…I was curious as to why IWR hasn't been officially adopted as a practice by any of the dive agencies (at least not that I've heard of), or why DAN hasn't developed some sort of official procedure/manual...
DAN is on top of it, we just haven’t seen much product yet.
Scuba Diving Medical Safety Advice ? DAN | Divers Alert Network
You can tell change is in the wind. See Bret Gilliam’s article
In water recompression - How to save a life on a remote dive that was recently posted on the TDI site. Bret has been around longer than the current “IWR = BAD” mantra and has done a lot of expedition diving.
Medical professionals are governed by the
Hippocratic Oath, which is often summarized by “first do no harm”. Accurate diagnosis is very high on the IWR problem list. Hyperbaric medical professionals rarely (never?) base their diagnosis on “this guy’s been diving so is probably bent” — even though a layperson like me is likely to reach that conclusion and miss the fact that the diver is having a heart attack or some other medical condition that won’t be helped by recompression of any kind.
This kind of “educated guess” isn’t nearly as risky when all the divers are young and doing deep mixed gas dives on rebreathers with hours of decompression. How about an overweight and out of shape 58 year old warm water vacation diver with elbow pain who just completed his fourth no-D dive on 32% Nitrox that day? “But the computer says I am fine”… Bent, strained elbow, or serious medical problem???
Adequate preparation is another problem. Let’s throw out the word safe. Diving isn’t safe under ideal conditions. IWR is much less safe, or more dangerous. There has been a lot written on equipment and training already, but you can see it isn’t trivial. You also have to understand that dive agencies don’t lead, they follow. They aren’t hyperbaric professionals and this isn’t a criticism.
The great majority of the cumulative knowledge presented in diving classes at all levels resulted from accidents that scared the hell out of, injured, or killed someone. Thanks to all the pioneers the preceded me, living or not.
IWR has been used at least since the 1950s — on rare occasions and usually with some success. That’s what you do when it is the only viable option. As the sport progressed, the need for IWR diminished dramatically because decompression was better understood, chambers were more available, and the industry was moving toward what we now call “recreational limits”. Meanwhile, IWR has become taboo since it was rarely appropriate. The confluence of technical diving, rebreathers, and liveaboards in very remote locations is a fairly new phenomenon… and is an appropriate application of IWR.
BTW, thanks for the kind words.
