Heart Attacks

ROB DAVIE · 7th April 2005, 06:47

Quote: (Originally Posted by dteubner)

The media (particularly) often translate cardiac arrest as heart attack and, of course, cardiac arrest just means dead from whatever cause - drowning especially in the diving context.

Whilst older divers will have a higher incidence of MI than younger divers the incidence in people aged 40-60 is really not that high at all and I would be surprised if there were many Rebreather deaths genuinely due to MI's

Dave T

Dave,

All extremely good points! This fits in directly with a discussion you and I were having, and I am still having on another Board with Doc Saturation. How the heck do we get a grip on accurate stats and reports when we are trying to assess what the accident/mortality rate is in the Rebreather community, so that we can express it in some meaningful way?

As for the drop in MI's you mention, what do you attribute this to? More awareness? Better medicine? Just curious.

Rob

dteubner · 8th April 2005, 01:37

Quote: (Originally Posted by ROB DAVIE)

Dave,

As for the drop in MI's you mention, what do you attribute this to? More awareness? Better medicine? Just curious.

Rob

Rob,

Dunno. I understand it's a thing that's being seen world wide. It is probably about people being seen/investigated/treated (more angioplasties, more cholesterol lowering etc) much earlier than was the case a decade ago.

Dave T

ROB DAVIE · 8th April 2005, 05:36

Doc T. et al,

It looks as if the ME got it right in the Dutch Springs incident. Despite the poor guy being more active than most of us, the report showed 80% blockage in one or more of the vessels supplying the heart muscle.

Overall, MI's may be going down as you note, but there are still those incidents like this one that are seemingly unexplainable. At least this one did not get laid on the "deadly re-breather diving equipment".

My sympathies to family and friends left behind. I gather he was well known and liked in the diving community

Rob

Robert Cook · 11th April 2005, 02:18

Medicals are another potential hot topic here. In Aus, we have a compulsory medical prior to the OW course, but there is no need to re-do them (unless one is working as a diver). IMO this is strange - all an old medical proves is that the diver was medically OK prior to his OW course. On top of this AFAIK no medical is required in most countries. The question here is whether the medical actually helps much.

As a side-note, I had one again in December (needed for a trip I was going on, probably more for their lawyers than anything else), and it turned out that I was fitter than the previous one about 7 years before.

Thanks,
Robert

Mark Chase · 11th April 2005, 08:01

Quote: (Originally Posted by ROB DAVIE)

Doc T. et al,

It looks as if the ME got it right in the Dutch Springs incident. Despite the poor guy being more active than most of us, the report showed 80% blockage in one or more of the vessels supplying the heart muscle.

Overall, MI's may be going down as you note, but there are still those incidents like this one that are seemingly unexplainable. At least this one did not get laid on the "deadly re-breather diving equipment".

My sympathies to family and friends left behind. I gather he was well known and liked in the diving community

Rob

Don’t you believe it M8.

Divers like De8us are out there sarcastically saying things like "no doubt this will again be attributed to hart attack" and suggesting a cover-up by the Rebreather manufacturers of their deadly equipment. Personally I think this is DIR diver bullshit as it’s quite hard to get the coroner to falsify his / her findings in the civilised world. However it has become a bit of a standing joke in the OC RB80 community.

ATB

Mark Chase

decoweenie · 11th April 2005, 08:32

Quote: (Originally Posted by Mark Chase)

However it has become a bit of a standing joke in the OC RB80 community.

And there are many standing jokes for the DIR/RB80 community as well as other communities, so don't get wind up by snide comments.

Mark Chase · 11th April 2005, 09:17

I don’t, but I have concern over the wider audience who don’t understand CCR but soak up like a sponge the death trap image put about even by OC instructors who should know better. This kind of bad press causes problems with boat skippers insurance companies and official bodies.

I was at the dive show last year when an underwater naturalist was explaining how they were banned from using CCR for an ice dive despite her trying to explain the systems inherent warmth and gas management options made it the safe choice.

