DCS - saw it 1st time in my life

[lamont]

In water recompression is frowned up by agencies these days but it DOES have a use in remote locations and personally im not 100% convinced it isnt a good recreational idea either. The main worry is the casualty losing conciousnesses and drowning in water but for a dive exhibiting no obvious symptoms im not convinced going with a safety diver back down to the stop depth for a long time isnt a good idea. You are effectively putting them in a mini-chamber under supervision until such time as help arrives.

I certainly know of divers that have missed stops and gone straight back down to complete them without issues.

(Bet this opens a hornets nest).

Those are two different things. One is in-water recompression and one is a missed deco stop.

The missed deco stop relies on the fact that you seem to have a 5 minute window after surfacing before any DCS symptoms hit. This is why divers can surface and 'skip' all their deco, then crawl into a chamber on a ship, get recompressed and go through all their deco obligation.

After DCS symptoms hit, then you're looking at IWR and the risk of DCS symptoms turning the diver into a drowning casualty are much greater. In order to properly do IWR you really need a full-face mask in case the diver goes unconscious or toxes, and you should have a way to tie the diver off so that they maintain their depth, and everyone needs to be trained. The reason why open water divers are told not to attempt IWR is that they don't have the training or the equipment, and there are a lot of incidents that start with a diver in a panic over DCS symptoms that ends in a body recovery. It isn't the same thing as a chamber because in a chamber you are not immersed in water...

Also, recreational divers probably aren't going to have immediately life-threatening DCS symptoms. They'll probably live to get to a chamber, and their chances of complete recovery are generally good. For tech divers missing a substantial amount of obligatory deco the risks of IWR may be substantially less than the risks of waiting for a chamber.

 

[mania]

Here is a story of one guy with quite a good picture of DCS rash. Still I don't know why it's called rash - it's more of spot than dots.
Mania
http://www.diver.net/bbs/messages/44633.shtml

 

[partridge]

Here is a story of one guy with quite a good picture of DCS rash. Still I don't know why it's called rash - it's more of spot than dots.
Mania
http://www.diver.net/bbs/messages/44633.shtml

Thanks. Just what I needed.

 

[String]

Those are two different things. One is in-water recompression and one is a missed deco stop.

Thats not quite what i mean. A lot of agencies now recommend for missed stops to not go back in but to get on the boat, get on O2 and get evacuated not just those exhibiting symptoms of DCS.

Im not particulary happy with this and my own view is it can lead to complications that could have been avoided if an asymptomatic diver went back down to a stop depth and stayed there for the needed time plus more. The latter is treating the cause, the former solution is just treating the symptoms.

 

[lamont]

Thats not quite what i mean. A lot of agencies now recommend for missed stops to not go back in but to get on the boat, get on O2 and get evacuated not just those exhibiting symptoms of DCS.

Im not particulary happy with this and my own view is it can lead to complications that could have been avoided if an asymptomatic diver went back down to a stop depth and stayed there for the needed time plus more. The latter is treating the cause, the former solution is just treating the symptoms.

Yeah, that seems like you're causing a lot more risk for the diver than if they just grabbed a tank and went down and finished their deco. If they're still within that window and still asymptomatic, then the risk of them hopping back in the water seems much less than the risk of letting the symptoms come and evacuating them....

 

[voop]

The same with me. I read about, saw some pictures of the rash, I'm not medically trained ( in the sense I haven't finished any medical school) and so on. Simply from logical point of view crossed my mind that it could be DCS, not simple headache and rash from corals. In this case several symptoms shown together so maybe this is why it was easier. I wouldn't be that convinced if the guy had only rash and that's it. Or only numbness in fingers (although this was the first thing I checked remembering neurological symptoms).
So thanks for kind words from all of you but I still think it was a pure chance deciding on DCS. Now, after seeing it - at least these symptoms it would be easier, no doubt about it.
Mania

First off: ya' did GREAT!

Secondly, I usually try to get the message through to my dive students that "if something doesn't seem right, assume the worst" (something I learned from an ER-doctor, btw). Just seems like good sense to me...

Numbness, rash, nausea etc -- unless you're a medical professional, better to assume that the guy has DCS, and treat him as such. You're (hopefully) wrong, but O2 and EMS is not likely to kill or harm him -- whereas untreated DCS definitely is.

A little bit like "if it walks like a duck and it quacks like a duck -- it might taste good in an orange sauce". If it looks like DCS symptoms, it might just be DCS.....just as you correctly asserted and insisted upon!

Thirdly: ya' did GREAT!

Feel free to "name names" of whoever that SOB DM, who didn't want to get this guy medical treatment, was, as well as the center he's working for. If I had a potentially bent guy in my crowd, as a (I like to think) ethical human being, legal reprecaussions would be the least of my concirns. The fact that this DM and center were thinking more about "staying in business" says something about their ethics -- and I'd like to be able to avoid sending business their way....

Ohh, and about the O2-thing. It wasn't your fault that it wasn't there. It should have been there, and the captain/DM in charge should had double-checked it. I always check whenever boarding a boat, as instructor or diver/client (even if it is for the second time in the same day, I check). If it is as a client, normally after 1-2 days, the captain/DM in charge incudes O2 in the briefing before heading off the dock.

But it can't be said enough: ya' did great!

 

[GrierHPharmD]

Great job, Mania. And that was a wonderful report.

-Grier

 

[mania]

Feel free to "name names" of whoever that SOB DM,

OK I need an advice from all of you. Should I publish the name of the diving centre or not. We have the same debate in our Polish Diving Forum. My main worry is that a lot of people have short memory. So now they would read the story and would remember the name. But a year later they would end up in Egypt, encounter this particular diving centre and all they would remember was "Oh, I've heard about them. So it means they are good if I remember their name"
What should I do? It's also important fo SB, because a lot of Europeans are going there
Mania

 

[Stivo]

OK I need an advice from all of you. Should I publish the name of the diving centre or not. We have the same debate in our Polish Diving Forum. My main worry is that a lot of people have short memory. So now they would read the story and would remember the name. But a year later they would end up in Egypt, encounter this particular diving centre and all they would remember was "Oh, I've heard about them. So it means they are good if I remember their name"
What should I do? It's also important fo SB, because a lot of Europeans are going there
Mania

For your own liability, I would be wary making a public post... For me though, I would appreciate the info if you wouldn't mind PM or emailing me.

Great job and a terrific report!

 

[htn123]

Mania,
Wonderful story. You did a great job. Bravo.

OK, hope I am not going off topic here, but I followed one of the link above to look at the DCS rash picture of Elaine
http://www.diver.net/bbs/messages/44633.shtml
and one of the divers asked her if she used air, Elaine response was " Yes, I think I'm going to use nitrox more frequently in the future - computer set to air of course ".
Hmmmm, I haven't dive alot but don't you supposed to set your computer for your dive profile? ie nitrox? why would Elaine comment was to set the computer to air profile?

Thanks for any comments.