After dive oxygen: shouldn’t the diver decide?

[The Chairman]

That I don't agree with. If the crew suspects DCS, over expansion injuries etc, they have s duty to highly suggest to a conscious person to get on O2....that is being part of the decision.

If said person becomes unconscious, the crew has a DUTY to follow thier training which unless I'm way off base here...means going on O2.


If a diver thinks he has the niggles and wants O2..put him/her on O2 obviously, but that in my mind automatically get a call to USCG and has EMS waiting at the dock at a very minimum.

We agree more than you let on. My biggest beef isn't with a boat recommending O2, but with denying it. Charge the client if you must recoup the cost, but when they make the decision that O2 is for them, you should provide it pronto.

 

[Kmart4321]

Quick question? What is the setup of most oxygen systems in your experience? Tank, regulator and mask with tubing? What style of mask? Is it a demand system? Is it a power ventilator?
Stating categorically that "i had a couple hits of oxygen following a dive and it made me feel better" does not convince me of its necessity. That is anecdotal at best. I could give you "a gas " that I call oxygen and prob get same result from you.
Without a blind study to point to I have a hard being convinced.

That being said..... I will not and do not advocate withholding oxygen from someone that appears to require it.
Some signs are accesory muscle use in neck and abdomen, indrawing of the intercostal spaces, tachypnea, tachycardia, skin colour changes and changes in speech patterns. A trick I like to use is try to get patient to count out loud starting at one. I just have to wait till they take a breath. 2-3 word dyspnea is worse than 7-8 word dyspnea and requires more aggressive treatment.
If someone "really" needs oxygen, that boat better be headed for shore.

 

[Akimbo]

We agree more than you let on. My biggest beef isn't with a boat recommending O2, but with denying it. Charge the client if you must recoup the cost, but when they make the decision that O2 is for them, you should provide it pronto.

Maybe, but that would deplete the supply on most boats, leaving none for passengers who might develop symptoms later. I’m all for boats carrying lots of Oxygen but that isn’t the case now.

 

[tomfcrist]

We agree more than you let on. My biggest beef isn't with a boat recommending O2, but with denying it. Charge the client if you must recoup the cost, but when they make the decision that O2 is for them, you should provide it pronto.

Correct, but the caveat is that the client is also going to be forcefully referred to medical professionals..like it or not.

I can just see now the goober that insists on sucking down O2 but doesn't want to go to the hospital for evaluation... There is no room for that in my personal paradigm.

 

[Subcooled]

Oxygen is commonly used as (not a decompression gas but as an) offgassing-of-nitrogen gas. As far as I understand the models, it is beneficial in this respect and it can reduce the amount of nitrogen bubbles in blood (oxygen bubbles are much more convenient).

Many people falsely believe that offgassing stops once the computer clears. This is obviously not the case. Breathing oxygen on the surface can actuallly be beneficial. It can also be harmfull (see the posts above). The BIG problem here however is the STIGMA: "Unskilled loosers breathe oxygen".

Well, when I did my modest 150 feet air dives, and felt a bit tired afterwards, I did breathe surface oxygen. I did not have any clinical DCS symptoms, but I took O2 as a precaution. And WILL do that in future. There MUST NOT be a stigma associated with oxygen. Therefore, sometimes I take oxygen just for fun. The amounts are small but the act itself is important.

Oxygen is a very reactive gas and it really affects ones body chemically but it has both benefits and drawbacks. How much is too much is a really difficult question. I would guess that if one feels tired after a dive then the benefits of O2 would be higher than the drawbacs.

Maybe some people falsely believe that oxygen is a "first aid gas" and that delivering oxygen means you plead guilty? I must disagree.

 

[The Chairman]

Stating categorically that "i had a couple hits of oxygen following a dive and it made me feel better" does not convince me of its necessity. That is anecdotal at best. I could give you "a gas " that I call oxygen and prob get same result from you.
Without a blind study to point to I have a hard being convinced.

Anecdotal evidence is hard to deny, especially when it's your own. I remember a longish albeit shallow dive in an alpine lake up in Idaho at a Boy Scout camp. My PDC wasn't wigged out, but I sure was. After the sixth person commented that I looked like crap, I put myself on O2. It was a standard medical DD cylinder with a standard medical demand valve. I stayed on the O2 until I felt lucid and then added another half hour. I think I've gone on oxygen after a dive four times that I can remember. Three were on my deco bottle with the one time on the med O2 kit. One was on the drive back to Orlando from West Palm and my shoulder hurt badly. I thought it might be DCS so I put myself on O2. It wasn't DCS as my subsequent ride in the chamber ascertained, but the O2 didn't seem to otherwise affect me. The other two times I just had a hard time staying awake. Was it sub-clinical DCS? Both times, after just a few minutes, I did not feel the need to curl up into a little ball and sleep. I haven't had that problem though since I started doing deep stops and lengthened my safety stop to at least five minutes. So, in thousands of dives, I have used it only four times. Only once did it appear to be superfluous but I would do the very same today given the same circumstances. I think that's utterly reasonable even for being anecdotal.

 

[Akimbo]

… I can just see now the goober that insists on sucking down O2 but doesn't want to go to the hospital for evaluation... There is no room for that in my personal paradigm.

That is a huge incentive for a boat operator not to give O2 because it would require “the” radio call and heading to shore with a boat load of PO’d divers who didn’t get their second tank in on that charter.

What about wanting to use O2 for prophylactic reasons? I do it all the time but usually at 10-20' and plan for it in advance. Granted, most hyperbaric docs see the efficacy of that on deck for DCS as pretty limited.

That brings up the question: Would the boat operator be obligated to prevent reped dives after administering O2? It all sounds like more than an operator would want to deal with.

 

[Yoyodyne-88]

Interesting debate, and I'm not taking a side.

But speaking as a one-time EMT, another contra-indication for O2 is hyperventilation, for instance in a anxiety attack.

This IS something you may find in a diving scenario - in one memorable case I had to rescue my assigned Divemaster, who was panicking at the surface.

 

[The Chairman]

That brings up the question: Would the boat operator be obligated to prevent reped dives after administering O2? It all sounds like more than an operator would want to deal with.

That would have to include the guys using it for deco at depth then, wouldn't it? As it was pointed out, the surface is your last deco stop.

 

[The Chairman]

I can just see now the goober that insists on sucking down O2 but doesn't want to go to the hospital for evaluation... There is no room for that in my personal paradigm.

So how did you arrive at your personal paradigm? In most of the first aid for divers, including a missed deco stop, it tells us to administer O2 and check for symptoms. Why would breathing O2 by itself require a visit to the hospital?