations.
apy model is much more profitable than emergency hyperbaric treatment for pressure-related diving injuries. In the past, hospitals and other hyperbaric treatment facilities underwrote the additional costs associated with providing 24/7 access to emergency hyperbaric treatment as a public service for those who required it. Now, because of the negative economic impact, concerns for staffing and training considerations, and the potential for legal liability, most hyperbaric treatment facilities have ceased to provide 24/7 access to emergency hyperbaric treatment.
and
available from 9:00 AM to 5:00 PM between 2006 and 2025. Even fewer 24/7 facilities may be available if the diving injury requires more complicated treatment modalities, such as the need for a ventilator.
For the recreational diving community, this is a critical safety issue. Recreational divers are regularly diving in locations where they believe emergency hyperbaric treatment will be available at nearby treatment facilities that have, in the past, been available to treat injured divers when they needed it most. Unfortunately, this may not be the case at all and, if injured, they may have to endure long delays in treatment as they must be transported to a distant treatment facility willing and able to provide the emergency care they need.
The graphic on the opposite page was provided by John Peters, Executive Director of the UHMS and identifies the UHMS-accredited Level One Hyperbaric Facilities in the U.S.
According to Dr. Matias Nochetto, DAN VP of Medical Services, DAN does not limit its Recompression Chamber Network (RCN) to UHMS-accredited facilities, nor to hospital-based ones (see chart above). The primary focus of the RCN database is facilities that are willing and able to treat divers; whether they do any other Hyperbaric Oxygen (HBO) indications is secondary to them. In addition, about 80% of the chambers in the RCN are not in the US, and very few international chambers seek UHMS accreditation. DAN has its own recompression facility classification system, where it factors in technical capabilities, operational capabilities, placement, availability, and communication with DAN. Two notable examples of such facilities are Catalina and Pacific Grove (CA, USA).
As a business enterprise, the scheduled wound healing ther-
From a diver safety perspective, there is an urgent need to correct this decreasing availability in the U.S. healthcare system and make emergency hyperbaric treatment available to those who require it. This may be especially true as divers are increasingly attracted to artificial reef shipwrecks in deeper water off the Gulf Coast of northern Florida.
The UHMS has been working to address this situation within the U.S. healthcare system by alerting governmental organizations. In a letter to the editor of the Journal of Undersea and Hyperbaric Medicine on 22 August 2020, Doctors Frank Butler and Richard Moon described the decreasing availability of emergency access to hyperbaric oxygen therapy in many U.S. areas. This lack of treatment capability presents significant challenges to providing optimal care for divers who suffer decompression sickness or arterial gas embolism.
Options for addressing this critical issue include:
1) Direct federal or state grants to hyperbaric treatment facilities that offer emergency hyperbaric treatment.
The above graph, provided by Dr. Matias Nochetto, VP of Medical Services at DAN, demonstrates the change in hyperbaric chambers available 24/7
those only
SAFETY
2) Indemnification from legal liability for hyperbaric treatment facilities and medical providers who provide emergency hyperbaric treatment to divers and other non-diving patients who require it.
3) Recognition of the public service performed by the hyperbaric treatment facilities that offer emergency hyperbaric treatment when indicated.
4) Favorable consideration with respect to Medicare, Medicaid, and private insurance reimbursements to hyperbaric treatment facilities and medical providers that offer emergency hyperbaric treatment when indicated, including carve-outs to inpatient DRG (diagnosis-related group) payments.
5) Incentives for military hyperbaric facilities to provide emergency hyperbaric treatment to civilian patients through emphasis on the training benefit to military providers that this accomplishes; third-party reimbursement for emergency hyperbaric treatment provided to civilian patients by military hyperbaric facilities; and indemnification of the military facility from lawsuits resulting from this public service activity.
In addition, there should be federal support for non-profit organizations, such as DAN, that are willing to operate around the clock assisting any patient who needs emergency hyperbaric treatment by identifying the nearest hyperbaric treatment facility that is capable of providing this treatment and helping to arrange transportation to it. Since chamber availability may vary based on ongoing hyperbaric oxygen treatments, staffing issues, and chamber maintenance operations, the ability to quickly determine which hyperbaric treatment facility is the most appropriate for a particular emergency patient in a specific geographic area is critical to optimal care. It should likewise be a national healthcare priority to ensure that there is adequate funding for fellowship education in hyperbaric medicine so that appropriately trained physicians will be reliably available to oversee the hyperbaric treatment provided by these hyperbaric treatment facilities.
have the DAN Emergency Hotline number in your emergency assistance/action plan. If a pressure-related emergency were to occur, DAN can assist in getting you to the most appropriate, available treatment facility with as little delay as possible. Remember that the treatment facility you may be referred to may not be local to your dive location, but DAN is aware of the locations of all treatment facilities available to treat injured divers 24/7.
Divers can also determine if treatment facilities at or near their favorite dive location are, indeed, available on a 24/7 basis and, if not, encourage the local diving community to put pressure on that facility to be available when needed. This may require the local community to reach out to the treatment facility to express their concern and, possibly, offer support in the form of fundraisers or other activities that could help. In some areas of the U.S., the local diving community has sponsored “Divers Days” to raise awareness and funds to support local treatment facilities. There are organizations, such as DAN, and individuals who will gladly volunteer their time and resources to help such a worthy cause.
The graphic above was provided by John Peters, Executive Director of the UHMS and identifies the UHMS-accredited Level One Hyperbaric Facilities in the U.S.
So, what is a concerned and safety-conscious diver to do? First, it is important to be a member of DAN to support the emergency medical services they provide. And always
Like any other risk in diver safety, we must identify and find ways to mitigate that risk. We now know that the decreasing availability of treatment facilities willing or able to provide emergency hyperbaric treatment when we need it most increases our risk as divers. We must mobilize and mitigate that risk by working with local, state, and national officials to let onceavailable treatment facilities know of our concern and work with them to find ways to reduce that risk through cooperative and supportive measures. References: Butler, F. Capt. (ret). Personal communication. Buzzacott, P. A Report on 2016 Diving Fatalities, Injuries and Incidents. DAN 2018 Annual Diving Report. Divers Alert Network. 2018. Clarke, D. Divers Losing Access to Emergency Care. Alert Diver. Winter 2012. Denoble, P. A Report on 2017 Diving Fatalities, Injuries and Incidents. DAN 2019 Annual Diving Report. Divers Alert Network. 2019. Divers Alert Network. Health & Medicine, Health Resources, Diseases & Conditions, Decompression Illness. Gabriel, M. Lack of hyperbaric chambers in Pensacola continues to put divers' lives at risk, expert says. Pensacola News Journal. March 14, 2018. Garcia, J. Personal communication. Orr, D. A Crisis Lurking Below the Surface Emergency Hyperbaric Treatment Availability. DiveNewsWire. August 24, 2021. Peters, J. Executive Director, Undersea and Hyperbaric Medical Society. Personal communication.
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