The short answer
When decompression illness is suspected in Marsa Alam, the diver is kept out of the water, given 100% oxygen, and checked with a 5-minute neurological exam while someone simultaneously dials local ambulance 123 and the DAN hotline (+39 06 4211 5685). Transport should target the Baro Medical hyperbaric chamber at Marsa Shagra or the hospitals in Port Ghalib and Marsa Alam city, with private medical evacuation as the fallback for remote locations. A completed incident handoff card must travel with the casualty at every stage.
Key takeaways
- Around Marsa Alam, any new symptom after a dive is treated as suspected decompression illness until a doctor rules it out, so the first handoff is immediate oxygen and assessment rather than waiting or self-treatment.
- The beach- and boat-level handoff covers 100% oxygen, a 5-minute neurological exam, and a horizontal or recovery position, never a return to the water.
- Two parallel calls — local ambulance 123 (operators often speak only Arabic) and the 24/7 DAN hotline — cover both fast evacuation and remote specialist guidance with translation.
- The area's main hyperbaric facility is Baro Medical at Marsa Shagra, running around the clock, with general hospitals in Port Ghalib and Marsa Alam city and private evacuation services reaching outlying zones.
- With severe symptoms EMS is called first and DAN links the local crew to specialists; with mild symptoms there is usually time to start with the DAN hotline and plan the route.
- Dive-profile data, symptom onset time, oxygen details, and exam results must travel with the casualty, or receiving doctors and the chamber lose hours re-collecting information.
- Facility schedules, addresses and contacts shift with the season, so divers should confirm chamber status, contacts and insurance with their operator and DAN before the trip.
The rescue chain: where the handoffs happen
Marsa Alam is a remote resort region south of Hurghada where diving happens from shore villages, day boats and liveaboards. Rescuing an injured diver here is less a single call than a sequence of handoffs: the beach or deck, transport, an emergency department, and a hyperbaric chamber. Information is lost or distorted at each junction, so the crew's job is not only to treat but to pass the casualty and their record cleanly to the next link.
The pivotal point is the Baro Medical decompression chamber located on the grounds of Marsa Shagra Village: per the operator, hyperbaric specialists staff it around the clock. General hospitals sit in Port Ghalib and in Marsa Alam city. Knowing this geography in advance decides where and how a diver is moved, especially when boats are far out at the reefs.
- Beach/deck → first aid, oxygen and data collection.
- Transport handoff: EMS (123), resort vehicle or private evacuation.
- Receiving site: Port Ghalib or Marsa Alam hospital, or straight to the chamber.
- Baro Medical (Marsa Shagra) is the specialist DCS/AGE destination.
First response on the beach and deck: oxygen and the exam
The buddy, instructor or dive guide usually acts first. The recommended sequence is an ABC check (airway, breathing, circulation), 100% normobaric oxygen at high concentration (about 15 L/min) via a demand valve or non-rebreather mask if the diver is conscious, and a 5-minute neurological exam covering orientation, eye tracking, symmetry of face and tongue, coordination and balance.
Oxygen continues for at least 30 minutes and until medical staff take over. If the diver vomits or loses consciousness, they go into the recovery position; if breathing stops, CPR begins. Industry reporting puts the risk of DCI at roughly 1 in 10,000 recreational dives, and speed of treatment is the decisive factor: early care usually ends in full recovery, while neglected mild symptoms such as ear bends can require repeated sessions and months off diving.
- Give 100% oxygen from the highest available concentration as early as possible.
- Run the 5-minute neurological exam before and after oxygen.
- Keep the diver flat for early-onset symptoms; recovery position if vomiting.
- Hydrate about a litre an hour while monitoring urination and symptoms.
Who to call first: ambulance 123 and the DAN hotline
The first call depends on severity. With serious symptoms (limb weakness, speech, breathing or consciousness problems) dial the local emergency medical service immediately — Egypt's single ambulance number is 123, with police at 122 and tourist police at 126; operators often answer only in Arabic. In parallel, call the DAN hotline: the international number +39 06 4211 5685 is open 24/7, the first responder works in English, and the call is then routed to a diving-medicine physician who speaks many languages.
