Recompression And Medical Ethics

[Wookie]

First off, I find Kevrumbo's attacks to be quite rude, and misplaced. If a chamber were necessary, there would be one in Cave Country. Or Key West, or in many of the places where we appear to have a lot of divers, but no chambers. Quite frankly, I see this as free market healthcare at it's finest. In Key West there are 5 MRI machines to service 25,000 residents, 40,000 in the winter. That seems like a lot to me. In Key West we have 2 chambers, one at the community college, one at the Special Forces dive school, neither one takes civilians unless it's life or death. There is a chamber in Key Largo, not certified for patient care. If there were some great demand for emergency hyperbaric service, someone would have a chamber in a truck (quite feasible, Reku, but maybe not practical).

The question in my mind is this: Has anyone been hurt (or has that hurt been exacerbated) by distance to treatment or delay in treatment because some chamber was closed, and if so, who is at fault. You go on about the fabulous facilities at Chuuk. Maybe you might ask Capt Gary at CRD about the fabulous treatment he received at the Chuuk chamber.

While DCS can be quite serious, it usually isn't, and delay in treatment is minimized when DAN is happy to put you in a plane and rush you to an open chamber. Attacking DDM because he doesn't feel the same urgency to have 24/7 chambers in every dive destination is a little unfair. Climb down off of your high horse. You happen to have a system at Catalina that works, partly because you have a tremendous volunteer system set up to make it work. It doesn't work the same everywhere. Get over yourself.

 

[Reku]

First off, I find Kevrumbo's attacks to be quite rude, and misplaced. If a chamber were necessary, there would be one in Cave Country. Or Key West, or in many of the places where we appear to have a lot of divers, but no chambers. Quite frankly, I see this as free market healthcare at it's finest. In Key West there are 5 MRI machines to service 25,000 residents, 40,000 in the winter. That seems like a lot to me. In Key West we have 2 chambers, one at the community college, one at the Special Forces dive school, neither one takes civilians unless it's life or death. There is a chamber in Key Largo, not certified for patient care. If there were some great demand for emergency hyperbaric service, someone would have a chamber in a truck (quite feasible, Reku, but maybe not practical).

The question in my mind is this: Has anyone been hurt (or has that hurt been exacerbated) by distance to treatment or delay in treatment because some chamber was closed, and if so, who is at fault. You go on about the fabulous facilities at Chuuk. Maybe you might ask Capt Gary at CRD about the fabulous treatment he received at the Chuuk chamber.

While DCS can be quite serious, it usually isn't, and delay in treatment is minimized when DAN is happy to put you in a plane and rush you to an open chamber. Attacking DDM because he doesn't feel the same urgency to have 24/7 chambers in every dive destination is a little unfair. Climb down off of your high horse. You happen to have a system at Catalina that works, partly because you have a tremendous volunteer system set up to make it work. It doesn't work the same everywhere. Get over yourself.

This makes sense - I suppose if we really needed it we would have it.


I've never taken a hit so I don't know but - is time a factor when treating DCS? It seems that there is a lot of room for error - that guy in the article was almost dead only after like 12+ hours - that's a good buffer.

 

[Wookie]

This makes sense - I suppose if we really needed it we would have it.


I've never taken a hit so I don't know but - is time a factor when treating DCS? It seems that there is a lot of room for error - that guy in the article was almost dead only after like 12+ hours - that's a good buffer.

I took a vestibular hit many years ago, the account is posted here somewhere. Had I not ever been treated, I'm sure I would have taken my own life years ago. I was not treated for 5 days, as I went to the chamber instead of calling DAN. The chamber tech (the doc wasn't there) didn't believe me, when I got home to Houston I again went to the chamber, the chamber doc didn't believe me. Not until I called DAN did I get any traction, and when I was pressed on a table 6, my life was complete again (about 20 minutes after getting to 60 feet. Magic, I say). I've been "twinged" many times since then, and first aid is O2 treatment. I have always resolved on O2 following that first experience, and I dive very carefully now, But what I've seen with DCS (and I am no expert, believe me) is that most will resolve with first aid. This is no replacement for a doctor's evaluation. Many will not ever get better (I have a crewmember permanently disabled after 5 table 6's and a 5). Some, like me, will get better even if treatment is delayed. Every case is different which makes DCS so hard to put in a box.

 

[Kevrumbo]

I took a vestibular hit many years ago, the account is posted here somewhere. Had I not ever been treated, I'm sure I would have taken my own life years ago. I was not treated for 5 days, as I went to the chamber instead of calling DAN. The chamber tech (the doc wasn't there) didn't believe me, when I got home to Houston I again went to the chamber, the chamber doc didn't believe me. Not until I called DAN did I get any traction, and when I was pressed on a table 6, my life was complete again (about 20 minutes after getting to 60 feet. Magic, I say). I've been "twinged" many times since then, and first aid is O2 treatment. I have always resolved on O2 following that first experience, and I dive very carefully now, But what I've seen with DCS (and I am no expert, believe me) is that most will resolve with first aid. This is no replacement for a doctor's evaluation. Many will not ever get better (I have a crewmember permanently disabled after 5 table 6's and a 5). Some, like me, will get better even if treatment is delayed. Every case is different which makes DCS so hard to put in a box.

