Thoughts on in-water recompression

[VooDooGasMan]

A tec instructor made a dive on the diamond knot a year or so ago, went back down with no success, at the chamber it made it alot more complicated for recovery. That group and shop have first hand knowledge, right along with the boat captain. You have a choice, try it, or not.

If you go to a chamber confrence, you will know the many divers that tried and died, tried and never dive again, tried and succeded, yet went to chamber after.

Now with the knew Ike lite housing for a laptop it is easier to do IWR and Know all the times, stops, etc, plus watch a movie.


Happy Diving

 

[Ed L.]

I meet so many "divers" that go on and on and on about anything related to diving that is so patently false I just usually go "Ooohhh???!!!" (some of it here on SB!) and either change the subject, excuse myself or not comment at all.

Then there is this saying. "People who think they know everything. Really annoy those of who do!"

 

[Joe21]

I couple years ago I did a few dives in 80ft and follwed the plan to a T and was diving nitrox. A few days later I had pretty bad joint pain that ranged from my elbows to almost every joint in my rib cage, alot of the time it hurt even to breath that lasted for a month....till I went diving again, I came up and had no further joint pain. it then hit me that I was probally had a mild case of the benz. I know I broke some kind of SB law and now im probally goint to hell, but it definately worked and im still alive.

 

[bamamedic]

I couple years ago I did a few dives in 80ft and follwed the plan to a T and was diving nitrox. A few days later I had pretty bad joint pain that ranged from my elbows to almost every joint in my rib cage, alot of the time it hurt even to breath that lasted for a month....till I went diving again, I came up and had no further joint pain. it then hit me that I was probally had a mild case of the benz. I know I broke some kind of SB law and now im probally goint to hell, but it definately worked and im still alive.

Don't mean to be contradictory, but it's highly unlikely you had a case of DCS that would cause pain for a month...from what I understand joint-only pain tends to fade after a few days. Plus, something like 99% of DCS cases present with onset of symptoms prior to 24 hours...anything presenting later is usually a case of the diver being in denial about the initial onset of symptoms.

I just don't want to encourage anyone to treat their symptoms via in-water recompression....sometimes, it's the only option in remote locations, and for those situations, prior planning must be in place (full face mask in case of oxygen toxicity, etc)....for the vast majority of us, the most appropriate treatment is to get on 100% oxygen, call DAN, and go to the ER for evaluation.

 

[boulderjohn]

Some friends and I do a lot of diving in a remote area where the nearest chamber is many hours away. We have a full face mask and O2 on hand just in case. I was not on the trip when it happened, but we did have a diver who was clearly symptomatic--no question about it--and who went down for IWR on the Australian protocol. While he was down, people made preparations to get him out of there. I don't know any more of the details, but I know the symptoms resolved during the IWR. He did go to a hospital after that, but he required no further treatment.

 

[Superlyte27]

In-water recompression – treating DCI by putting the diver back underwater shouldn't be attempted. Recompression takes a long time and requires oxygen and often drug therapy.
Normally the required resources aren't available at a dive site and incomplete recompression will usually make the diver even worse.

No drugs in recompression. I'm a chamber operator.

 

[Superlyte27]

I've said this before when this topic came up on SB. I have two thoughts and I'm not sure how I'd treat this given the same scenario.

A friend of mine was making a living diving off of Daytona shooting fish in and around 200' of water. This was decades ago. They did this every day for several seasons. One day his buddy got bent, bad. There was no time for the boat ride back. The coast guard was called and shortly after the Coast Guard's boat arrived the CG called a helicopter. The hurt diver was being flown to the chamber when they encountered a bad storm. They raised their altitude to get above the storm and killed the diver.

So... That sucks! I am a commercial diver. In commercial dive school we are taught about in water recompression. We are even given a protocol for how to do it. The thought is that if we are hurt in a very remote location far from a chamber that IWR is better than nothing. But it was emphasized that this should be a very last measure. Consider it a very last measure with surface supply, limitless O2 and Air, and standby divers/tenders.

The exact protocol we were given (probably developed by the navy) was very long. It would consume tons of O2 at high PPO2, requiring tenders and divers. You would probably get very cold. I'm not sure what I would do. If a boat ride or car ride could get me to a chamber. I'd go to a chamber before IWR.

 

[boulderjohn]

The exact protocol we were given (probably developed by the navy) was very long. It would consume tons of O2 at high PPO2, requiring tenders and divers. You would probably get very cold. I'm not sure what I would do. If a boat ride or car ride could get me to a chamber. I'd go to a chamber before IWR.

I fully agree with this concept, but in the cases I am thinking of, I am not thinking of doing the full Navy 6 treatment or its equivalent. The Australian protocol, which our group followed, is much shorter and possible without a whole lot of extra support gear on hand. The same is true for the more recent protocol devised by Dr. Richard Pyle (See this article for some brief summaries.) What our group did was intended to give the diver some immediate assistance while preparations were made for effective transport, etc. In that case, the symptoms were completely resolved during the IWR, so heroic measures were unnecessary.

What is most intriguing to me is the oft-repeated statement that the earlier the treatment, the better. It seems to me that doing an immediate and relatively brief stint under water with a well scripted and prepared program will likely do no harm and may do a lot of good.

 

[tflaris]

I recently had a debate with man in his 50's or maybe even older regarding what to do int the event of DCS. This guy tells me that anyone would be stupid not to attempt in-water recompression for someone with DCS. I think this is very risky and should only be attempted by very advanced professional divers who have the experience, knowledge and training along with all of the logistics and support it would require to do so. This guy starts yelling at me, telling me that it is a better option than waiting for medical personnel to transport the victim to a hyperbaric chamber. I think in-water recompression should, for the most part, NOT be attempted by the majority of recreational divers, but this guy is basically insulting me calling me an idiot. I think he is the idiot. What do you all think?

I would only use in water re compression as a last resort. If there wasn't a chamber anywhere nearby or if it required an airplane ride over some really tall mountains to get to the chamber.

Also only with support divers to monitor and assist.

Just my 2 cents.


Sent from my iPhone using Tapatalk

 

[elmer fudd]

So what do the rest of you think about IWR as a preventative measure? Say someone has an uncontrolled ascent from 100' or blows a deco stop, but is otherwise not exhibiting any symptoms of DCS. That's when I'd be thinking, "go back down and off gas for awhile."