Australian Method IWR Equipment

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djhall

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First... before everyone jumps in to point out the obvious, let me say it for you. No, I am in no way qualified, experienced, or equipped to attempt in water recompression, decompression diving, or any similar situations. That said, I have seen the debates regarding prophylactic administration of surface O2 for asymptomatic diverts at increased risk of DCS, pros and cons of IWR, various IWR treatment methods, and so forth, and I had a couple of purely theoretical questions.

It seems that the "Australian Method" of 30-90 minutes of oxygen at 30 feet followed by a 1ft/4min ascent is the most practically feasible method for most divers. The procedure is easy to understand, and the shallower depths should be easier on tender divers, especially in case emergency complications arise. It seems unlikely that enough O2 would be available for the US Navy method, and the Pyle method sounds far to complicated. I just don't know enough to be able formulate an opinion on whether the Hawaiian "bounce" on air first is a good idea or not. Therefore, I will assume the Australian method from here out.

1) I assume no form of IWR is possible without pure O2? Could the procedure be carried out using standard air if that was all that was avaliable?

2) Could this method be used as a preventative measure for someone at increased risk of DCS, but who was sign/symptom free? If someone were to, say, miss a required deco stop, could they immediately switch to O2, select a tender diver, and re-descend to 30 feet to start the procedure in an attempt to prevent the onset of DCS?

3) 1ft/4min is an EXTREMELY slow ascent rate! 30ft * 4min/ft = 120 minutes to surface. That's 2 hours! In cold water where an additional 2 1/2 to 3 1/2 hours under water may not be possible, what happens if a 1ft/min or 1ft/2min ascent is used? Would that substantially negate any benefits gained from the 30-90 min at 30 feet?

4) What minimum equipment would be necessary to make this option possible? At the very least, I assume some method of anchoring at 30 ft and ascending slowly, sufficient avaliable O2, a knowledgeable tender diver, and environmental protection adequate for the additional period of immersion would be required.

For a rough calculation of what constitutes sufficient O2, how does this look? Assume a SAC of 1cf/min? 30 feet = 2 cf/min O2 consumption. 30 min = 60cf, 60 min = 120cf, 90 min = 180cf. Ascent is 120 min at an average consumtion rate of 1.5cf/min = 180cf. For the maximum treatment of 90 min + ascent, 360cf minimum would be necessary? For the minimum treatment of 30min + ascent, 240cf would be needed? That could be done with a set of double 120's of pure O2.

5) Twin 120's of pure O2 plus 2 1/2 hours water immersion is not looking very practical. Can anything be done to acheive a benefit from a singe 120/130cf of pure O2? Say 30 min at 30 feet + a faster ascent? Perhaps 1ft/min or 1ft/2min for the first 15 feet and 1ft/min for the last 30 ft?

I know this is long, and perhaps, unanswerable, but I hear of people attempting IWR, and I am fairly certain they did not just happen to have a spare 360cf of pure oxygen lying around. I've been curious about how this is done by people who actually attempt it, and how it could be done in a practical and informed manner, if there is such a combination.
 
HI djhall

Could you please clarify your source for the Australian Method ?
As I have never heard of such a method ever being used down under.
 
Could you please clarify your source for the Australian Method ?
From a post by DocVikingo, a Medical Regulator in this forum. I have also seen this procedure called the Australian method elsewhere, though I don't remember where.
Here's a long piece on in water recompression I did for the Sep '00 "Undercurrent"... Australian: The most popular to date, the Australian procedure mandates continuous breathing of 100% oxygen at a depth of 30’for 30 minutes for mild symptoms up to 90 minutes for severe ones. As a rule of thumb, it seems prudent to remain at the target depth for as close to the maximum time as diver & environmental conditions allow. Ascent rate is not to exceed 1’per 4 minutes, and inspiration of pure O2 is to continue for 1 hour periods interrupted with 1 hour breaks for a period of 12 continuous hours.
Here is a link: In water recompression w/ DCI
 
IWR, while mabe not the best choice may be an option for a group who is prepared and in a remote location. I have read that it has been used successfully many times and usually without O2. One can't ignore the obvious risks though.
 
Dear Readers:

Missed Deco

I cannot really comment on in-water recompression as I have not had any experience with it. Others have provided comments indicating that it is fraught with difficulties.

As far as missed deco is concerned, as has been stated many times on this FORUM, the deco schedules are so far into the conservative zone that it is unlikely that problems would arise from a missed deco. We are assuming decompression on the order of minutes here, nothing like that described in The Last Dive. A hasty assemblage of equipment and a plunge into the water can result in trouble.

What to Do?

If I was on the surface with missed decompression (or a dive with a very strenuous bottom time), I would
  • move may arms and legs for ten minutes while in the water (“the hidden stop”) to aid offgassing,
  • have someone help me aboard the boat so that I did not climb with all of my heavy gear,
  • while on board I would be seated and continue to gently move my arms and legs, and
  • breathe surface oxygen if it were available.
Unless you really “botched it,” this will probably result in subclinical DCS. There are not any laboratory trials of this since no one has ever performed a study of titrating a person to the “bends/no bends” point and withholding treatment. {This experiment probably would never be done in a peacetime setting.}

What Else?

If this predicament were the result of my foolishness, I would beg God’s forgiveness for my hubris, and in my contrition, vow not to allow myself to enter into such a condition again.:halo:

Dr Deco :doctor:
 
Dr Deco said...


Missed Deco

What to Do?

If I was on the surface with missed decompression (or a dive with a very strenuous bottom time), I would
  • move may arms and legs for ten minutes while in the water (“the hidden stop”) to aid offgassing,
  • have someone help me aboard the boat so that I did not climb with all of my heavy gear,
  • while on board I would be seated and continue to gently move my arms and legs, and
  • breathe surface oxygen if it were available.

Unless you really “botched it,” this will probably result in subclinical DCS.
Dr Deco

So after that, how long would you wait for your next dive?

Bill
 
BillP once bubbled...


So after that, how long would you wait for your next dive?

Bill

Until you learn to not skip deco!

IWR is not meant to be a missed deco proc. It is meant as a treatment for dcs. Procedures for missed deco is tought in all (as far as I know) classes.
 
Dear Bill:

How long a Wait?

My best guess would be to wait until the next day for the next dive.

In diving procedures by military and commercial groups, they would repressurize the diver to “reset” the system. That means , to squeeze decompression bubbles down and place the body in the naive, or base, state.

Dr Deco :doctor:
 

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