A review of DAN Annual Accident Reports shows that the most common problems contributing to diving accidents were making a rapid ascent, loss of buoyancy control, overexertion, feeling cold and missed decompression stops. Yet in some reports close to 50% of divers treated reported no problems occuring during their dives. So can you imagine developing symptoms after inadvertently having a problem during your dive (or completing a dive with no problems) and hearing "Sorry, there's no chamber in the area so there’s nothing we can do for you." Fortunately, that's NOT the case in SoCal because, since 1974, we can rely on the USC Catalina Hyperbaric Chamber to be there for us . . .Without proper treatment, major problems from diving accidents, most commonly Decompression Sickness (the "Bends") and Air Embolism, can lead to permanent disabling injuries and in some instances be fatal.

Goals for HBOT (Hyperbaric Oxygen Treatment/Therapy) in DCS/AGE:

• Bubble size reduction
• Bubble resolution through denitrogenation
• Hyperbaric oxygenation of hypoxic tissues
• Reduction of tissue edema
• Rehydration

Location > USC Catalina Hyperbaric Chamber > USC Dana and David Dornsife College of Letters, Arts and Sciences

First off, I find Kevrumbo's attacks to be quite rude, and misplaced. If a chamber were necessary, there would be one in Cave Country. Or Key West, or in many of the places where we appear to have a lot of divers, but no chambers. Quite frankly, I see this as free market healthcare at it's finest. In Key West there are 5 MRI machines to service 25,000 residents, 40,000 in the winter. That seems like a lot to me. In Key West we have 2 chambers, one at the community college, one at the Special Forces dive school, neither one takes civilians unless it's life or death. There is a chamber in Key Largo, not certified for patient care. If there were some great demand for emergency hyperbaric service, someone would have a chamber in a truck (quite feasible, Reku, but maybe not practical).

The question in my mind is this: Has anyone been hurt (or has that hurt been exacerbated) by distance to treatment or delay in treatment because some chamber was closed, and if so, who is at fault. You go on about the fabulous facilities at Chuuk. Maybe you might ask Capt Gary at CRD about the fabulous treatment he received at the Chuuk chamber.

While DCS can be quite serious, it usually isn't, and delay in treatment is minimized when DAN is happy to put you in a plane and rush you to an open chamber. Attacking DDM because he doesn't feel the same urgency to have 24/7 chambers in every dive destination is a little unfair. Climb down off of your high horse. You happen to have a system at Catalina that works, partly because you have a tremendous volunteer system set up to make it work. It doesn't work the same everywhere. Get over yourself.

That's right Wookie, we have a great system on Catalina Island and I've been part of that Volunteer Weekend Relief Crew manning that Recompression Chamber here in SoCal. . . So yeah I can and will preach & lecture to YOU, "on my high horse" both as a DCS patient AND a Chamber Operator.

Florida divers should be just as motivated to make a volunteer system work too, instead of being a passive, dismissive and ignorant victim like yourself Frank. . .

 

[The Chairman]

First off, I find Kevrumbo's attacks to be quite rude, and misplaced.

He's way off base, indeed.

I see this as free market healthcare at it's finest.

I kind of agree, Frank. I've been diving since 1969 and have never had a hit. Ever. Of course, I don't dabble in ratio deco either, which makes having a close by chamber pretty essential. We did have a death at Ginnie Springs from a DCS and another the week after that was treated in water. The closest chamber is in Georgia, but it's there.

 

[Wookie]

He's way off base, indeed.

I kind of agree, Frank. I've been diving since 1969 and have never had a hit. Ever. Of course, I don't dabble in ratio deco either, which makes having a close by chamber pretty essential. We did have a death at Ginnie Springs from a DCS and another the week after that was treated in water. The closest chamber is in Georgia, but it's there.

And if you call DAN, they will get you to the chamber in Georgia. Or if it's down, the chamber in Miami, or if it's full, the chamber at Duke. Or if they are all busy, the chamber at Catalina.

 

[Wookie]

Would Capt Gary been better off waiting for a medevac flight (2hrs flight time) to Guam and using the Recompression Chamber there instead of on Chuuk?.

That's right Wookie, we have a great system at Catalina and I've been part of that Volunteer Relief Crew manning that Recompression Chamber. . . I can and will preach & lecture to YOU, "on my high horse" both as a DCS patient and a Chamber Operator. And I refuse to be a passive ignorant victim like you. . .

Well, he did in fact get medivacced to Guam. The doc in Chuuk happened to be off island that day. His treatment in Guam was top notch. Sadly, they had no pillows or blankets at the Chuuk facility.

 

[The Chairman]

And if you call DAN,

The in-water recompression in Ginnie last week was due to DAN not being willing to send the diver to a chamber. Well, that's what I heard from two of the divers involved. I wasn't on the phone with DAN at all, so this surprised me.

 

[Duke Dive Medicine]

The in-water recompression in Ginnie last week was due to DAN not being willing to send the diver to a chamber. Well, that's what I heard from two of the divers involved. I wasn't on the phone with DAN at all, so this surprised me.

That surprises me too, and I suspect it's not the whole story.

Best regards,
DDM

 

[The Chairman]

That surprises me too, and I suspect it's not the whole story.

That's what I'm hoping.