Lessons Chamber Fatality in Malta

[rjack321]

Yes, with a lot of "ands". One big one: there are a lot of facilities in the US (and I'm sure outside) that have properly trained hyperbaric physicians and are quite capable of treating emergent indications but are not equipped to manage critically ill patients in the chamber. There's a good example in your neck of the woods: a hospital in the Denver metro area can take emergent hyperbaric indications but isn't equipped to manage critically ill patients in the chamber. The closest hyperbaric facilities to you with critical care capability are in Salt Lake City. There's a complex risk-benefit calculus that goes into deciding when and where to treat a hyperbaric patient who may decompensate. Treat in the closer chamber while gauging and accepting the risk of decompensation, or fly the patient 500-ish miles and accept the risk of a delay in care?

Best regards,
DDM

This is not unlike the decision to try IWR vs potentially sending someone many hours (or even days) away to a even a basic chamber, never mind one with ICU level capacity.

 

[Duke Dive Medicine]

This is not unlike the decision to try IWR vs potentially sending someone many hours (or even days) away to a even a basic chamber, never mind one with ICU level capacity.

Similar mindset, with different risks.

Best regards,
DDM

 

[rjack321]

I confess when I first read this article, I thought the chamber attendant made a mistake (over/under pressurized the vessel) perhaps due to lack of supervision/oversight and that led to the diver's death. It wasn't clear to me.

 

[dmaziuk]

I think what @scooba_kev was driving at was not the dive history that led to the DCS but what could cause a diver with DCS who initially looked fine to suddenly take a turn for the worse.

I understand, but from my reading of the original thread, it's not the outcome that is surprising, it's that the victim "looked fine" for a little while.

 

[Duke Dive Medicine]

I understand, but from my reading of the original thread, it's not the outcome that is surprising, it's that the victim "looked fine" for a little while.

"Looked fine" could mean a lot of different things depending on who's doing the looking. And, it's unusual but not unheard of for someone whose presentation isn't alarming at first to decline rapidly and without warning. I'm mindful that we're well into the realm of speculation at this point. Without firsthand information, we really can't know what happened.

Best regards,
DDM

 

[dmaziuk]

My reading of that thread is that an experienced tech. instructor omitted an hour of deco, tried to get back in the water for IWR but the boat crew stopped stopped him, lost feeling in his legs on the way to the chamber, and then "everyone though he was going to be OK".

I don't think he thought he was going to be OK when they stopped him from getting back in the water.