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Thread: In water re-compression

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    bubbles... what bubbles ngamokai is an unknown quantity at this point ngamokai's Avatar
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    In water re-compression

    HI all :) I am interested in the concept of in water re compression and your thoughts on the matter....
    I am about to have a chat with Simon Mitchell on this subject and feel it is a valid and in some cases, may be the only option, it could be a few hours to get a chopper to a bent diver on any live aboard or remote dive location and in extreme cases with the right training and support crew i believe it is a viable option. your thoughts?

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    Re: In water re-compression

    Recent discussion about this on TDS including some comments by Duke Diving Medicine.
    The Deco Stop
    I hope you will share Simon Mitchell's thoughts after you speak with him.
    Ken

    Quote Originally Posted by Dsix36  View Original Post
    Just remember that listening to an idiot such as myself may very well get your arse dead.

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    Fake Diver Jeff Pack will become famous soon enough Jeff Pack will become famous soon enough Jeff Pack will become famous soon enough Jeff Pack will become famous soon enough Jeff Pack's Avatar
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    Re: In water re-compression

    When I was operational long ago, we often had times when we had to dive deep, surface quickly, deploy, and descend again. we had no decomp chambers even remotely nearby.

    We were using in water recompression way back then, and it kept us from getting bent. I'm a firm believer in it.

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    Re: In water re-compression

    As my grandfather said : When you have nothing, everything is better
    In other words, when in a remote area and when the shit hits the fan, it may be good to know a possible way out.
    In practice, and for what I understand about IWR you have to plan for extensive amount of O2 for your expedition. The "usual" amount will not cut it, in other words it is NOT bailout situation, it is a medical treatment, it takes quite serious logistics which cant be improvised.
    Just my two cents...

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    Re: In water re-compression

    we had a general rule we used, correct or not, I dunno, buts its what we used.

    4x Deco, and like you said, lots of O2.

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    Re: In water re-compression

    Quote Originally Posted by Jeff Pack  View Original Post
    we had a general rule we used, correct or not, I dunno, buts its what we used.

    4x Deco, and like you said, lots of O2.
    Hello Jeff,
    I hope I did not offend. You are probably a bigger expert than I am. Did you use the so-called Hawai, australian or US navy procedure?
    The purpose of my reply was not to criticize anybody but to explain that IWR is a very very serious thing to plan and not a "Damned! I am in deeeep shit in the middle of nowhere, lets try IWR". This kind of attitude would not cut it I think.
    Needless to say you have to be preferably in dry suit and have ways to hydrate+ a way to maintain precise depth + friends to care for the poor bastard...
    For O2 a rule of thumb could be a B50 for IWR/diver with long hose 12m.

    What do you think?. Take care guyes

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    RBW Member floridakid is an unknown quantity at this point floridakid's Avatar
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    Re: In water re-compression

    Where I currently do most of my diving is only an hour from a fairly reliable chamber, but if I was any further than that from a chamber I would think long and hard about doing it. I have just heard way too many horror stories about EDs and EMS agencies being absolutely ignorant to dive related emergencies even to the point to where they are unwilling or apprehensive to call DAN.

    Scary stuff

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    So many CCR So little etc Mark Chase has a reputation beyond repute Mark Chase has a reputation beyond repute Mark Chase has a reputation beyond repute Mark Chase has a reputation beyond repute Mark Chase has a reputation beyond repute Mark Chase has a reputation beyond repute Mark Chase has a reputation beyond repute Mark Chase has a reputation beyond repute Mark Chase has a reputation beyond repute Mark Chase has a reputation beyond repute Mark Chase has a reputation beyond repute Mark Chase's Avatar
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    Re: In water re-compression

    Quote Originally Posted by ngamokai  View Original Post
    HI all :) I am interested in the concept of in water re compression and your thoughts on the matter....
    I am about to have a chat with Simon Mitchell on this subject and feel it is a valid and in some cases, may be the only option, it could be a few hours to get a chopper to a bent diver on any live aboard or remote dive location and in extreme cases with the right training and support crew i believe it is a viable option. your thoughts?
    This is not a black and white question.

    • If the diver is half paralised do you put him back in the water?
    • If therie CNS is high and you planning on sending it into the 1000s can you cope with an 02 tox?

    • WHats the sea conditions?
    • Is there enough gas?
    • Do you have willing support divers skilled enough to take on the problems
    • Whats the water temperatue



    Thers a massive difference between missed deco recompression which is being refered to in the various "missed deco" scheduals

    I beleive all of the start with the cavieat "If free of signs of DCI"


    IWR is not Missed deco


    If I missed a deco stop id defo go back down and re do deco. Infact i have done exactly that folowing a rapid ascent incident.


    If i were bent on the boat? that would take some thinking about.