Bear in mind that I was an OC diver for 15years before going CCR and only after extensive research on sites like Mad Mole did I begin to realise its not quite the killer its made out to be. Only now after 8 months of diving it am I starting to think it’s actually safer than OC for deep diving.

It’s a shame the details of these cases take so long to appear and are so lacking in information when they do.

ATB

Mark Chase

decoweenie · 11th April 2005, 09:32

Quote: (Originally Posted by Mark Chase)

It’s a shame the details of these cases take so long to appear and are so lacking in information when they do.

Fully in agreement there.

Unless we could learn more about the investigations, bad press will continue to exist from the competitive communities and too-old-to-learn crowd. And at the end, everyone lose out as CCR is here to stay and will only get more popular.

dteubner · 11th April 2005, 09:55

Quote: (Originally Posted by Robert Cook)

Medicals are another potential hot topic here. In Aus, we have a compulsory medical prior to the OW course, but there is no need to re-do them (unless one is working as a diver). IMO this is strange - all an old medical proves is that the diver was medically OK prior to his OW course. On top of this AFAIK no medical is required in most countries. The question here is whether the medical actually helps much.

As a side-note, I had one again in December (needed for a trip I was going on, probably more for their lawyers than anything else), and it turned out that I was fitter than the previous one about 7 years before.

Thanks,
Robert

The Coroner is South Australia has recommended that all divers have a medical at least every two years. My feelings about this are somewhat mixed.

If it were to be 'compulsory' which branch of the scuba police would enforce it, especially technical divers who fill their own tanks?

How many problems will a medical discover? It is very unlikely that an 80% coronary artery stenosis in someone with no symptoms would be picked up on a routine medical. An exercise test may have discovered it but it may not. Routine exercise testing in asymptomatic fit people will yield a lot of positive results which are not assosciated with disease. These results will then lead to more testing which has risks in and of itself.

If you have a medical and the doctor finds something that you didn't know about what do you then do with the information. Do you sit and have a chat about relative risks - given that for most conditions no-one has any idea what the numbers are? Are you "unfit to dive" and who enforces this.

Don't get me wrong, regular health checks for things like high blood pressure and diabetes etc are a good idea. It's just not clear to me how many diving deaths they prevent.

Dave T

***caveseeker7*** · 11th April 2005, 16:09

Quote: (Originally Posted by Mark Chase)

Divers like De8us are out there sarcastically saying things like "no doubt this will again be attributed to hart attack" and suggesting a cover-up by the Rebreather manufacturers of their deadly equipment.

Michael (db8us) is a pretty fair and level headed guy, and quite frankly, the same thought usually crosses my mind. I generally don't post it, but I've said so often enough in private conversations. Including e-mails to Michael.

The reason either of us make these sarcastic comments is not that we believe that there is a manufacturer based conspiracy to hide the truth, but a lack of investigative facts available after a fatality. When all you get is "appearant heart attack" or "drowning", that's not a helluva lot. The reason for it is usually missing. The question is, is it missing from the coroner's report or just the pulic announcement?

The heart attack at Dutch Springs was the first one that offered some detail (the 80% blockage) for credibility. Last year's on a liveaboard should be real as all guests aboard were medical personel, doctors, nurses etc. ... seems fair enough to believe they can diagnose it. Reason for it unknown afaik.

In any way, tracing any accident back to the unit is hard unless it is based on a problem that is permanent (physical damage, design problem etc). Probably the single most important clue, the gas in the loop, is frequently lost by people handling the unit after the accident. Not shutting off a KISS supply or DSV, pushing a valve button to see if it works and of course opening the loop all change the gas composition inside, or loose it entirely.

