Welcome to ScubaBoard, the world's largest scuba diving community. Registration is not required to read the forums, but we encourage you to join. Joining has its benefits and enables you to participate in the discussions.
Benefits of registering include
That never ever has to be a last resort option here in SoCal, the birthplace of recreational Scuba. . .There are quite a few divers who self treat due to lack of insurance and/or money.
Thanks! This is interesting (haven't read it fully yet), and I just want to be clear that I'm not saying that IWR should never be done. But it's also important not to read beyond the data in this or in any published article. Pyle (in this 1999 paper) cites the same caution. The two reports discussed are retrospective case series, and there is always going to be a selection bias if you collect data after the fact relying on individual reporting. As was alluded to upthread, do failed IWR efforts make it into the studies?
Certainly, people with real insight into this problem (e.g;. Doolette and Mitchell) have more recently said that IWR isn't a good first option in all cases of DCS, and despite this report raise the concern of the risks of IWR:
Does that mean that IWR never should be done? Of course not. But going back to the OP, a gross oversimplification of the problem and casting aspersions on experts in the field isn't the same thing as thoughtfully exploring where and when IWR is appropriate.
Missing a safety stop is rarely an issue--it is not a requirement to do it in the first place. That is why most agencies recommend against going back down in the event it is missed. On the other hand, missing a decompression stop is more serious, and every agency I know does recommend going down and doing it, with the exact procedure depending upon what was missed and how long it took to get back down.
doctormike:2) We know that safety stops reduce the risk of DCS considerably... Correct me if I'm wrong
You are wrong.
assuming you know how long it's safe to breathe this without getting O2 poisoning, and don't get anywhere near that limit?
...a safety stop is the exact same thing as a decompression stop
The problem is that you have no idea IF initially mild symptoms are going to progress to the point of life threatening or if they will spontaneously resolve. And except for Kevin and SoCal, your time to treatment is almost always measured in many many hours (sometimes days). You are unlikely to die by redoing a bunch of deco. So those of us who have been bent and at the scene of a mildly bent person often escort them back in the water. Prompt treatment now being more useful than a chamber ride 8+ hours from now.
Even if it doesnt completely fix them, between 30 and 60 mins of extra deco (thermal units being a big consideration) will almost assuredly attenuate their symptoms. Bringing an extra 40cf of O2 really isnt magic. Or going back in to the depth symptoms resolve on CCR. Happens ALOT more than you probably realize.
“I grabbed an open circuit steel 72 filled with 100% oxygen that had a green regulator on it. I put it under my arm while someone tossed the anchor…I do not recall clearing my ears, the journey downward or hitting the bottom. I became aware again when Jennifer grabbed my arm and pulled me from 40-45 feet up to hang on the anchor line at 30 fsw. Jennifer had little more than a back pack on and was known for being able to dress for diving very quickly. She undoubtedly saved my life.
In water recompression is not the only thing a diver needs to do if they have a DCS. In water recompression is by no means a medical treatment. It is merely a method of lessening the severity of issues that a diver will encounter because of DCS and affording immediacy of care.”
“These data and case series suggest that recompression treatment comprising pressures and durations similar to IWR protocols can be effective. The risk of IWR is not justified for treatment of mild symptoms likely to resolve spontaneously or for divers so functionally compromised that they would not be safe in the water. However, IWR conducted by properly trained and equipped divers may be justified for manifestations that are life or limb threatening where timely recompression is unavailable.”