Is it safe to administer IV's underwater??

[TRUETEXAN]

I was just wondering why it would not be an excellent idea for divers that have long decompression requirements to administer an underwater IV. The only reason I can think of is that it probably would not be a sterile field. The reason I ask is that I am thinking seriously about getting into cave and wreck diving, and I am one of those people that dehydrates quicker than most for some reason and I am quite used to giving myself IV's after very strenuous activity, such as cross country enduro and desert racing, or days when I have had to do lots of work outside in the heat for several days in a row, and yes, even if I drink and drink water I can still dehydrate sometimes. Since the threat of dehydration is a serious one when it comes to DCS I was just thinking that it made sense to do the underwater IV thing, I mean how could it hurt? I hope this does not sound like a stupid question, but you don't know until you ask, and I want to know.

 

[DocVikingo]

Hi TRUETEXAN,

This is not a direct answer to your question. But, having to self-administer IVs to rehydrate after such events as doing lots of work outside in the heat for several days seems a bit unusual in an otherwise healthy individual who is taking all appropriate measures to stay well hydrated.

What has your physician said about this?

Be well.

DocVikingo

 

[TRUETEXAN]

Well, Doc, I didn't really give you the whole story, I am also a type I insulin dependent diabetic and I when I was much younger it was very poorly controlled and I would dehydrate badly and have frequent bouts of high glucose levels and I always wound up in the ER getting IV's, also sometimes my blood sugars would unexplicably rise to anywhere between 600-800 and the only way to get it down quick was by way of an insulin drip in an IV bag. These kind of poorly controlled blood sugars stopped after about 17 years of age partly because I learned to eat right and monitor glucose levels properly, however during those teen years I was shown how to administer IV's to myself because my family and I often traveled and sometimes we would be far from medical help, so the doctors thought it would be a good idea for me and my family members to learn how to do the IV's and run the insulin drip in case we had to. So you see I have lots of experience at giving myself IV's and my concern is not that I am going to dehydrate so badly whie diving that I will nee one while in the water, but I read so much about the dangers of even slight dehydration and DCS that I was just simply wondering why tech divers did or didn't or shouldn't do this? I rarely ever have to give myself IV's anymore, I was just giving examples of when I had had to and was just curious. I certainly hope that this was not an inappropriate place to discuss this as I was simply curious and not trying to recommend that anyone do it.

 

[DocVikingo]

Hi TRUETEXAN,

Heavens, Old Pippin, there was nothing in my post to imply that this is an inappropriate place to ask such questions, nor anything in yours indicating that you were recommending the practice to others. I simply had strong suspicions that there was more to your story than you included in the original post and was curious.

As for your rehydrating by IV while u/w, off the top of my head & in no particular order I'd say issues would include:

1. Maintaining sterile conditions (this procedure carries a greater risk of infection than we'd like even under good conditions). Introducing water from the water column, likely loaded with pernicious microorganisms, would be courting very serious trouble;
2. Possible threats to the integrity of the fluid bag with exposure to the rigors of diving;
3. Assembly of the rig in a moving (sometimes vigorously) marine environment. I suppose this could be done topside, but then see #2 above;
4. Placement of needle while wearing u/w thermal protection;
5. Stability, orientation & flow of the rig in a moving (sometimes vigorously) marine environment. Also entanglement issues;
6. Possibility of over hydration (can be more dangerous than under hydration);
7. Divers with long decompression obligations may already have substantial task loading. This procedure would add another task of some degree of complexity & risk. Ditto for their buddies; and,
8. Getting a medical supply house to sell you the rig, particularly needles that likely are controlled & require a prescription (not many competent physicians are going to sign off on this plan).

Hope this gives you something to think about.

DocVikingo

 

[BillP]

I share DocV's concerns about the safety of admistering IV's underwater. It is not a practice that I would recommend.

I would go on to say that if a recreational diver has a medical condition (or even a physiological quirk) that would require specific medical intervention during a particular dive, then they should seriously reconsider the wisdom of doing that kind of dive.

Just my 2¢,

Bill

 

[devjr]

C'mon TT, can't you just carry a goatskin full of Gatorade or something? Hey, I like to experiment too, but that's the limit.

There was a fellow in his early 30's, and a diabetic, who dove off my boat for three years. He was a stranger from CA to whom I took a liking, and just accepted his word that the type I issue was under control. He told me that the cattle boats in CA would not let him on board if he told them about his condition. On our first trip offshore he had a problem with surface swimming and puking but in a few weeks he got in shape and really began to shine.

Almost immediately, he moved beyond his basic certs to freedive, spearfish, and in between, we dived some of the WWII shipwrecks. I was impressed with his overall progress and congratulated myself for making a good investment. Eventually he returned to CA but we kept in touch and reunited for some exciting dives in the Bahamas. We did it our way; chartered and sailed a trimaran to places of our choice. Had some friends along, fishing poles, diving gear, compressor--- fresh fish and lobster every evening.

Recently, at age 38, his knees were giving him trouble and he had surgery. His diving has been curtailed but I think he still does beach dives on occasion.

 

[rcohn]

Not sure of all the physics here but I believe that most IVs use gravity to move the fluid, at least I've always seen them hung well above the patient in air.

In the water buoyancy will conteract the effect of gravity and you would need to squeeze the bag to force the fluid to flow. You might need a check valve to prevent blood pressure from driving a reverse flow, sending blood into the IV tube and bag. My guess is all this wouldn't help the issue.

Ralph

 

[TRUETEXAN]

Thanks for the input everybody, and let me also say that I was only talking about divers doing dives that included really long deompressions such as some of those extreme deep divers that try to set records and really long cave penetrations where I have read about guys having to deco for up to 7-8 hours, I didn't mean that I wanted to pop in a line during my safety stop. I was just thinking that if it were possible, it might help them to have an underwater IV while hanging out at there last long shallow stop. By the way, I have since read that this had been done before before by a guy I believe his name is Jim Bowden, I am trying to find te site that talked about it and I will post it.

By the way, I have never heard of being over hydrated, what are the ill effects of this condition and how does it usually happen?
Thanks for the replys.

 

[DocVikingo]

Howdy TRUETEXAN,

Overhydration is also termed water excess or water intoxication, and occurs when the body takes in more water than it excretes, significantly diluting normal sodium levels.

In a healthy adult, it's pretty hard to bring this on. I think you'd need to drink in excess of 2 two gallons of water a day. However, if you're drinking very large amounts of water & receiving IV rehydration as well, it could happen.

Given all of the dehydrating effects of diving, most notably immersion/thermal enuresis, it's hard to conceive of it occurring in that situation. Please appreciate that my above response to you was sort of stream of consciousness.

Best regards.

DocVikingo

 

[TRUETEXAN]

Thanks Doc!