Young and not bent

[Alban]

Genesis

I can understand your point but you may be leaving yourself open to be sued. If a diver is suffering from dcs they could be unable to make a rational decsion as you probably know we all have a duty of care to each other , by giving O2 with or without consent you or the diver reconise a problem any delay in treatment could prove costly to all concerned.

Yours Alban

 

[Genesis]

try reading for comprehension.

I have never said I would "give" someone O2.

I freely acknowledge that I can't (ethically, legally and morally) "give" anyone anything of the kind. I am not a hyperbaric MD and do not claim to have the specialized knowledge necessary to make a medical diagnosis or prescribe any sort of medical treatment.

I do have, on board my boat for my personal use, a supply of aviators breathing O2, along with O2-safe equipment for its use. I did not buy it for anyone else. I bought the kit (at considerable expense) for ME. The kit is there for the specific purpose of allowing me to breathe it as a decompression gas ON THE SURFACE if I have reason to believe that I may need it. I accept full responsibility for my own decision to do so if I choose to avail myself of that gas supply.

If YOU, as a diver, judge that YOU need a 100% O2 decompression mix on the surface for any reason whatsoever, you are welcome to consume that gas if you are a guest on board my vessel. My interference with your doing so will be limited to insuring that you don't blow up my boat (e.g. you're not going to be turning it on in the cabin, especially if someone is smoking a cig!) I will advise that you call DAN in such a circumstance, and if it can be done where we are at that point in time, will offer you my cell phone to do so if you don't have one - simply for convenience, since DAN's emergency number is programmed into mine and its a one-button deal to call them.

If you believe that you are bent, or its blatently obvious that you are to anyone in the vicinity, then I will call the USCG to advise them that there is a diver in distress and we will take things from there. They, and DAN, are the experts - not I. The USCG will probably advise me to proceed at once towards port and while en-route we will work out how to transfer you to real EMS personnel with real credentials. I will advise THEM that I have O2 on board and if THEY tell me to "give" it to you, I will - but in all likelihood, if you have half a brain, you will have already helped yourself.

I do not owe you a duty of care that extends to any professional capacity as an ordinary diver. I am not a divemaster, an instructor, an MD, or a charter boat operator. I do not take people diving for money (or anything else of value.) I have my own, private boat from which I and my friends dive. I explain before any friend dives with me who has not before that I have O2 on board, where it is, and that their own training, knowledge and experience must guide any decision on THEIR part to retrieve and use that supply. I also explain that they should never be afraid of the financial impact of consuming it as a factor in their decision, as it only costs me $10 to have the bottle refilled.

There is a huge difference between this and a charter operator, or an instructor on the beach, both of whom have a duty of care due to their professional status.

I am a DAN member, but not a parrot. As a thinking, sentient human being I make my own decisions related to my health and safety, and carry whatever I think I reasonably may need with me for a given dive excursion. When it comes to my boat, that happens to include a supply of O2 in the unlikely event that I severely screw up somehow.

I strongly urge those who I dive with to become educated, to learn about O2 consumption, to form their own opinions, to get DAN's insurance and to dive intelligently. Nonetheless, the risk of an accident does exist and to the extent that we can mitigate those risks at an acceptable cost it only makes us all safer.

 

[MikeFerrara]

Genesis
I wasn't trying to say there was anything wrong with the way you run your boat. And I understand that you are not administering treatment but only making the O2 available.

There is a difference between using O2 for efficient and excelerated decompressio (to avoid DCS) and traeting DCS. The symptoms are not the desease. The bubles and the damage they cause, wether temporary or permenant, is the desease. Symptoms can come , go, get worse and get better over time.

In treating DCS the administration of O2 has been known to lessen or even temporarily eliminate symptoms, however, in all but the most mild cases recompression combined with O2 therapy is required to cure DCS. It is also thought that it is important to get complete treatment as soon as possible to prevent permenant damage. Therein lies the concern in administering O2 after an incedent. If the temporary lack of symptoms results in delayed treatment the end result may be worse. The administration of O2 is the correct first aid for DCS it is not a complete tratment for DCS.
These recommendations change from time to time and I am only trying to explain the concern behind this recommendation. This is not to say that using O2 will never totally prevent the onset of symptoms but I think the worst case is being accounted for here. The worst case being a delay in recompression treatment for a significant hit as apposed to a delay in O2 administration for a very minor hit. Also, it is likely assumed that any hit that is (if possible) totally avoided by O2 (after the fact) is likely minor.

Certainly everyone must make their own decisions. What every diver should realize though is that much of what we call decompression theory is just that theory. We need to stay as up to date as we can on the state of this black art. We need to take the most current information available into account while making our decisions. In this case we should consider that in the jugement of at least some of the "experts" the arbitrary administration or use of O2 may not be the best approach.

 

[MikeFerrara]

joens once bubbled...
I'm with genesis all the way .I am a member of DAN but I dont agree with everything they say. Oxygen is a tool for dealing with one of the hazards of diving .If I planned my dive to use O2 at a deco stop or if I think it would be prudent to use it at the surface Its all the same .I will go diving with Genesis any day he will have me aboard.
Chris Joens

Which DAN recommendations do you disagree with?