There is no guidlines or like available (yet) to first responders (and dive buddies for that matter) to aid in handling a rig involved in an accident. How often have we read accounts of dive buddies "checking the rig which worked properly"? How many rescue and law enforcement personel have knowledge about rebreathers, much less specific units? In one fatality here in the western parts of the US authorities contacted instructors and competing manufacturer (who turned down the request on that basis) to help analyze the unit involved ... .

Until we get more info then just 'heart attack' or 'drowning' rebreather's will be a cracking joke to some, cause a raised eyebrow with others and intimidate or scare away plenty of people. Since I'm not a medical pro I have no clue if there is anything within a correct or incorrect working or operated CCR that can lead to heart attacks. But the thought has occured, and I have asked the question a time or two ... without getting a certain answer.

7th April 2005, 06:47	#21 (permalink)
ROB DAVIE Administrator Current Rebreather/s: Inspiration Classic Other Rebreather/s: Join Date: Feb 2005 Location: HOUSTON, REPUBLIC OF TEJAS Posts: 1,120	Quote: (Originally Posted by dteubner) The media (particularly) often translate cardiac arrest as heart attack and, of course, cardiac arrest just means dead from whatever cause - drowning especially in the diving context. Whilst older divers will have a higher incidence of MI than younger divers the incidence in people aged 40-60 is really not that high at all and I would be surprised if there were many Rebreather deaths genuinely due to MI's Dave T Dave, All extremely good points! This fits in directly with a discussion you and I were having, and I am still having on another Board with Doc Saturation. How the heck do we get a grip on accurate stats and reports when we are trying to assess what the accident/mortality rate is in the Rebreather community, so that we can express it in some meaningful way? As for the drop in MI's you mention, what do you attribute this to? More awareness? Better medicine? Just curious. Rob __________________ [SIZE=2]"CC Rebreathers will become a viable part of tech diving [U]WHEN PIGS FLY[/U]!!"--GI3[/SIZE]
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8th April 2005, 01:37	#22 (permalink)
dteubner Pedant Current Rebreather/s: Sport Kiss Classic Kiss Other Rebreather/s: Join Date: Mar 2005 Location: Adelaide, Australia Posts: 216	Quote: (Originally Posted by ROB DAVIE) Dave, As for the drop in MI's you mention, what do you attribute this to? More awareness? Better medicine? Just curious. Rob Rob, Dunno. I understand it's a thing that's being seen world wide. It is probably about people being seen/investigated/treated (more angioplasties, more cholesterol lowering etc) much earlier than was the case a decade ago. Dave T
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8th April 2005, 05:36	#23 (permalink)
ROB DAVIE Administrator Current Rebreather/s: Inspiration Classic Other Rebreather/s: Join Date: Feb 2005 Location: HOUSTON, REPUBLIC OF TEJAS Posts: 1,120	MI's Doc T. et al, It looks as if the ME got it right in the Dutch Springs incident. Despite the poor guy being more active than most of us, the report showed 80% blockage in one or more of the vessels supplying the heart muscle. Overall, MI's may be going down as you note, but there are still those incidents like this one that are seemingly unexplainable. At least this one did not get laid on the "deadly re-breather diving equipment". My sympathies to family and friends left behind. I gather he was well known and liked in the diving community Rob
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11th April 2005, 02:18	#24 (permalink)
Robert Cook Custom Title Allowed! Current Rebreather/s: Megalodon Other Rebreather/s: Join Date: Apr 2005 Location: Edinburgh Posts: 107	Medicals are another potential hot topic here. In Aus, we have a compulsory medical prior to the OW course, but there is no need to re-do them (unless one is working as a diver). IMO this is strange - all an old medical proves is that the diver was medically OK prior to his OW course. On top of this AFAIK no medical is required in most countries. The question here is whether the medical actually helps much. As a side-note, I had one again in December (needed for a trip I was going on, probably more for their lawyers than anything else), and it turned out that I was fitter than the previous one about 7 years before. Thanks, Robert
