I did a pot dive last Thursday and the hyperbaric doctor said a couple of things that might be worth repeating.
I think by now most, if not all, divers are aware that administering O2 to a DCS victim is very important. What the Dr. said many divers still do *not* seem to understand is that administering a large amount of water (at least 1 litre) is equally important as first-aid treatment for DCS. The reason she gave for that is that additional fluid volume in the blood will help blood flow around slightly larger bubbles (or the bubbles may move), which in turn will help avoid unnecessary tissue damage.
Second thing that she said that I thought was interesting is that many first-aiders do not send the victim *and* their buddy to the chamber. This is important for two reasons, namely that (a) if the diver being evacuated got hit then the buddy may also still get hit and should be diagnosed and observed and (b) that the buddy obviously knows what happened, which is very important to treatment.
Third is that first-aiders often forget to send the diver's computer with them. Most chambers are able to download the majority of computers and the computer obviously has important information. Police will often try to seize the equipment, including computer, for their own purposes but as first-aider you must be firm that the computer goes with the victim.
Fourth, is that a significant number of the cases of DCS from the statistics are caused by emergency ascents, skipped safety stops/deco and/or OOA situations, all of which are completely avoidable problems. Take home message is plan your dives, dive nice profiles and watch your instruments.
Fifth, she said that part of the diagnosis may involve making a heart film and a lung x-ray. I thought that was interesting because it's the first time I've heard that.
Lastly, she said that treatments are done at a maximum depth of 18 metres on O2 (2.8po2) and single treatments can last from 2 to 6 hours depending on which tables they have to apply and most divers are treated from 1 to 6 times.
Finally, I'd like to say that if you think you're not sensitive to nitrogen narcosis you should do a pot dive. I usually don't feel narced until I'm at 36 metres on air but in the chamber it's very *very* clear that the majority of people are already getting well and truly narced at 25-27 metres (80-90ft). You just have a different frame of reference when you're not in your gear and it makes it so much easier to see the effect.
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For the Dutch and Belgian divers out there she said a couple of interesting things:
1) after calling 112, victims in Zeeland are usually transported to Goes for diagnosis, prep (i.v., heart and lung films and downloading the computer) before being taken to Antwerp. By the time you get to Antwerp the staff know exactly what happened and you go straight into the chamber.
2) Even though there are a more than a dozen chambers in Holland and Belgium, the chambers in Antwerp, Oostende, Amsterdam and Den Helder are the only chambers large enough, properly staffed and open 24/7 that divers should go there on their own initiative. If you're in Zeeland it's tempting to drive to Antwerp but if you call an ambulance they'll be there faster and they'll be properly prepped by the time they get there. (i.e. if you're going to drive *anywhere* with your victim, take them to Goes). The four big chambers also have landing for a helicopter so you can request an air ambulance if you're in a really big hurry.
3) Antwerp treats about 130 divers every year. Given that there are four commonly used chambers .... well .... you do the math. This is a bigger problem than I thought it was.
R..
I think by now most, if not all, divers are aware that administering O2 to a DCS victim is very important. What the Dr. said many divers still do *not* seem to understand is that administering a large amount of water (at least 1 litre) is equally important as first-aid treatment for DCS. The reason she gave for that is that additional fluid volume in the blood will help blood flow around slightly larger bubbles (or the bubbles may move), which in turn will help avoid unnecessary tissue damage.
Second thing that she said that I thought was interesting is that many first-aiders do not send the victim *and* their buddy to the chamber. This is important for two reasons, namely that (a) if the diver being evacuated got hit then the buddy may also still get hit and should be diagnosed and observed and (b) that the buddy obviously knows what happened, which is very important to treatment.
Third is that first-aiders often forget to send the diver's computer with them. Most chambers are able to download the majority of computers and the computer obviously has important information. Police will often try to seize the equipment, including computer, for their own purposes but as first-aider you must be firm that the computer goes with the victim.
Fourth, is that a significant number of the cases of DCS from the statistics are caused by emergency ascents, skipped safety stops/deco and/or OOA situations, all of which are completely avoidable problems. Take home message is plan your dives, dive nice profiles and watch your instruments.
Fifth, she said that part of the diagnosis may involve making a heart film and a lung x-ray. I thought that was interesting because it's the first time I've heard that.
Lastly, she said that treatments are done at a maximum depth of 18 metres on O2 (2.8po2) and single treatments can last from 2 to 6 hours depending on which tables they have to apply and most divers are treated from 1 to 6 times.
Finally, I'd like to say that if you think you're not sensitive to nitrogen narcosis you should do a pot dive. I usually don't feel narced until I'm at 36 metres on air but in the chamber it's very *very* clear that the majority of people are already getting well and truly narced at 25-27 metres (80-90ft). You just have a different frame of reference when you're not in your gear and it makes it so much easier to see the effect.
-------
For the Dutch and Belgian divers out there she said a couple of interesting things:
1) after calling 112, victims in Zeeland are usually transported to Goes for diagnosis, prep (i.v., heart and lung films and downloading the computer) before being taken to Antwerp. By the time you get to Antwerp the staff know exactly what happened and you go straight into the chamber.
2) Even though there are a more than a dozen chambers in Holland and Belgium, the chambers in Antwerp, Oostende, Amsterdam and Den Helder are the only chambers large enough, properly staffed and open 24/7 that divers should go there on their own initiative. If you're in Zeeland it's tempting to drive to Antwerp but if you call an ambulance they'll be there faster and they'll be properly prepped by the time they get there. (i.e. if you're going to drive *anywhere* with your victim, take them to Goes). The four big chambers also have landing for a helicopter so you can request an air ambulance if you're in a really big hurry.
3) Antwerp treats about 130 divers every year. Given that there are four commonly used chambers .... well .... you do the math. This is a bigger problem than I thought it was.
R..