I don't think using O2 as part of the dive plan is the same as using it because a dive plan was not followed. the first is an attempt to efficiently decompress so as to not get DCS the other is an attempt to treat DCS as in the case of the rapid ascent. O2 may certainly have its uses in both application but they are not the same.

 

[joens]

Offgassing starts any time you ascend and continues for days afterward . breathing O2 at a deco stop makes the stop more effective .just as breathing O2 at the surface makes the continued offgassing more effective.

 

[AquaTec]

Using O2 after a big dive is a great thing,

I start breathing O2 or 80% at my 20/30 foot stop when i surface I sit on the surface for a minimum of 5 minutes, then continue to breath it for sometime afterwards.

I am not displaying DCS symptoms, I am just continuing to off gas. keeping the pressure gradient high.

If i where a recreational diver and did a dive which exceed my run time or depth, and was not trained in decompression procedures, i would extend my safety stop and when surfacing i would take the o2 and continue to off gas. and monitor myself for signs of DSC [also let my fellow divers know of the situation]

having O2 available on a boat is mandatory, it should not lead to any special procedures, other than monitoring. and it should not be frowned on by other divers.

In my world of diving breathing O2 on the surface is as natual as breathing it underwater.

 

[boomx5]

What did the diver say that almost killed you?

 

[MikeFerrara]

AquaTec,
I was only stating that in some cases, according to DAN, the administration of O2 is thought to have contributed to the delay in treatment.

 

[Genesis]

Its pretty much consensus that the rapidity of onset of DCS has a great deal to do with the severity of the case.

That is, if you REALLY screw up, you'll probably get nailed almost immediately. If you have only a "minor" hit, you may not feel it for hours.

(Yes, I'm aware that's not exhaustive, and that you can get a nasty hit that doesn't show up for several hours - but from my understanding it holds in GENERAL)

Now let's look at what's being proffered in this scenario...

If you consume O2 immediately after surfacing with a deco violation or blown profile for some reason, you may well delay the onset of symptoms of DCS. I admit that this may happen. But what is probably happening here is that the delay in onset is correspondint with a less-severe hit overall!

Nowhere did I imply or state that O2 alone is a complete treatment for DCS, even though I'll bet my last $100 in some cases it ends up being that way. There are cases where someone comes up, gets hit, goes on O2, gets transported, and never has the symptoms come back. With no way to gauge whether there was a hit or not (the test for a hit being the remission of symptoms when challenged by a hyperbaric exposure), the person never gets the chamber treatment.

Does it happen often? I don't know that the statistics for this are available, but even ONE instance is enough to prove that it CAN.

The bubbles and damage to tissues are the disease, but the only DIAGNOSTIC means of knowing if there has been a hit are the presence of symptoms in the diver, and the PROOF of a hit is when the symptoms remit, in whole or part, under recompression. If there's nothing to remit....

As I'm sure you know, Mike, doppler studies have shown that a LOT of divers have some bubbling in their venous system after surfacing from a dive. There appears to be some critical amount of bubbling, both in quantity and size, below which the diver suffers no symptoms. We call that "no hit", even though to be technical the MECHANICS of DCS were present, since the bubbles were there. This may have something to do with the reason that heavy exercise can "trigger" a hit that would otherwise not take place. It is also why "bounce dives" are dangerous.

If someone comes up and believes they have taken a hit, then I am going to act as if they have, because they have told me that they have. It is THEIR call.

If someone comes up and believes they've blown their profile, has no symptoms, and wants to breathe O2, they know where the bottle is. It is perfectly reasonable to assume that someone who grabs the bottle and sucks it dry is going to be VERY aware for the next day or so of anything that feels like DCS in their body, as they KNOW they screwed up - that's why they grabbed the O2!

I see no difference between breathing O2 on the surface to offgas Nitrogen and breathing it in the water to offgas Nitrogen. None whatsoever. Both are done to improve the partial pressure differential between the nitrogen in the body (specifically the blood and lung tissues) and the gas in the lungs - you can't get a higher partial pressure differential than 100% - in order to increase the amount of N2 that is offgassed over a given period of time.

Since it is the overpressure of N2 in the body that CAUSES DCS, anything I can do to LOWER the overpressure of N2 in the body will DECREASE either the risk of a hit or its severity.

In fact, I believe that it is near-axiomatic that if a diver was to surface, knowing they had blown their profile somehow, had no symptoms, and breathed pure O2 for a period of time (say, an hour), then LATER suffered the symptoms of a hit,
there could be no question that the severity of the hit they suffered had been mitigated to some extent. The proof is simple science - the hour of pure O2 consumption has without question flushed some percentage of the overpressure of N2 out of their body - and since it is that overpressure that causes the hit in the first place, there is simply no scientific way to argue that a benefit has not been conferred.

This is simple logic and for that reason if I blow my safety margins on a given dive I'm gonna reach for the O2 bottle.

 

[Alban]

Genesis

This link is from a UK site but I would assume it would be much the same in the US
Http://www.divernet.com/safety/court0700.htm

Yours Alban