Very good point, probably not. I should have been clearer. As rsingler points out, this was meant from a inert gas loading standpoint. A better way to phrase this might have been: "pretend your NDL limit is X minutes shorter than what your computer is showing you."
Hi Kathy,
In keeping patient confidentiality, I don't want to reveal too much information on him that might suffice to identify him. He was of the age of many divers seen on Cayman. Let's say between 50 and 70. He claimed to be a very experienced diver with excess of 1000 dives. I don't know when he last dived before he arrived in Cayman, but he was on vacation from a state that isn't know for diving. He told me in the chamber he was diving nitrox, but I later found out he was in fact diving air. According to his boat captain who I later spoke with, he had dived 4 dives that day. I'm not sure how quickly he sought out treatment, but due to the fact I was his last attendant at 12:30 would indicate he went in the chamber around 8:30. He could have done a night dive, but I'm unsure.
With gross symptoms like he had, it's unlikely he delayed treatment due to denial, like we see with many type 1 hits. Or he could have had an extended evaluation in the ER. I didn't see his chart when I got there. Not sure if he has DAN or not.
I try not to press too much in the chamber. Typically you can only chat with them during the 5 minute air breaks. The oxygen mask makes talking too difficult. Some patients are more forthcoming than others. This guy didn't seem like he wanted to chat too much, but then again, he had some pretty severe symptoms.
You maybe aware, our 2019 Innerspace event was held in Little Cayman. During our year-long planning with LCBR, we discussed, among other things, the emergency plans for diver injuries. If the diver is symptomatic, they get them off island a quick as possible. (Scubydrew who works for us, has a funny story about a false alarm in this regard with one of his divers.) If it's after dark, there is a real chance you'll be laying in the nurses office until daylight. According to LCBR management and staff, sometimes the chopper will come over, but most often not, due to the fact there are no lights on the runway there. A friend of mine who worked at LCBR for several years said she had seen an incident of a severely bent diver, where a twin otter came over at night, and residents of Little Cayman lined their vehicles up along the runway to provide landing light with their headlights.
I've also heard sometimes Cayman Brac would send the fire boat over to bring injured divers back to the Brac, but they stopped that when the Brac chamber closed.
To my knowledge I haven't seen any cases from the Brac or LC come in, but I don't always know where they are from and I also don't see every case that comes in. It's a volunteer program, and often when they call, I'm at work, or have been diving that day. (The chamber does not allow you to be an attendant if you've dived within 12 hours.)
I do know time is of the essence, and the quicker they get in the chamber (especially with type 2 hits) the more likely they are to make a full recovery.
Tony
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