Young and not bent

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changes a thing - nor does it present a "problem" - in terms of how I handle my vessel and the fact that the stores on it are free to be used by my friends who dive with me.

First, the law as I have been led to understand it (and IANAL, although I've paid for plenty of legal advice over my years) is very different in the US .vs. the UK. Among other things, the waivers signed here, at least in Florida, ARE effective. There have been people who have killed themselves diving, the next-of-kin have attempted to pierce commercial dive boat liability releases, and they have failed. There is a whole host of case law on this point, and scuba diving has been effectively designated as an "inherently dangerous" pursuit. In fact, such is drilled into your head during even primary dive training. So the snide quips in that "article" aside, the US (or at least Florida!) appears to actually be a SAFER environment for dive operators than the U.K.

Next, I'm not arguing that there isn't a duty owed if you're someone's dive buddy. There is, but it is not absolute. Again, back to case law, there are a bunch of cases here where one member of a pair has gone off and done something beyond the original dive plan, put themselves at risk by doing so, got bent (or dead), and then tried to come after their buddy, instructor, or the operator. These kinds of suits fail around here too.

(As an only somewhat-dive-related example, if I am on the water in my boat and see you thrashing in the water, clearly in peril, I am required by international - and US - law to assist you. That requirement, however, does not extend to putting my own vessel or complement in peril! That is, if shutting down propulsion to retrieve you would expose my veseel to being thrown against the rocks, I am not required to accept that risk.)

Finally, part of living in the US is that you can be sued for any reason and at any time. The better question is whether you have a prayer in Hades of winning such a suit.

The issue postulated here by you, Alban, is some theory of liability attaching due to my having O2, telling people that I have O2, and not forcibly preventing someone from consuming it who chooses to do so as their own sole, personal choice, and then in fact does do so.

In other words, we're talking not about duty of care but a hypothetical duty of interference.

And again, just to be clear, we're talking about someone who has just regained the surface, is not exhibiting any signs or symptoms of DCS at the present time, but knows that they screwed up in some way.

You are also applying this scenario to a boat full of divers, none of whom is an MD, say much less a hyperbaric physician, and none of whom is acting in a professional capacity (that is, our training such matters is that of a scuba diver, and what we have learned as divers about O2 and its role in removing N2 from the body.)

I don't buy it.

The fact is that by breathing pure O2 on the surface you will increase the rate of N2 departure from your body and lessen the overpressure of N2 within your tissues. This is a scientific fact, and since it is that very same overpressure of N2 that causes DCS, it is axiomatic that having done so you will have lessened the available overpressure to cause a (potential, but not yet occuring) DCS hit. Since the severity of a hit, all other things being equal, is determined by the available overpressure (the degree of supersaturation) of N2 in the body, it is axiomatic that by lessening that supersaturation you are reducing the severity of any hit that you may subsequently suffer, and in fact you may prevent the hit from occuring in the first place IF you can reduce the supersaturation sufficiently prior to the aggregation of those bubbles and the onset of symptoms.

Think about this for a minute.

Let's say that I exceed the NDL and have a 10' ceiling for 5 minutes, on 32% EANx as a consequence. Let's further say that I don't HAVE 5 minutes of gas left, so I surface, having blown off my deco obligation.

Ok. I've now reduced the ambient pressure to the point where statistically I am exposed to a DCS hit. This does not necessarily mean I am going to get bent, but it DOES mean that statistically speaking, I am more likely to get hit than someone who stayed the 5 minutes.

BTW, my computer's beeping at me says that I have three minutes (in the case of my Sunnto) to get BACK to 10! In other words, if I can surface, grab a NEW bottle of gas, and go BACK to 10', I have not violated the computer! (In-water de/re-compression - officially sanctioned by computer manufacturers - anyone?!)

For the sake of argument, let's say I can't (or don't want to) do that, having bought into the proffering of opinions that IWR is so hazardous that it should not be attempted. I get on the boat, knowing that I blew the profile.

I grab the O2 bottle and consume it.

What have I done?