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11th April 2005, 08:01	#25 (permalink)
Mark Chase I go down for ages Current Rebreather/s: Classic Kiss Other Rebreather/s: Inspiration Classic Join Date: Jan 2005 Location: Kent Posts: 2,539	Quote: (Originally Posted by ROB DAVIE) Doc T. et al, It looks as if the ME got it right in the Dutch Springs incident. Despite the poor guy being more active than most of us, the report showed 80% blockage in one or more of the vessels supplying the heart muscle. Overall, MI's may be going down as you note, but there are still those incidents like this one that are seemingly unexplainable. At least this one did not get laid on the "deadly re-breather diving equipment". My sympathies to family and friends left behind. I gather he was well known and liked in the diving community Rob Don’t you believe it M8. Divers like De8us are out there sarcastically saying things like "no doubt this will again be attributed to hart attack" and suggesting a cover-up by the Rebreather manufacturers of their deadly equipment. Personally I think this is DIR diver bullshit as it’s quite hard to get the coroner to falsify his / her findings in the civilised world. However it has become a bit of a standing joke in the OC RB80 community. ATB Mark Chase __________________ Is it supposed to make that noise ? I took my unit to the dive shop and demanded they bolt on every thing that would fit. Join my elite diving teem and get a Tshirt "Doing It Chasey"Hammerhead Eccr Advanced Diving System
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11th April 2005, 08:32	#26 (permalink)
decoweenie Crash Test Dummy Current Rebreather/s: Other CCR Other Rebreather/s: Other CCR Join Date: Feb 2005 Location: Cairo Posts: 5,510	Quote: (Originally Posted by Mark Chase) However it has become a bit of a standing joke in the OC RB80 community. And there are many standing jokes for the DIR/RB80 community as well as other communities, so don't get wind up by snide comments.
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11th April 2005, 09:17	#27 (permalink)
Mark Chase I go down for ages Current Rebreather/s: Classic Kiss Other Rebreather/s: Inspiration Classic Join Date: Jan 2005 Location: Kent Posts: 2,539	I don’t, but I have concern over the wider audience who don’t understand CCR but soak up like a sponge the death trap image put about even by OC instructors who should know better. This kind of bad press causes problems with boat skippers insurance companies and official bodies. I was at the dive show last year when an underwater naturalist was explaining how they were banned from using CCR for an ice dive despite her trying to explain the systems inherent warmth and gas management options made it the safe choice. Bear in mind that I was an OC diver for 15years before going CCR and only after extensive research on sites like Mad Mole did I begin to realise its not quite the killer its made out to be. Only now after 8 months of diving it am I starting to think it’s actually safer than OC for deep diving. It’s a shame the details of these cases take so long to appear and are so lacking in information when they do. ATB Mark Chase __________________ Is it supposed to make that noise ? I took my unit to the dive shop and demanded they bolt on every thing that would fit. Join my elite diving teem and get a Tshirt "Doing It Chasey"Hammerhead Eccr Advanced Diving System
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11th April 2005, 09:32	#28 (permalink)
decoweenie Crash Test Dummy Current Rebreather/s: Other CCR Other Rebreather/s: Other CCR Join Date: Feb 2005 Location: Cairo Posts: 5,510	Quote: (Originally Posted by Mark Chase) It’s a shame the details of these cases take so long to appear and are so lacking in information when they do. Fully in agreement there. Unless we could learn more about the investigations, bad press will continue to exist from the competitive communities and too-old-to-learn crowd. And at the end, everyone lose out as CCR is here to stay and will only get more popular.
(Offline)

