Great point. That's why I asked...Originally Posted by Andreas
The whole point was to start a discussion of where you draw the line. "Niggles" are OK for IWR, "chokes" are not. What's in between?
"Those who make peaceful revolution impossible will make violent revolution inevitable." --JFK
Niggles??? What heck is that? Back when I was young and stupid I pushed things alot lucky to never get bent, My buddy on the other hand would get skin bent all the time. Would you consider this "Niggles" and jump back in? He just took Benadryl and moved on, always went away in a day or two.
niggles, in my experience, seem to be what people who get bent call their DCS when they don't go to the chamber. so anything short of an ambulance ride
as i have never been bent or had niggles (knock on wood) i will leave you gents to discuss the line between bent/niggle
I think we could equate "niggles" with skin bends. How many people get skin bends and blow it off as no big deal-breathe a little oxygen and one less beer. The truth is if you have skin bends, you are bent,and you have a type II DCS.
The truth is the state of chambers in the state of Florida is awful, and getting care for a diving related injury is not guaranteed. Friend had numbness around 3pm, and we figured out it was DCS that needed treatment shortly after that. A drive to Shands meant sitting in their ER until 1:00am before they decided to sent to Tally to start treatment, so over 12 hours elapsed. IWR may be a cave diver's best option in the future as we progress further in managed care.
"Not all change is improvement...but all improvement is change" Donald Berwick
+1
The "old" advice of "Don't IRW, get to a chamber" was based on the theory that A CHAMBER WAS AVAILABLE! And in the '60's and 70's they WERE! But we are now approaching a situation were there may be NO chambers available (in under 12 hrs). And D.C.S. is a TIME CRITICAL injury. Delayed treatment may be almost worthless. I.R.W. vs Chamber is going to end up being a judgement call based on delay getting to chamber vs patient condition (risk assessment).
At the very least, immediate 100% O2 should always be initiated.
Do not go gentle into that good night.
Old age should burn and rave at close of day;
Rage, rage against the dying of the light.
After having had the experience of needing a chamber and the extreme delay in getting to the chamber (caused by the ER), my personal rule is now that if I can walk and drive unaided I will choose IWR. If I can't walk and drive unaided I'm at the mercy of whomever is helping. The exception would be if I know that I am closer to an active and staffed chamber than I am to a body of water. Then the choice is obvious.
"Niggles" is a term used by the US Navy and refers to mild pain that normally goes away within half an hour after surfacing. Being "bent" is having the pain linger for more than half an hour. I guess some people choose to get back in the water immediately if feeling any bubbles, so semantically I guess it's then hard to draw the line between "niggles" and "bent".
My experience with the chokes was that surface O2 cleared it up within 30 minutes.
Ken Sallot
Me too,but the skin bend rash with swelling and pain didn't go away for a couple days. Recompression may have saved that,be it a fictional Florida chamber or IWR.
"Not all change is improvement...but all improvement is change" Donald Berwick
Um sure.
Blown deco stops and an aggressive profile...curious of your pedigree.
Bob
blown deco stops due to emergency situation, getting another diver on a boat, some catastrophic gear failure etc, physical issue, unexpected change of conditions in river caves etc. The two DCS incidents I have had were on light deco dives but involved blowing most of the O2 stop, and a long surface kick towing a semi-conscious diver back to the boat. Bubbles showed up in my knees, got the diver back on board, and performed IWR, symptoms went away once I hit 30'
I don't run aggressive deco profiles but know some that do, higher GF's, ratio deco etc. The cave incidents mentioned above aren't dive buddies of mine, merely people I know that have been bent or have been at the cave when someone has come out and started showing tier 2 *not Type II* dcs symptoms after they came out. I run 30/70 and usually give an extra 2-3 minutes on the last stop since my knees are prone to developing bubbles due to various injuries and surgeries I've had over the years. The point of my first post was that most of the dcs incidents that involve IWR aren't going to be massive Type II CNS hits, and the diver is likely going to know that they are going to get hit, or if they don't know, it's going to be relatively mild and they can jump back in the water, follow whichever IWR procedure they have chosen, and be perfectly successful. Even the USN's excessive IWR is only about 3 hours in the water, and while not quite as comfortable as a chamber, is certainly going to resolve symptoms long before you can get into any of the chambers in Florida, and that is important
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