1. I have increased the rate of perfusion of N2 out of my body significantly. I do not know the exact percentage by which I have done so, but it is axiomatic that I have done so. Let's say, for the sake of argument, that I have doubled the rate of perfusion out of my body.

2. Let's further postulate that I am two pressure groups "off the chart" of the SSI tables (which is why I'm at risk of being bent in the first place.) That is, instead of being a "K" diver, I'm a (theoretical) "M" diver (which they don't chart, because that's in a decompression-required range that they don't include in their tables)

Now, the issue at bar becomes "how long does it take for the micronuclei in my body to attract enough additional gas molecules - and grow enough - to cause me to become symptomatic, and can I bleed off supersaturation quickly enough to prevent that from happening", right?

Does doubling (or increasing by "X%", whatever that value of "X" really is) prevent that?

There is no way to know with certainty the answer to that question.

But can we say with any kind of certainty that breathing the O2 will HELP, in other words, such an act will, without fail, provide at least no worse a chance of a hit, and no worse of a hit if you DO get nailed, than you would have if you did nothing?

Absolutely.

THAT is, for me as an individual diver, THE gold standard.

Having already screwed up, which is THE reason that I am at risk of getting hit, I will take every reasonably-available action to attempt to reduce the odds of a hit, and the severity of a hit if I get nailed anyway. I will do so knowing that the original set of acts that placed me at risk of beig bent were my responsibility, and further, as a sentient adult who accepts responsibility for my own actions I am choosing to attempt to mitigate those risks - win, lose or draw.

The ONLY act that I can take ON THE BOAT that will materially change the odds is to grab and breathe the bottle of O2.

Further, by grabbing the bottle I announce to the entire boat that you believe you may be at risk for a hit. Its pretty hard to miss someone toting around an O2 cylinder and demand valve. If anything, this is going to lead to heightened awareness by every other person on that boat for any signs and symptoms of DCS in your person for the duration of the journey - which can only improve the odds of someone other than you detecting such a subsequent condition.

You're going to have to show me something a whole lot more convincing than the general rubric that I can't drive my buddies around in a boat that's about to sink, knowing that it is about to sink, and then get sued when it DOES sink, to make your point here!

In fact, I would argue that for the boat that HAS O2 on board, discouraging people from consuming it who have reason to believe they are at risk of a DCS hit is the irresponsible (and potentially legally risky) act - not the converse.

Mike, the cite you're giving related to DAN is related to people who WERE symptomatic, breathed O2, became NON-symptomatic while doing so and never followed up! THAT is, indeed, a position that DAN takes (and which is, IMHO, quite reasonable) - that once you have signs and symptoms of DCS you CANNOT count on O2 alone to reverse or treat the disease, and that having experienced the symptoms of DCS, you should never delay in seeking treatment, even if breathing O2 gives you relief. We're talking here, however, about someone who is NOT symptomatic, but knows they have blown their profile in some fashion.
 
Giga Idiot! That's funny stuff!

I'm rigging up for a Technical Nitrox class so I can stay down longer and safely kill more fish. Did I say kill, I meant Slay.

I'll actually apply my instructor's teaching to real life situations. I'm sure MOST of us here actually do the same.

Sharing experiences and techniques is great, but trying to educate someone here is a great way to get a newbie killed by misrepresenting yourself as an expert with real life experience.

Standing by for a long winded reply.
 
Genesis

It would appear then we are more likely to be sued here than the US !
There was a recent bsac case where a diver suffered dcs at the time all including the lady diver attributed the problems to menstrual problems and seasickness. Much later she was diagnosed as having suffered dcs and the injuries had worsened due to the delay in treatment. Her case was that at the time of the incident her judgement was impaired due to the dcs , others on the boat where O2 qualified and as divers should have known the signs and symptoms of dcs .This case was actually settled out of court for financial reasons ,or perhaps it was to avoid setting a prescient .
The point I was probably trying to make is , if your diver missed some stops , he decided to go on O2 as a precaution and then he decided he was OK and later that evening went to a chamber over here we could be liable. A misconception then is you are more likely to be sued in the US than anywhere else .

