4,000 mile rescue - Chuuk Atoll

[dadediver]

Interesting. DAN often pays for this evac, since the Chuuk chamber has been down for a while. I wonder if the victim didn't have DAN insurance (the expense to send a CG helo to Dry Tortugas cost the taxpayer over $80k, I can't imagine what it costs for this one), or DAN didn't want to fly a plane, or the rest of the back story. Whatever it was, the taxpayers sure took it in the shorts for this one, with no chance of recompense.

When the call comes in from sector for help, the USCG goes. They dont debate cost. I am proud to have sons in the USCG and proud of what they do.

 

[Strongdiver]

The patients' prognosis is "not good."
Cavediver.ron; I thank you for this!! I love facts, not speculation, idle gossip, etc., all of which I have been accused of elsewhere on the net. Can I meet you in July?

 

[Akimbo]

The patients' prognosis is "not good."…

Sorry to hear it, but not surprising given the long delay in treatment. What was the time between the diagnosis of symptoms and 60' in the chamber?

Is this more than a DCS problem?

 

[Scared Silly]

Doesn't someone make a portable +1 atm one man chamber? Basically it's a big fiber reinforced bag with pressure control fittings. Is my memory playing tricks on me or has anyone else heard of such a thing?

You are thinking of the Gamow Bag which was designed for athletes but used more for high altitude AMS (HAPE/HACE).

Gamow Bag Hyperbaric Chamber, Civilian Model | www.chinookmed.com


I going to pick nits here people keep referring to DAN insurance. DAN insurance is for paying for the chamber ride - not for the ride to the chamber. The ride to the chamber is done through TravelGuard and administer as DAN TravelAssist. TravelGuard/Assist one gets with basic membership to DAN at least in the USA.

 

[scuba5150]

Just another reason the United States is the greatest country in the world. What other country would have done this for one of it's citizens, which ones wouldn't have? I'd much rather see tax payer money being spent on this than the IRS or another government institution sending 200 of their workers to Vegas for a tax payer paid retreat with tax payers paying for suites at the Bellagio, caviar and Dom, and flying in Britney Spears for a tax payer paid concert for them.

Ditto and Kudos to the USCG. While the cost commitment is one thing, the risk to the personnel involved in the rescue operation is significant, also. It's amazing that the USCG and our military branches can pull off operations like this and make it look routine. This takes great dedication and training. Bravo Zulu.

 

[fozzy]

For simple type I DCS, pain only in one limb or joint-space, IWR works.

A very interesting discussion. Given i am not a medic: Shouldn't it be considered that recompressing poses the risk of moving the bubbles blocked in the lungs to the artherial flow and thus risking an added type II DCS if the recompression is too short?

Thanks.

 

[Kevrumbo]

A very interesting discussion. Given i am not a medic: Shouldn't it be considered that recompressing poses the risk of moving the bubbles blocked in the lungs to the artherial flow and thus risking an added type II DCS if the recompression is too short?

Thanks.

Yes . . .if the recompression happens to be an ill-advised repetitive, no surface interval, short "bounce" deep dive versus a proper therapeutic standard Table 6 Hyperbaric Chamber Oxygen Therapy Treatment, or even an impromptu IWR session --both therapies roughly two orders of magnitude longer in minutes of time compared to a typical bounce dive. Pathological inert gas bubbles can simply overwhelm the capacity of the pulmonary capillary bed to filter them; they can arterialize through intrapulmonary arteriovenous shunts; and/or they can pass through a patent foramen ovale (PFO) (particularly during a Valsalva maneuver or any other that raises right-sided pressures). In this instance the "recompression" is too short and there is an increased risk of then developing type II neurological DCS/AGE.

 

[Akimbo]

Just to expand on Kevrumbo’s discussion a little, anything you can do to remove diluent gas from tissues and blood stream faster is helpful in a DCS treatment. Breathing pure O2 on deck is the simplest and least risky, regardless of symptom severity. Unfortunately, it isn’t all that much better than nothing.

Going beyond that requires increasing the ambient pressure to increase the PPO2… pretty simple really. The added pressure not only increases the partial pressure but compresses any gas bubbles that may be compromising blood flow or even physically damaging tissue. The complicated part is managing the potential risks associated with doing that.

A chamber allows you to take this concept to extremes in a much more manageable form… like 60' on pure O2 to compress the bubbles about a third and a PPO2 of 2.8. This link explains it. Take a close look at the chart of treatment table 5.

Oxygen Toxicity Limits & Symptoms