    I'd want minimum two compitent divers in the water with me and a gag strap for my CCR loop or preferably a full face mask. I'd want a tether to the boat and id want to be warm and comfortable.

    But if i am not that seriously bent (IE pain only) and thers no chance of help comming? all bets are off and id have a crack at it.


    ATB

    Mark

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    Re: In water re-compression

    Here are the three most commonly used methods of IWR. As already stated, if there's no other viable option close by, you use what's available.
    Pressure is pressure, whether in a dry recompression chamber or water pressure. If you were to follow the US Navy table 6 in the water, with a "tender" for saftey, the results would in-factbe the same had you taken a chamber ride. Obviously there are environmental and hydration issues that one could argue could change the outcome, however the treatments are basically the same.

    The three most common IWR shown below are much shorter recompressions and take into account the limited supply of Nitrox, oxygen and the potential environment issues for the diver undergoing treatment and the tenders.

    Given a chioce of long delay's for starting treatment, or IWR, I'm a believer in the latter. On off shore trips, having a full face mask available for the DCS diver is a cheap insurance plan.

    Don
    Australian Method

    The diver descend to 30 feet breathing 100% oxygen for between 30 and 90 minutes,
    depending on the severity of the symptoms, gas supply, condition of the diver and so
    the symptoms disappear or in some cases, emergency transportation arrives. The
    ascent rate of 1 foot every four minutes until reaching the surface should be
    maintained. Once the diver is on the surface, 100% Oxygen should continue until the
    supply is depleted.

    Hawaiian Method

    The diver descend on Air to 30 feet deeper than the depth where the DCS symptoms
    disappear, not to exceed 160 feet for a maximum of 10 minutes including the descent
    time. Following this short “air bounce dive”, the diver ascend at a decreasing slow
    rate to 30 feet where 100% O2 is breathed for no less than 60 minutes or until the
    symptoms disappear and/or depending on the gas supply, condition of the diver and
    in some cases, emergency transportation arrives.
    Once the diver is on the surface, 100% Oxygen should continue until the supply is
    depleted.


    US Navy

    Descend to 30 feet on 100% O2 with a standby diver and remain at 30 feet for 60
    minutes for Type I and 90 minutes for Type II symptoms. Ascend to 20 feet even if
    symptoms are still present. Decompress to the surface by taking 60-minute stops at
    20 feet and 10 feet. After surfacing, continue breathing 100% O2 for 3 hours. If
    symptoms persist or recur on the surface, arrange for transport to a recompression
    facility regardless of the delay.

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    RBW Member LeCrabe is an unknown quantity at this point LeCrabe's Avatar
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    Re: In water re-compression

    Quote Originally Posted by donlabbruzzo  View Original Post
    Here are the three most commonly used methods of IWR. As already stated, if there's no other viable option close by, you use what's available.
    Pressure is pressure, whether in a dry recompression chamber or water pressure. If you were to follow the US Navy table 6 in the water, with a "tender" for saftey, the results would in-factbe the same had you taken a chamber ride. Obviously there are environmental and hydration issues that one could argue could change the outcome, however the treatments are basically the same.

    The three most common IWR shown below are much shorter recompressions and take into account the limited supply of Nitrox, oxygen and the potential environment issues for the diver undergoing treatment and the tenders.

    Given a chioce of long delay's for starting treatment, or IWR, I'm a believer in the latter. On off shore trips, having a full face mask available for the DCS diver is a cheap insurance plan.

    Don
    Australian Method

    The diver descend to 30 feet breathing 100% oxygen for between 30 and 90 minutes,
    depending on the severity of the symptoms, gas supply, condition of the diver and so
    the symptoms disappear or in some cases, emergency transportation arrives. The
    ascent rate of 1 foot every four minutes until reaching the surface should be
    maintained. Once the diver is on the surface, 100% Oxygen should continue until the
    supply is depleted.

    Hawaiian Method

    The diver descend on Air to 30 feet deeper than the depth where the DCS symptoms
    disappear, not to exceed 160 feet for a maximum of 10 minutes including the descent
    time. Following this short “air bounce dive”, the diver ascend at a decreasing slow
    rate to 30 feet where 100% O2 is breathed for no less than 60 minutes or until the
    symptoms disappear and/or depending on the gas supply, condition of the diver and
    in some cases, emergency transportation arrives.
    Once the diver is on the surface, 100% Oxygen should continue until the supply is
    depleted.


    US Navy

    Descend to 30 feet on 100% O2 with a standby diver and remain at 30 feet for 60
    minutes for Type I and 90 minutes for Type II symptoms. Ascend to 20 feet even if
    symptoms are still present. Decompress to the surface by taking 60-minute stops at
    20 feet and 10 feet. After surfacing, continue breathing 100% O2 for 3 hours. If
    symptoms persist or recur on the surface, arrange for transport to a recompression
    facility regardless of the delay.
    +1

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