Underwater Tourist
Contributor
Saw a recent youtube upload:
Simon Mitchell - Should divers treat DCS in-water?
- Thread starter Underwater Tourist
- Start date
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johndiver999
Contributor
Wow thanks!
Robert H. Diver
Contributor
Very interesting
Boarderguy
Chief Narctopus Wrangler
Interesting. Worth the 27 minutes to watch and listen
Always a treat to watch Dr. Mitchell explain his findings so elegantly. Thanks for posting!
How times have changed.
It is quite interesting that DAN Europe had sponsored the talks, since IWR (in water recompression or “decompression“ years ago) had always been verboten by the organization, "DAN strongly recommends that in-water decompression using either air or oxygen, should never be attempted," and had only previously encouraged onboard treatment of DCS with O2.
There had been a number of reasons for that proscription, including a potential increase of danger to the patient (paralysis or loss of consciousness) and to his or her attendants (DCS themselves, for one); the depths that were originally suggested for IWR (up to 50 meters); the long periods of time required (usually measured in hours); risks of hypothermia; the availability of a very large gas supply; a possible decline in the patient's condition — even unforeseen weather changes.
Shallow-water IWR on O2 seems to carry some real benefits, that not even DAN can really ignore any longer -- no added nitrogen debt and a larger gradient for its excretion; a maximum depth reduced to less than 10 meters and a time reduced from around five hours, on air, to about three on O2; less of a threat to any attendants; and no nitrogen narcosis.
That use of positive pressure full face masks for shallow water IWR was also interesting, should a patient either convulse from O2 treatment or lose consciousness for another reason . . .
It is quite interesting that DAN Europe had sponsored the talks, since IWR (in water recompression or “decompression“ years ago) had always been verboten by the organization, "DAN strongly recommends that in-water decompression using either air or oxygen, should never be attempted," and had only previously encouraged onboard treatment of DCS with O2.
There had been a number of reasons for that proscription, including a potential increase of danger to the patient (paralysis or loss of consciousness) and to his or her attendants (DCS themselves, for one); the depths that were originally suggested for IWR (up to 50 meters); the long periods of time required (usually measured in hours); risks of hypothermia; the availability of a very large gas supply; a possible decline in the patient's condition — even unforeseen weather changes.
Shallow-water IWR on O2 seems to carry some real benefits, that not even DAN can really ignore any longer -- no added nitrogen debt and a larger gradient for its excretion; a maximum depth reduced to less than 10 meters and a time reduced from around five hours, on air, to about three on O2; less of a threat to any attendants; and no nitrogen narcosis.
That use of positive pressure full face masks for shallow water IWR was also interesting, should a patient either convulse from O2 treatment or lose consciousness for another reason . . .
One of the first things Capt. J.Y. Cousteau did when he outfitted the Calypso in the 1950s was to include a recompression chamber. There is a segment on its use in his movie, The Silent World. I’m curious why, after all these years, dive resorts do not equip themselves with a recompression chamber. In-water recompression may have some applicability, but cannot replace a recompression chamber.
SeaRat
SeaRat
Sadly -- expense and, nowadays, massive Godzilla-sized liability . . .
As always, excellent medical analysis presented in an easily understood manner.
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