Your points about O2 I would agree with but again for legal reasons I would be obliged to follow the recommendations of my insurers / training agency who at this time recommend giving O2 , I find it very ironic we are covering our butts more than you .

Yours Alban

:upset:
 
Genesis said
"Mike, the cite you're giving related to DAN is related to people who WERE symptomatic, breathed O2, became NON-symptomatic while doing so and never followed up! THAT is, indeed, a position that DAN takes (and which is, IMHO, quite reasonable) - that once you have signs and symptoms of DCS you CANNOT count on O2 alone to reverse or treat the disease, and that having experienced the symptoms of DCS, you should never delay in seeking treatment, even if breathing O2 gives you relief. We're talking here, however, about someone who is NOT symptomatic, but knows they have blown their profile in some fashion."

I just got off the phone with DAN. According to them...If O2 is administered in response to a blown dive plan or other incedent that would cause concern it constitutes the beginning of treatment and needs to be followed through with an evaluation by a phisician preferably one knowlegable in diving med. The concern is as I stated before that the O2 can mask symptoms and prevent or delay treatment and/or complicate diagnosis.

In such a case the recommendation is to rest, stay out of the water and monitor for symptoms. If symptoms appear administer O2 and seek further treatment. This recommendation is for someone who is NON-symptomatic and has blown their profile in some fashion.
 
on a private boat or a chartered vessel?

There's a pretty significant difference!
 
Genesis

I am not sure about that I don't think over here it wouldmake any difference , her argument was she was not in a position to make a rational descesion , others that where on the boat should have made the descision for her . It may have been a club rib where it is non commercial , even if it was a commercial boat the skippers at the moment are saying they are only taxi drivers there responsibilities extend only to the sea conditions.
When booking a hard boat dive it is not necessary to produce any qualifications.
If a diver was to go on O2 they would inform the coast gaurd who then decides what action to take.

Yours Alban
 
Genesis once bubbled...
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.

I thought this case of a hit resolved using O2 only might be of interested to those who haven't read it before.

http://staff.washington.edu/parker/scuba/tech/bendstory2.htm

Ralph
 
do whatever they want Mike...

I just got off the phone with DAN. According to them...If O2 is administered in response to a blown dive plan or other incedent that would cause concern it constitutes the beginning of treatment and needs to be followed through with an evaluation by a phisician preferably one knowlegable in diving med. The concern is as I stated before that the O2 can mask symptoms and prevent or delay treatment and/or complicate diagnosis.

In such a case the recommendation is to rest, stay out of the water and monitor for symptoms. If symptoms appear administer O2 and seek further treatment. This recommendation is for someone who is NON-symptomatic and has blown their profile in some fashion.

The problem I have with DAN's view on this is the italicized portion above.

You can't treat something that hasn't happened and may not happen!

I further disagree that you are "treating" anything in such a case. I also disagree that you are "administering" something.

Either DAN was misunderstanding what you said, deliberately obfuscating the issue, or there's a rotten apple in their barrel.

Did you follow up by asking "so you're saying that if I'm on a 100% O2 deco that I'm "administering" myself O2 and therefore need to go see a doctor if I take one or more breaths after breaking the surface?"

I would have, and the answer would have been interesting to say the least.

To be consistent, DAN would have to take a position against breathing O2 at all, unless of course you are symptomatic. That would include a position against staged decompression diving with O2 (or any high-percentage O2 Nitrox mix) as a deco gas, among other things, because it might "mask symptoms."

So, because I don't believe DAN is either obfuscating the issue intentionally OR has a rotten apple, I called them.

I just spoke with Dan Noord, who is the guy who wrote the position piece. We had a nice conversation, and the bottom line, from the Horse's Mouth, is:

1. DAN does not in any way recommend withholding O2 from anyone who believes they may need it. If you as a diver think you need it, you grab the bottle and use it. Period. This includes someone who blows a profile but is asymptomatic. They recognize that deciding to consume the O2 may in fact prevent a hit you would otherwise take, but that it also may not, and there is no way for you to know if it will or, if you don't get hit, if it did, or whether or not such a hit's severity would be changed.

