Getting 100% O2 fills?

[Mustard Dave]

What about the legalities? Is there a danger of being sued if you administer O2, or just recommend and provide O2 etc. when you are not a liscensed physician etc. ?

The USA's reputation is that when things go badly the search for guilty parties can get a bit enthusiastic.

I was going to comment on this earlier. I know we hear stories all the time about crazy lawsuits but I have always felt most get exaggerated somewhat. I mean, who would sue somebody for trying to help them? Then I saw this on a British dive forum on a topic entitled 'Underwater Ambulance Chasers'...

Negligent Rescue Attempts Diving Accident | Scuba Lawyers

 

[rx7diver]

What about the legalities? Is there a danger of being sued if you administer O2, or just recommend and provide O2 etc. when you are not a liscensed physician etc. ?

FinnMom,

I wouldn't think you need to be a physician to administer oxygen during a scuba emergency. If you are trained and certified to do so (e.g., you've received DAN training and certification) and you are faithful to your training, this should minimize your liability risk--at least, this is what my DAN instructor told me and what I think I remember reading in the DAN Emergency Oxygen Administration manuals.

Maybe some of those among us with legal training can comment on what's to be expected if you're neither trained nor certified, and act anyway or refuse to act because of fear of litigation? Trained but not certified? Trained and certified?

Safe Diving,

rx7diver

P.S. Here's an interesting older thread related to Dive Rescue: www.scubaboard.com/forums/advanced-...ication-make-you-potentially-more-liable.html.

 

[kelemvor]

The local DAN instructor told me that the regular DAN first aid qualified you to administer emergency o2. o2 administration is covered briefly in that class. I would not think having the o2 provider card that lets you buy o2 would be any more a liability than the first aid card with respect to administration.

 

[freewillie]

You should have medically approved oxygen cylinders with medically approved oxygen. To safely administer oxygen in an emergency setting you should also have the appropriate training. At the very minimum you need to take and complete a standard CPR class. For oxygen you need a slightly higher certification in ACL or Advance Cardiac Life support. The DAN first aid courses including the Emergency Oxygen course would also be highly recommended.

As far as giving 100 O2 you are not delivering it directly to the lungs. You generally put the patient on nasal cannula or face mask and allow the patient to breath. AS they breath the supplemental O2 mixes with the normal atmospheric O2 and the concentration is less than 100% by the time it reaches the lungs. There should not be any concern at relatively low levels of flow such as 2-4 L/min unless the patient has underlying lung disease like COPD but those patients wouldn't be able to pass a medical physical to dive anyways. But, you should have adequate training in the use of oxygen for emergency situations if you are doing commercial dive trips.

 

[Akimbo]

…AS they breath the supplemental O2 mixes with the normal atmospheric O2 and the concentration is less than 100% by the time it reaches the lungs...

Not the oral-nasal masks fitted with demand regulators that I use. You want the maximum O2 percentage reaching the lungs as possible when treating DCS… on deck or at 60' in a chamber.

 

[rx7diver]

Not the oral-nasal masks fitted with demand regulators that I use. You want the maximum O2 percentage reaching the lungs as possible when treating DCS… on deck or at 60' in a chamber.

Yes, there are several ways of administering oxygen. Some ways deliver 100% oxygen to the lungs. I was taught that protocol is very important: you absolutely must ask, and receive the permission of, the injured diver before commencing administration, and the only time you don't have to ask is when the patient cannot respond. All of this is covered in the first DAN Oxygen course and again in the Advanced DAN Oxygen course.

Caveat: I am *not* a DAN Oxygen Provider instructor.

Safe Diving,

rx7diver

 

[Phil_C]

Interesting thread - and timely, I have just built an O2 kit for diving use here in the UK. I am DAN trained and have both O2, CPR, O2 enhanced CPR and AED certification but had a real problem getting 100% O2 at a reasonable price (most place wanted $200-$300 for a cylinder).

My solution was to buy an variable rate (medical) oxygen regulator that will supply a constant flow between 5 and 25 litres per minute to a mask, or supply a demand valve, (this regulator has a pin index fitting) then I bought a pair of adaptors - pin index to bull nose and bull nose to DIN adaptor. This gives me the best of all worlds. I can connect it to any cylinder, dedicated medical (pin index), industry bull nose cylinder or diving tank with DIN, or 'A' clamp with a standard yoke adaptor.

I have a 5 litre O2 clean diving cylinder (DIN fitting) with 100% O2 filled to 200 bar, but I can also connect to any diving cylinder with Nitrox (lots of people round here have high O2 % deco gases with them) if I need to if mine were to run out. The dives shop that filled the cylinder knows me, gives me O2 fills against my O2 provider card, and trusts me that I'm not going to put a diving regulator on it and use it for deco, which of course I could easily do configured this way.

To finish the kit off I am just looking to source a suitable size peli case at a reasonable price.

Regarding liability the only thing I was told quite forcefully was that I should only ever use O2 in a diving emergency, not for any other collapse etc. because there are some medical conditions (mainly lung diseases) which administering 100% O2 can make worse, but these conditions are not likely to be suffered by divers (or they have lied or their medical certification). The kit will be available in the back of my landrover 24/7 so whenever I am diving it is there, and it will be easy enough to lift it out and onto our club boats when we take the rhibs out. - P

 

[Rich Keller]

Any industrial gas supplier who deals with medical gas will fill your tank without the need for any certification.

 

[Akimbo]

…I was taught that protocol is very important: you absolutely must ask, and receive the permission of, the injured diver before commencing administration, and the only time you don't have to ask is when the patient cannot respond…

They told us the same thing for ANY intervention at my Red Cross CPR and first aid class… including the Heimlich and arterial bleeding! I suspect that a conscious diver that “might” benefit from O2 will snatch the mask out of your hand and put it on themselves! Not as aggressively as being OOA on the bottom, but close.

On the surface, pure O2 is pretty benign in terms of over treatment for anyone healthy enough to dive, let alone freedive like the OP.

Edit: I really prefer a demand mask over freeflow oxygen admin for diving applications. You want max O2 to the lungs and you want the cylinder to last as long as possible if you are offshore.

 

[DennisS]

I needed to get a DAN cylinder filled when the ship was in port. I went to a medical supply company and had to jump through a bunch of hoops, explain it was for a govt ship, show my O2 provider card, get a form filled by the Capt. They explained it was prescription and they had to have all the paperwork. Long story short, I get a form from the state of FL, 8-9 months later, asking me to verify that I had purchased the O2 and had submitted the attached forms. JFC it was a tank of O2, some bureaucrat needs find another prescription drug to chase