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Old 23rd March 2007, 02:24   #49 (permalink)
cjgbur
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Re: DCI: What could have triggered it?

Interesting....

The risk of DCI is very low, a PFO will essentially double your risk, but again it is still very low. The best way to detect a PFO is with contrast echocardiography while the patient valsalva's. If I had a truly "undeserved" hit, I would get the echo to know my true risk.

Agree with everyone elses comments about the dive profile and that the tables are based on statistics and all decompression theory is based on tissue models.

I am sure that I have made those types of dives many times. There are several things that can change your risk, as I am sure you all know. The fever is interesting, febrile people are usually dehydrated, at least to some degree.

Put it all together you have a moderately aggressive series of dives, a couple beers the night before, possible illness (fever), and possible dehydration. And a 1 in 3 chance of a PFO which would double your risk. Also, what was the water temperature and what was the workload during the dive?

You are unlikely to really know why they took the hit with this information. But for the future, you need to do everything to decrease that risk. In my humble opinion, air is perferct at sea level, but in the water between 0 and 100' Nitrox and deeper Helium mixes. Stay hydrated, when you hit the water, the body releases BNP and that causes the diuresis which we all experiance once at depth. Hence a little dramatic, but "hydrate or die".

I am a beer drinker myself, 2 beers may worsen the dehydration, so I again stress the stay hydrated point (with water)

Realize this is late, but maybe someone will find it helpful... CJG
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Charles J Gbur Jr, MD, FACC, FSCAI, DMO
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