DAN's role in a remote area is not to replace EMS but to connect local staff who rarely see diving pathology with specialist doctors, point to the nearest operating chamber, and arrange medical evacuation and direct payment through an insurance case. With mild symptoms, when there is more time, it often makes sense to call the hotline first for a decision about the chamber, and to bring in local EMS if transport for diagnosis is preferable.
- Severe symptoms: EMS (123) first, DAN immediately after.
- Mild symptoms: DAN hotline first to decide the route.
- Keep your membership number and policy handy; the DAN app's SOS button sends your GPS position.
- Expect the 123 operator to speak Arabic — prepare a short English phrase or hotel help.
The transport leg: EMS, private clinics and evacuation to Hurghada
The road is the riskiest part of the chain. Hurghada is several hours from Marsa Alam, so the route is decided by condition: a suspected decompression casualty goes to the nearest specialist chamber or emergency department, not to any general hospital. The state ambulance (123) is available, but in a remote area response and equipment can vary, which is why many resorts and operators rely on their own vehicles and agreements with private services.
Private providers in the region, such as Thebes hospital in Hurghada, state that 24/7 crews respond on site and carry out transport from remote areas and medical evacuation to zones including El Gouna, Marsa Alam, Soma Bay and Makadi. For liveaboards and distant beaches the practical route is often not to the nearest town but to a meeting point where a crew can intercept. The choice of transport should be fixed in the emergency plan before the dive and confirmed with the operator.
- EMS (123) for severe symptoms; speed beats hospital choice.
- Private crews (e.g., Thebes ER-24/7) reach remote zones.
- For chamber treatment the nearest target is Baro Medical at Marsa Shagra.
- Confirm the boat or center has oxygen-trained staff on board.
What must travel with the casualty: the clinical handoff
The classic failure is moving the patient while leaving the record on the beach. The receiving doctor and the chamber need the dive profile (depth, bottom time, stops, gas, and repeated dives over the previous day), the time symptoms first appeared and how they evolved, oxygen-therapy details, and the neurological exam findings. Without these they lose time re-interviewing, and in decompression illness that delay directly shapes the treatment protocol.
Part of the record is produced by whoever made the first call to DAN: the open case number, the physician's advice, and the agreed destination and route. A handoff card is filled in as care proceeds and passed with the casualty at every junction — from instructor to ambulance crew, then to the emergency department and the chamber physician. No figure should rest on memory hours later.
- Full dive profile for the last 24–48 hours, including stops and gas.
- Exact surfacing time and time of first symptoms.
- Oxygen details: start time, concentration, L/min, duration.
- Exam findings, pulse, breathing and level of consciousness at handoff.
- The DAN case number and the hotline physician's recommendations.
Seasonal and local realities in Marsa Alam
The resort runs year-round, but seasonal peaks and long boat itineraries change the real time to the chamber. In the high season there are more staff and vehicles on the beaches; in the cooler months ear and sinus barotrauma rises with colds and air-conditioning. Clinic schedules, chamber hours and private-service contacts can change, so divers should verify their status with the operator before each trip rather than rely on last year's notes.
Account for language barriers and insurance mechanics: a DAN or equivalent policy covers chamber treatment and repatriation, but only if a case is opened in time and medical reports and receipts are collected. That is an organisational safety net, not a substitute for professional care, and it only works when information is handed off correctly at every link in the chain.
- Verify chamber status and center contacts before the dive.
- In colder months watch for ear and sinus barotrauma.
- Keep policy copies and a data card on the phone and in paper form.
- Build road time into the plan and agree on meeting points with transport.
Put it into practice
Diving incident handoff card (beach → transport → medics)
Fill it in as care proceeds and pass it with the casualty at every junction. Keep one copy in your phone notes and one paper copy in the dive center first-aid kit.
- Casualty: name, age, weight, chronic conditions, current medication.
- Last dive: site, time, depth, bottom time, profile, gas, decompression stops.
- All dives in the last 24–48 hours with surface intervals between them.