2. DAN agrees with the point that ALL dives are decompression dives, and that your final decompression is in fact taking place on the surface.

Now, here's the important part....

3. DAN DOES believe that once you have taken the O2, that YOU (the diver) should, if you remain asymptomatic, not "assume all is well." That's prudent - it might not be! IOW, you SHOULD take it upon yourself to be evaluated. (They also recognize that you might not, but that this would be "against medical advice." Well, yeah, and this is news? :))

4. DAN FURTHER believes that if you believe you are at a significant risk of a hit that you should also seek that evaluation, regardless of whether or not you breathe the O2! In fact, Mr. Noord specifically cited the fact that some doctors, knowing that you had a missed deco obligation or other blown profile problem but were asymptomatic, might put you in the chamber anyway, and that this is, in fact, exactly what the Navy typically would do.

In other words, the O2 is not the triggering event for the need to be monitored and pay attention for DCS symptoms - the blown profile is.

IOW the only REAL difference is the level of paternalism (and perhaps standard of care if there is one in your particular circumstance.)

Bottom line, according to Mr. Noord - if, as a diver, you think you have a reason to grab the O2 bottle, do so.

That was (and still is) my position.
 
I think my conversation with them was much simpler and to the point. This is from memmory but very close to word for word.

I simply asked ...Is it recommended that a recreational diver on a planned no-stop dive who inadvertantly missed a stop required by their computer or was subjected to a rapid ascent or some other incedent and is asymptomatic breath O2?

The answer was... No, because symptoms might be masked resulting in a delay in complete treatment. She also went on to say that if O2 was used the diver should be evaluated by a phisician regardless of wether or not they were asymptomatic. And she specificly said that the administration (taking) of O2 constituts the beginning of treatment and the treatment should be continued by medical evaluatiuon.
I thanked her and that was the end of the conversation.

You see the point is that the arbitrary use of O2 can render the absence of symptoms over the short term an unreliable indicator.

And that is the only thing I coutioned against from the beginning.

Are you certain they didn't say any of this to you? They were very clear about it to me.
 
You talked to Celia.

So did I (she remembered you).

I was dissatisfied with her answer, and pointed out that the physics of the situation did not comport with a simple exhortation (don't breathe the O2 unless you have symptoms) and made no practical sense.

She then asked me if I wanted to talk with the person who actually WROTE the material, since I was not easily dismissed with what I perceived to be a "PR-style" response.

I said "yes".

She passed me over to Dan Noord, and the above conversation ensued.

Now you can either take the advice of a front-line person, or you can take the advice of the person who wrote the material in question and is an actual expert.

You talked to the first.

I talked to both.

They had very different interpretations of the same alleged material, and yet, the material was written by the second individual.

As such either there is a communication issue (either externally or internally within DAN) or the issue isn't REALLY amenable to a "simple exhortation", despite the desire of everyone today to distill things down to 15 seconds or less.

If the desire is to get a 15-second answer, where you are going to completely ignore your body (and act like nothing happened) then perhaps not breathing the O2 is a good idea, because you might need to be hit over the head with a 2x4 before you'll admit you might be bent and head to the chamber!

On the other hand, if you're a sentient individual, you know you blew your dive profile in some dramatic way and thus are at risk, and you have every intention of monitoring yourself (ideally having assistance in doing so) for DCS symptoms, then breathing the O2 isn't a bad idea at all. In fact, its a pretty good idea and it might even keep you from developing symptoms - and damage - in the first place. Just don't use it as a panacea and think that because you took the hits off the bottle that you no longer have a heightened risk - the causative event happened when you blew the profile - and until the period of danger - a day or two - has passed, you STILL have a heightened (although perhaps mitigated) risk.

Do what 'ya want - I'm satisfied that the man who wrote the material understands the issue and, within the difference of being a medical man and advising people to always seek medical advice when in doubt (which is what any medical person does for obvious reasons) there is no practical difference between how I see this and how DAN sees this as elucidated by the person who actually wrote DAN's documents.
 
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