In Water Decompression?

[Sarah]

There seems to be a lot of controversy surrounding the efficacy of using in water recompression, with anecdotal evidence to suggest that many camps including DAN are opposed to it, yet in the field it seems that there are proponants who say their lives were saved or were spared serious injury.

Do you think DAN and other major agencies have it all wrong, or should there never be a circumstance where in water decompression isused?

[seasnake]

Distance from conventional medical treatment and severity of symptoms would have to be a factor to consider . . .

[SoCalDiveGirl]

http://www.cisatlantic.com/trimix/AQUAcorps/Bent/inwater/IWRcsrev.htm

Long read about in water REcompression, but really interesting.

[JS1scuba]

There seems to be a lot of controversy surrounding the efficacy of using in water decompression, with anecdotal evidence to suggest that many camps including DAN are opposed to it, yet in the field it seems that there are proponants who say their lives were saved or were spared serious injury.

Do you think DAN and other major agencies have it all wrong, or should there never be a circumstance where in water decompression isused?



First and foremost. Terminology.

In Water Decompression is where decompression is completed while in water. This is the standard mode of operation.

Sur-D = Surface Decompression this is where decompression on commercial and military dives are completed partially in-water and the rest in a "deck decompression chamber"

What you are looking to discuss here is: In-Water-Recompression (IWR)

This is where a diver did NOT complete decompression properly and requires "recompression therapy treatment." It is normally used in-place of hyperbaric chamber treatment when in remote locations or where the distance to a recompression chamber is so long that this "field treatment" would do more good than harm.

IWR is NOT an easy task. It requires an enourmous amount of support and should not be considered except in extreme emergencies.

More on it later.....

[Sarah]

Joel,

In water decompression upon ascent is sort of redundant now that I think about the common term.

I edited my post to in water recompression, thanks!

[seasnake]

I knew what you meant ... ;)

[Zero]

Id never count it out as long as the equipment was available. To put someone back in the water isnt just wack a reg in there mouth and send them down it takes gear and backup. Needs O2 for the patient and something better than air for the observer. FFM for the patient at least in case of convulsions. Shot lines and trapeze. A means of hydrating and staying warm for inexcess of 4 hours in the water you just got out of. Tropical water is cold when your hanging around doing nothing.
When your 6 to 36 hours away from a chamber id always be prepared for it. The risk to me is worth it. For under 6 hours id consider it on the day depending on the case.

Matt

[cowleyp]

Hi, exactly as you say. In water emergency recompression is fraught with difficulties and hazards associated with the environment and monitoring:
PO levels in a chamber can be higher than acceptable in water as a spasm in a chamber is not life threatening but can lead to drowning in water.
Assistants and monitoring staff must also be in water with patient putting them in harms way and making their job difficult; meds are extremely difficult to administer, hydration is difficult, body temp difficult to maintain especially if patient is unconsious.
Careful planning and use of correct equipment can help or minimise some of these issues but cannot make it anwhere near as safe or effective as chamber treatment.
If it's the only option you have it can and has worked but no professional organisation is going to stick its neck out and recommend it

[greenturtle]

Thanks for this thread! I was wondering about this as I read the book "The Last Dive" whether in water recompression (IWR) could be done to save the lives of both father and son. Shared with a couple of friends the incident in the book and the question about IWR came up.

Looks like there is more than just sending the divers back in water again, but it's something we can consider if there are lives at stake provided there are sufficient resource and monitoring. This is versus getting to a chamber that may be several hours away.

[lars2923]

There ya go... Pack that in your gear bag...

[BigBlueTech]

In water recompression is very easy but not always accurate. There are tables in commercial diving books like the dive medic manual that are comprehensive but they're not so great for repetative diving. Like the US Navy table has info to 90m but it's for single dives.

I would however strongly recommend a full face mask to prevent drowning from cns toxicity if using pure oxygen.

You need a good support team, a good buddy and proper gas to do it effectively.

but if you're offshore you don't have much choice.