- Surfacing time and the time the first symptoms appeared.
- Symptom description from the 5-minute neuro exam and how it changes.
- Oxygen: start time, concentration, flow (L/min), duration, who administered.
- Pulse, respiratory rate, level of consciousness and ABC at handoff.
- Fluid intake: volume and over what period.
- Vomiting, seizures or loss of consciousness: whether and when.
- The DAN case number and the hotline physician's advice.
- Destination, transport mode and who is accompanying the casualty.
- Boat/center contacts and the insurance policy number (DAN or other).
Questions people ask
Which number should I call in Marsa Alam and when do I involve the DAN hotline?
Egypt's single ambulance number is 123 (operators often speak only Arabic; police is 122 and tourist police is 126). With severe symptoms call EMS (123) first, then the DAN hotline +39 06 4211 5685 in parallel — it runs 24/7, provides interpretation, and connects you to a diving-medicine physician. With mild symptoms, when time allows, calling DAN first is useful to decide whether a chamber visit is needed and to coordinate the route.
Should a diver with mild symptoms like a rash or fatigue be driven straight to a hyperbaric chamber?
Any new symptom after a dive counts as suspected decompression illness until a doctor rules it out. For mild symptoms you first give 100% oxygen and run a 5-minute neurological exam, then consult the DAN hotline, whose physician advises whether observation suffices or a chamber visit is warranted. In Marsa Alam the specialist Baro Medical chamber is at Marsa Shagra, so the target is that chamber or a proper emergency department rather than any general hospital.
Why must a diver with suspected decompression illness not go back underwater?
A repeat dive while nitrogen remains in the tissues increases bubble formation and worsens symptoms. Descending 'on symptoms' is not a substitute for chamber treatment. The correct sequence is to stop all diving for the rest of the trip, give 100% oxygen, perform the exam, and get the casualty to a diving-medicine doctor or chamber as fast as possible. Early care gives near-full recovery in most recreational cases, while delay leads to repeated sessions.
What should be done if the casualty is on a liveaboard far from shore?
Start first aid on board immediately: 100% oxygen, ABC assessment and the 5-minute neurological exam. Then contact the DAN hotline for specialist advice and evacuation coordination; with severe symptoms also alert the shore and rescue services so a meeting point is arranged. The nearest land destination is usually Marsa Alam with the Baro Medical chamber at Marsa Shagra or the hospitals in Port Ghalib and the city, with private medical evacuation as the fallback. Agree on this plan with the captain and operator before departure.
What does '100% oxygen' mean and can a non-professional administer it?
It means normobaric oxygen at high concentration, around 15 L/min, delivered through a demand valve or non-rebreather mask if the diver is conscious. Oxygen is a medical gas and ideally its administration is supervised by a physician or a certified oxygen-first-aid assistant. In remote areas where a doctor is absent, the accepted approach is that properly trained and certified first responders act immediately while hotline physicians support them remotely.
How real is the risk of decompression illness and how do mild and severe symptoms differ?
Industry estimates put the risk at roughly 1 in 10,000 recreational dives, with some cases unreported because divers self-treat or skip care. Mild symptoms include unusual fatigue, itchy or mottled skin, tingling and minor pain; severe symptoms include limb weakness, trouble speaking, seeing, hearing or breathing, impaired consciousness and difficulty urinating. Either set demands immediate oxygen and assessment, but severe symptoms mean EMS is called first.
Sources and further reading
Sources were checked when this page was generated. Confirm changing dates, rules and prices with the original publisher.
- DAN Europe – Emergency: hotline and emergency proceduresDAN Europe (Divers Alert Network)
- Should I call DAN or EMS first?Alert Diver Europe
- Recompression, DCS and diving safety in the Red Sea – an expert’s viewEmperor Divers
- Red Sea Diving Safari – Safety and Security FAQ (Marsa Alam)Red Sea Diving Safari
- Thebes International Hospital – Emergency Department (ER-24/7 hub)Thebes Hospital
- 在エジプト日本国大使館：安全の手引き（緊急連絡先）Embassy of Japan in Egypt