Accident analysis and feedback

Simon Mitchell

Hello,

With respect to rebreather accidents, there has been much recent commentary about the lack of high quality analysis and feedback of potentially life-saving lessons to the diving community. This stems directly from the frequent lack of reliable and accurate information that would allow reasonably firm conclusions to be drawn. There was one recent and conspicuous exception to this usual scenario in which the diver filmed the events, and he and his equipment were recovered. Many will know that I was a member of a group that conducted a very careful analysis of the information. Some of the findings have been presented at various meetings and discussed on boards such as Rebreather World. However, I have been approached many times by divers concerned that the key findings of the analysis had never been formally reported and that, as with other accidents, the lessons might be lost.

I can now tell you that our analysis of this accident will soon be published in the medical journal "Aviation Space and Environmental Medicine"; hopefully in the February edition. As is customary with medical papers, the subject is not named and I have "anonymized" this post in keeping with that custom, though I have little doubt that since the accident was so unique and widely reported that everyone interested in the field will immediately know which accident is being described. Once the diving community has demonstrated this I will be happy to participate in the discussions that will inevitably take place after the paper is published and read. Although the diver paid a terrible price, the lessons learned are so important that being the type of guy he was he would have wanted his fellow divers to be appraised of the potential pitfalls he encountered.

The reference:

Mitchell SJ, Cronje FJ, Meintjes WAJ, Britz HC. Fatal respiratory failure during a "technical" rebreather dive at extreme pressure. Aviation Space and Environmental Medicine 2007: In press.

Keep an eye on Medline around February.

Simon M

Steve

Thanks for the heads up, your work on this matter and participating on this list. I for one truly apreciate it.

I hope you are crossing the ditch in March for Oztek. It is always good to catch up for a beer.

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schford

Thanks Simon - much appreciated heads up.

Will there be an online source that we can access / pay to read?

Stuart

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Simon Mitchell

Hi Stuart,

I can access ASEM on line through University of Auckland as a member of faculty. There are many Rebreather World members who probably have similar access. Also, there is probably a website where anyone in the general public can pay for access to download the paper (the fees are typically $USD 5 - 10). In the old days, people requested reprints through the corresponding author (which is me) and I guess there is no reason why we still can't do that!

Gidday Steve,

I am speaking at Oztek so will see you there.

Warm regards

Simon M

Gene_Hobbs

Thanks Simon,

The ASEM Journals are online at: IngentaConnect Publication: Aviation, Space, and Environmental Medicine

Most of their articles are $USD 15.00 to download from the above site. UHMS Members can make a request to the Duke University Library and receive a copy at no cost (Instructions are available online in the "Members" section of the web site). UHMS Membership is only $USD 40.00 a year for Associates and $USD 30.00 a year for students.

It may be worth sending an email to Sally. Ingenta can set "Free Trial Content" on select articles. I am not sure how this is negotiated but I would start with Sally or Jim Webb. Let me know if you want me to contact her. There may be a few more options if Ingenta does not have a system in place. Just let me know and I'll work on those.

Thanks!

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Gene_Hobbs

Simon's paper "Fatal Respiratory Failure During a “Technical” Rebreather Dive at Extreme Pressure" is available online at IngentaConnect. The price is $US 15.00.

Nice work Simon! Thank you!

Also worth a read this month from ASEM:-Stress Biomarkers in a Rat Model of Decompression Sickness.-Validation of Decompression Procedures Based on Detection of Venous Gas Bubbles: A Bayesian Approach.
-Prevalence of Right-to-Left Shunts in Active Fighter Pilots

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caveseeker7

Thanks Simon, on all points that Steve mentioned, and congrats on the publication.

One positive difference in the analysis of the accident in question with several others that occured may be underappreciated, your expertise in rebreathers and the equipment used in particular. Am looking forward to read the analysis, you've done an excellent job in the aftermath of the accident shedding some light into it.

Gene, thanks for the additional info and links, much appreciated.

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Stefan



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