Treatment of a suspected victim of decompression Sickness outside Recompression Chamb

[boulderjohn]

In a phone conversation, the encyclopedia’s author and IANTD founder Tom Mount reported that IANTD does not yet teach IWR because of its lack of broad acceptance. He includes a caveat that IWR is only to be done by qualified & properly equipped individuals in remote areas where a chamber is not readily available. When pressed for an example of such a location, he named Bikini, where chamber treatment could be 36 hours away. Fascinatingly, he mentioned performing the technique on about 15 divers over the years, including his wife during a trip a Roatan before a chamber was available there. His reported success rate is a startling 100%.

I don't want to sound like a cheerleader for IWR--I am not. However, I think this illustrates a problem with statistics on IWR, as I mentioned above. When someone does it in an emergency situation and it works, we never hear about it. We only hear about it when it doesn't work. That skews the performance statistics more than a little bit. I personally know of three attempts, although I was not physically present for any of them. All three were successful--and not reported except to the agency under whose instruction the incidents occurred. I do not know what they did with those reports, but I do know the agency was considering creating a course for it.

So far based on the information reported here, for the Libyan specific scenario where no 100% O2, properly trained divers or support personnel are available, IWR on air for divers who surface with DCS is, in the best scenario, useless and would actually cause more harm than good.

I would like to refer to what I just said for comparison. In the cases I mentioned, the treated divers had full face masks, oxygen, and a printed version of an established protocol (I believe Australian) ready to go when the symptoms began. That was not blind luck. The divers were in a remote area, and they knew they were very, very far from a chamber. They decided ahead of time that they would have those implements on hand in case they were needed. I dived many times there with those implements on hand, but we didn't need them when I was present. If I were diving in a remote location where I thought it might be possible that we would need to do IWR, I would try to make sure I had the equipment needed for it on hand.

 

[danvolker]

And this is the "galling" thing about this problem in Libya ... you just should not have people doing dives this deep, without pure O2 available.....and of course without any knowledge of no-deco tables, lot less the ignorance of decompression procedures. All of the good ideas that IWR might be useful with, involve pure O2. If these guys want to have extra "air" tanks for emergency recompression for bent imbeciles, I think they ought to stencil "KEVORKIAN 100% MIX" on the sides of these tanks!

 

[boulderjohn]

All three were successful--and not reported except to the agency under whose instruction the incidents occurred.

I just thought I would add that it is unlikely those incidents were reported outside of the agency, since the agency is proud to maintain the public perception that no one gets bent using their protocols.

 

[BoltSnap]

... you just should not have people doing dives this deep, without pure O2 available.....

I did NOT have do any of this at all, this is outside my control or knowledge. In fact, I am fighting to convince them not do ANY of this suicidal insanity but one can't undo decades worth of ignorance in few months. There is so much education work that needs to be done here, it is discouraging sometimes especially when these guys are so stubborn and actually fight somebody who they know/perceive to be far more educated than them and would work hard to convince themselves that what they are doing is OK. The greater majority of these people have no clue of how to use the tables. They remember specific dive times for specific dive profiles and sequences that were passed down to them from their buddies or "elders."

My other challenge here is to teach and promote "DAN O2 and dive accident management" courses in addition to figuring out a way to have few recompression chambers available in locations along the Libyan coastline (about 1200 miles worth of a beautiful south Mediterranean coastline).

 

[danvolker]

I did NOT have do any of this at all, this is outside my control or knowledge. In fact, I am fighting to convince them not do ANY of this suicidal insanity but one can undo decades worth of ignorance in few months. There is so much education work that needs to be done here, it is discouraging sometimes especially when these guys are so stubborn and actually fight somebody who they know/perceive to be far more educated than them and would do to convince themselves that what they are doing is OK. The greater majority of these people have no clue of how to use the tables. They remember specific dive times for specific dive profiles and sequences that were passed down to them from their buddies or "elders."

My other challenge here is to teach and promote "DAN O2 and dive accident management" courses in addition to figuring out a way to have few recompression chambers available in locations along the Libyan coastline (about 1200 miles worth of a beautiful south Mediterranean coastline).

Burhan,
I know this was not your fault....I was speaking hypothetically.....It is beyond the control of all of us....only the Culture, families and peer groups where these divers are, will exert any influence over their futures in this.