11th April 2005, 09:55	#29 (permalink)
dteubner Pedant Current Rebreather/s: Sport Kiss Classic Kiss Other Rebreather/s: Join Date: Mar 2005 Location: Adelaide, Australia Posts: 216	Quote: (Originally Posted by Robert Cook) Medicals are another potential hot topic here. In Aus, we have a compulsory medical prior to the OW course, but there is no need to re-do them (unless one is working as a diver). IMO this is strange - all an old medical proves is that the diver was medically OK prior to his OW course. On top of this AFAIK no medical is required in most countries. The question here is whether the medical actually helps much. As a side-note, I had one again in December (needed for a trip I was going on, probably more for their lawyers than anything else), and it turned out that I was fitter than the previous one about 7 years before. Thanks, Robert The Coroner is South Australia has recommended that all divers have a medical at least every two years. My feelings about this are somewhat mixed. If it were to be 'compulsory' which branch of the scuba police would enforce it, especially technical divers who fill their own tanks? How many problems will a medical discover? It is very unlikely that an 80% coronary artery stenosis in someone with no symptoms would be picked up on a routine medical. An exercise test may have discovered it but it may not. Routine exercise testing in asymptomatic fit people will yield a lot of positive results which are not assosciated with disease. These results will then lead to more testing which has risks in and of itself. If you have a medical and the doctor finds something that you didn't know about what do you then do with the information. Do you sit and have a chat about relative risks - given that for most conditions no-one has any idea what the numbers are? Are you "unfit to dive" and who enforces this. Don't get me wrong, regular health checks for things like high blood pressure and diabetes etc are a good idea. It's just not clear to me how many diving deaths they prevent. Dave T
(Offline)

11th April 2005, 16:09	#30 (permalink)
*caveseeker7* Who loves ya, baby Current Rebreather/s: Sport Kiss Other Rebreather/s: Prism Topaz Join Date: Jan 2005 Location: Too far from Neverland Posts: 5,416	Quote: (Originally Posted by Mark Chase) Divers like De8us are out there sarcastically saying things like "no doubt this will again be attributed to hart attack" and suggesting a cover-up by the Rebreather manufacturers of their deadly equipment. Michael (db8us) is a pretty fair and level headed guy, and quite frankly, the same thought usually crosses my mind. I generally don't post it, but I've said so often enough in private conversations. Including e-mails to Michael. The reason either of us make these sarcastic comments is not that we believe that there is a manufacturer based conspiracy to hide the truth, but a lack of investigative facts available after a fatality. When all you get is "appearant heart attack" or "drowning", that's not a helluva lot. The reason for it is usually missing. The question is, is it missing from the coroner's report or just the pulic announcement? The heart attack at Dutch Springs was the first one that offered some detail (the 80% blockage) for credibility. Last year's on a liveaboard should be real as all guests aboard were medical personel, doctors, nurses etc. ... seems fair enough to believe they can diagnose it. Reason for it unknown afaik. In any way, tracing any accident back to the unit is hard unless it is based on a problem that is permanent (physical damage, design problem etc). Probably the single most important clue, the gas in the loop, is frequently lost by people handling the unit after the accident. Not shutting off a KISS supply or DSV, pushing a valve button to see if it works and of course opening the loop all change the gas composition inside, or loose it entirely. There is no guidlines or like available (yet) to first responders (and dive buddies for that matter) to aid in handling a rig involved in an accident. How often have we read accounts of dive buddies "checking the rig which worked properly"? How many rescue and law enforcement personel have knowledge about rebreathers, much less specific units? In one fatality here in the western parts of the US authorities contacted instructors and competing manufacturer (who turned down the request on that basis) to help analyze the unit involved ... . Until we get more info then just 'heart attack' or 'drowning' rebreather's will be a cracking joke to some, cause a raised eyebrow with others and intimidate or scare away plenty of people. Since I'm not a medical pro I have no clue if there is anything within a correct or incorrect working or operated CCR that can lead to heart attacks. But the thought has occured, and I have asked the question a time or two ... without getting a certain answer. __________________ Cheers Stefan "Political Correctness is a doctrine, fostered by a delusional, illogical minority, and rabidly promoted by an unscrupulous mainstream media, which holds forth the proposition that it is entirely possible to pick up a turd by the clean end.'!"
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