In Water Recompression for DCI

[fins wake]

staying down too long, and getting DCS that way.

The victim already has (suspected) DCI.

staying rigorously within the rule of thirds will avoid the temptation to stay down too long. take a look at The Last Dive.

The rule of thirds isn't aimed at IWR in any way, shape or form (nor is IWR mentioned in "The Last Dive" as far as I can remember). Don't confuse IWR with emergency decompression for previously omitted decompression stops. The risk with IWR is drowning (not least as a result of elevated partial pressures of oxygen, hence the FFM), and making the DCI symptoms worse by incomplete recompression.

 

[Bob3]

Bob, that link is dead

I caught it, dang Linux is case sensitive.

 

[fins wake]

Bob, that link is dead

Arnaud, you mean you're not Jimmy Hoffa either?

 

[UWSojourner]

http://www.bishopmuseum.org/research/treks/palautz97/iwr.html

My favorite line from the article:

"Even if the diver is functioning nearly perfectly, the risk of drowning while underwater far exceeds the risk of drowning while resting in a boat."

Gotta like that.

 

[5615mike]

Good read. Thanks

 

[GDI]

Getting DCI can have nothing to do with the air management or time or work load or ascent habits. There are risks divers take that will make them more susceptable to getting DCI than less riskier dives but keep in mind that sometimes it is just your day or rather just not your day. Taking a DCI hit is not a sign of weakness of the diver and may not be related to poor habits diving or otherwise there are so many varibles involved. It is because of these variables that the question of IWR and it's potential benefits or risks makes for good dicussion. Would you consider it or not?

 

[rmediver2002]

Getting DCI can have nothing to do with the air management or time or work load or ascent habits. There are risks divers take that will make them more susceptable to getting DCI than less riskier dives but keep in mind that sometimes it is just your day or rather just not your day. Taking a DCI hit is not a sign of weakness of the diver and may not be related to poor habits diving or otherwise there are so many varibles involved. It is because of these variables that the question of IWR and it's potential benefits or risks makes for good dicussion. Would you consider it or not?

Depending on the area of operations it is something I would most certainly plan (proper equipment and training...) for and conduct...

But I also understand much of the resistance to it from the diving community in general and I feel that is a healthy thing...

It is not something to be conducted without proper equipment and training, if you know enough about it you might choose to conduct it...

If you do not have experience in diagnosing and treating injuries and would not be comfortable conducting a surface recompression treatment then in my opinion you have no business compounding the difficulty of the situation by trying it in the water...

Jeff Lane

Jeff Lane

 

[pipedope]

I would certainly try IWR if the only alternative is to die while waiting to be transported to a chamber.

OTOH I would not choose to do dives with serious staged deco without a chamber on site.

Remember that Pyle points out that the 'in water' may be more important than the 'recompression' part. A compromise might be breathing O2 *on the surface* *in the water*. This makes monitoring and treating much easier than at depth and may have a great deal of benefit.

You pays your money and you takes your chances.

 

[BigJetDriver]

Hi, all!

In regard to the useful application of IWR, the two most important keys are: (1) patient assessment, and (2) risk/benefit analysis.

(1) The main question is: How badly is the patient affected? What is the result of the preliminary diver neuro exam? What is the current physical state of the diver? What was the extent of the exposure, i.e. gases used, time/dosage, etc? What is the prognosis?

(2) Are we prepared for IWR? Are the environmental conditions acceptable? Is there better help, i.e. chamber and medical staff within reasonable transport time and distance? Please note the word "reasonable" here. The farther you are away from shore-based or platform-based recompression and medical help, the more reasonable IWR becomes IF, and it is a large IF, (no pun intended) you are prepared for it!

In general, unless you have the set-up, the training, and the staff to assist, IWR is more dangerous to the patient/diver than surface 02 and transport.

It is, however, as Fins pointed out, a personal decision.

BJD :doctor:

(FYI: Just as a foot-note, I am a certified Diver Medic Technician and the course included study of the practice of IWR.)

 

[RICoder]

Interesting debate.

I just got done reading "Fatal Depth", and I was suprised to read that IWR was used on one of the incidents that occured. Really good read btw.