Taboo Decompression

[boulderjohn]

If people are serious about IWR, you must be setup for it. Realistically you need to go to 60 feet on 50% O2. And get on 100% as soon as possible, depending on the depth that symptoms subside.

There are several different protocols for IWR. This Wikipedia article summarizes 5 IWR systems. None of them describe going to 60 feet on 50%. The most common depth mentioned is 25 feet, and most prefer using 100% oxygen from the start.

 

[johndiver999]

A given volume of O2 is going to last 50% longer on the surface than at 20ft - which for a scant few minutes really isn't IWR its redoing deco. So less time on o2, a whole pile of extra risk, and when/if you surface you still have made zero progress towards getting to a higher level of care

If the re-descent is effective in ameliorating or eliminating all symptoms, then there is no longer a need to seek a higher level of care? I’ve seen and heard of so many instances when the pain is very quickly resolved on re-descent, that I no longer view it as necessarily dangerous

 

[Celt]

There are several different protocols for IWR. This Wikipedia article summarizes 5 IWR systems. None of them describe going to 60 feet on 50%. The most common depth mentioned is 25 feet, and most prefer using 100% oxygen from the start.

Symptoms might not subside at 25 feet and you might need to go deeper. We had to bring one diver deeper than 40 feet to reduce paralysis on his left side.

 

[jadairiii]

If the re-descent is effective in ameliorating or eliminating all symptoms, then there is no longer a need to seek a higher level of care?

The treating physician would be able to answer that question....................

 

[Superlyte27]

The treating physician would be able to answer that question....................

That’s not been my experience. ER Docs are morons when it comes to diving medicine. And I say this as a retired chamber operator who has administered more table 6’s than everyone here combined, both inside and outside the chamber.

 

[Nick_Radov]

Are you talking about the 2 instructors in the Webellinsee?

There was a long thread about the two instructors who died at Lake Werbellin in 2021. Recommend reading through that thread first before revisiting it in this thread. Based on dive computer profiles it seems that the dead divers might have attempted to conduct some sort of omitted decompression or IWR protocol after making a rapid ascent to the surface, but no one knows for certain exactly what they did or why.

Fatal dive accident - Lake Werbellin, Germany

Two dive instructors had a fatal accident last Sunday while diving in lake Werbellin. Both divers were found in 6 m depth and were brought to the surface. According to the dive computers they were at max. 38 m and spent approx. 20 minutes at 6 m depth, when they were found. Resuscitation was...

scubaboard.com

 

[boulderjohn]

There was a long thread about the two instructors who died at Lake Werbellin in 2021. Recommend reading through that thread first before revisiting it in this thread. Based on dive computer profiles it seems that the dead divers might have attempted to conduct some sort of omitted decompression or IWR protocol after making a rapid ascent to the surface, but no one knows for certain exactly what they did or why.

Fatal dive accident - Lake Werbellin, Germany

Two dive instructors had a fatal accident last Sunday while diving in lake Werbellin. Both divers were found in 6 m depth and were brought to the surface. According to the dive computers they were at max. 38 m and spent approx. 20 minutes at 6 m depth, when they were found. Resuscitation was...

scubaboard.com

Okay, I read through it all, but the only relevant information is in the last couple of posts. In it, we learn that the divers had an extremely rapid ascent to the surface from depth, then, after several minutes at the surface, descended and eventually died. A couple people concluded that it must have been an attempt at IWR, with no explanation as to why that would be true.

About a decade ago, a joint study by DAN and PADI concluded that the number one accident-related cause of scuba fatalities was a rapid rise to the surface causing an embolism. That would be my first thought.

 

[Nick_Radov]

Say I was making a 20 minute deco stop at 10 feet and a swell takes me to the surface , I will recompress by descending to a deeper depth and make a much longer decompression obligation .

I don't understand this comment. If you can't hold a stable deco stop with excellent buoyancy control then you shouldn't do those dives in the first place. For ocean diving we usually try to make it easy on ourselves by clearing the deco obligation at 20 ft / 6 m. But I've done offshore dives in fairly large swells and it was still possible to hold at 10 ft / 3 m, just required a bit more attention. Your position in the water column relative to the surface doesn't change much.

If you do screw up and lose buoyancy control and pop up to the surface for a few seconds then just go back down and finish your planned deco profile (assuming you don't have a serious equipment problem and didn't give yourself an embolism or something). There's nothing to gain by descending to a deeper depth or extending the stop.

 

[rjack321]

If the re-descent is effective in ameliorating or eliminating all symptoms, then there is no longer a need to seek a higher level of care? I’ve seen and heard of so many instances when the pain is very quickly resolved on re-descent, that I no longer view it as necessarily dangerous

So you conducted a neuro exam on yourself? How long you gonna stay under there solo on high ppO2s? You're assessing, deciding on a 'treatment plan' self treating, and self monitoring - all while injured AND on top of that you're alone in the ocean. Lay on the deck and get yourself on surface O2 after calling the coast guard to get you outa there to proper care.

 

[jadairiii]

That’s not been my experience. ER Docs are morons when it comes to diving medicine. And I say this as a retired chamber operator who has administered more table 6’s than everyone here combined, both inside and outside the chamber.

You missed my sarcasm. Reread the question and my answer. I was including someone like you in that definition of "treating physician.