How bad for in-water recompression?
Looking at the dearth of chambers, and considering remote locations, how bad does it have to be before you choose an in-water recompression vs a long ride to a chamber?
If someone is inclined enough to create a meaningful poll, that'd be great. I have a sick kid and am only on my cellphone, so...
The question to me is not the long chamber ride it is how fast can a chamber be found when you are dealing with an emergent situation. What has happened in quite a few cases is there is significant delay between onset of symptoms and getting recompressed, and this could be related to being triaged in the ER while looking for a facility that will take you, then transport there. That can be as much as 12 hours before treatment has begun. So you may encounter a long chamber ride,because at this point you are treating damaged tissue as result of latent treatment. My thoughts are to be a knowledgeable consumer and know in advance what chambers are online and will take divers,because you may have to guide the caregivers in what steps to take to get you treated. But,over the years I have seen the list of available chambers shrink that will treat dive injuries. The bottom line, it is not profitable to recompress one diver while paying staff OT, when they can treat a couple wound care patients at the same time. So I really think this problem will get worse, and I think knowing IWR for cases that aren't overly complicated,may be the solution.Originally Posted by Danseur
"Not all change is improvement...but all improvement is change" Donald Berwick
if treatment is more than 6 hours away and I have access to enough O2, in the water we go. I will almost always try for IWR first due to the location and hassle of chambers. If symptoms go away at half pressure, then we'll do as much deco as we can and then call it a day. This is for mild dcs, i.e. joint pain, tingling, etc. If you have some legit symptoms where getting in the water isn't safe, heigh-ho heigh-ho it's off to the chamber we go
How bad for in-water recompression?
What resources are available for those interested in learning the most effective procedures?
Zach
zklukkert.com
I was present for one serious situation involving dcs and my buddy collapsed why we were filling tanks. We had been diving Bozel and had gotten out of the water, changed out of our drysuits, rode back on a nice leisurely boat ride and driven back to the shop before he experienced any symptoms I was aware of. I am guessing we were up for about 1.5 hours. I got him laid down and grabbed his O2 bottle. When I handed him the reg he couldn't put it in his mouth. In this case in water recompression was out of the question because there was no water readily available and I don't think it would have been safe.
Now I was in Truk Lagoon about 4 or 5 years ago and we had been doing deco dives for 3 days or so. The wrecks there are mostly on the deeper side so we were doing 4 or 5 dives a day and I was doing about an hour or so of deco on most dives. This was on 28% with no O2. The water is 83 degrees and most of the wrecks have stuff to look at all the way up to 30 or 40 feet so deco isn't bad. We went and did the Oite Destroyer which is 210' ish and doesn't have a lot of relief. Rob McGann had taken a buddy and I there even though we were on the Odyssey. After the dive we got back to the Odyssey and I felt like I had been runover by a truck. Splitting headache and I couldn't hardly lift my arms as my sholders were hurting. The next dive was on a ship that was about 160' to the sand. I forved myself to go and once I got to about 60' I felt fine. I went all the way to the sand and through a torpedo hole at about 154' I really took my time working my way up the ship. There were king posts that came to within 30' or so of the surface. I slowly went up them looking at all the small critters. I finally got onto the hang bar on the back of the Odyssey and stayed there till I was almost empty in my 108's. I think my dive was over 3 hours and I had cleared deco well before getting on the hang bar. I finally got out of the water and I felt great. I really padded my deco on the rest of the dives for the remaining trip and didn't have any more issues.
I believe in water recompression works for minor problems but for someone who is really having issues I would be concerned. Now in a remote area where a chamber isn't an option I would recommend a full face mask if the diver is really having issues.
There is some info here: http://rubicon-foundation.org/in-water-recompression/
and they have posted some of their info on the wikepedia listing:https://en.wikipedia.org/wiki/In-water_recompression
I also seem to recall some articles and discussions (on cdf) on this topic several years ago. Bill
"With regard to cave diving, the great thing is to be carried where you could not have imagined you would ever be, and then to come back alive."
"Wilderness. The word itself is music." Abbey, Desert Solitaire
Oct 2014
Location
Trinity, FL
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I encourage everyone to read our research article on the topic. It can be downloaded at researchgate.
https://www.researchgate.net/publica..._recompression
Sorry, cut and paste didn't work... our IWR paper is at this address: https://www.researchgate.net/publica..._recompression
Kelly - are chambers turning away divers with severe neurological hits?
Barbara
Barbara/San Francisco
It depends what time of day. A lot of chambers are only open during daylight hours now. They might not turn someone away if they were open, but...
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