Dive boat procedures for administering O2

[Marvel]

No matter what the circumstances are, there is a certain perceived stigma associated with a diver taking a hit. The usual question asked by divers & non-divers alike is "Did you come up to fast?" Unfortunately, even experienced divers can be subtly influenced by that perception which can lead to denial of symptoms- very common in all but the most severe cases of DCS. It sounds, from you account of the events, as if the diver was in denial & the behavior of the boat crew encouraged that denial. I hope that he did get treated & will be OK.

There are so many factors beyond a simple ascent rate that can contribute to DCS- fatigue, lack of proper hydration, & stress to name but a few. Yet, the overall PERCEPTION within, & without, the dive community is that the diver did something blatant, such as a rapid ascent or blowing a required deco stop to cause the hit.

 

[somewhereinla]

I took my DAN Oxygen first aid class a couple of month ago, and I have to say I am extremely surprised by the story. This is exactly what not to do. First as soon as the staff was infromed of the situation, they should have start administering O2 right away before even calling DAN. They should also have called the coast guard for possible evacuation of that diver... This is not good.

 

[plongeursousmarin]

No matter what the circumstances are, there is a certain perceived stigma associated with a diver taking a hit. The usual question asked by divers & non-divers alike is "Did you come up to fast?" Unfortunately, even experienced divers can be subtly influenced by that perception which can lead to denial of symptoms- very common in all but the most severe cases of DCS. It sounds, from you account of the events, as if the diver was in denial & the behavior of the boat crew encouraged that denial. I hope that he did get treated & will be OK.

There are so many factors beyond a simple ascent rate that can contribute to DCS- fatigue, lack of proper hydration, & stress to name but a few. Yet, the overall PERCEPTION within, & without, the dive community is that the diver did something blatant, such as a rapid ascent or blowing a required deco stop to cause the hit.

You're absolutely right. Of the 3 of us, he came up last so based on that and without seeing him actually ascend or seeing some visual alarm in his computer memory for that dive, we can suppose he ascended at a normal, conservative rate. I have screwed up a few times and have been just lucky that the only worry I have had is to ask myself why I screwed up (bad gas management, poor judgment of conditions) and if I had indeed been hit, it would have been normal. For this guy it sounds like an "undeserved" hit, all visible profile parameters check out for safety but there is something that happens in the person's body that makes the dive a dangerous one. Because of this some people say that there are no undeserved hits, there is always a reason, maybe the guy was not fit enough for the conditions (there was a bit of current) or maybe he was dehydrated, whatever. I don't know what's happened to him. I just hope I'll see him and dive with him again with or without this particular charter company.

 

[Dadvocate]

I don’t mean this as a personal slight and I hope it is not perceived as such, but I have to wonder why you and the other divers would risk compounding an already bad situation by entering the water again when this diver took on the symptoms he did.

Additionally, I am a bit perplexed by the protocol wrapped around the notion of the utterance of “acceptance” for O2 by a hit diver. Though I am from the States, I have not yet dived there. Here in the Philippines, O2 is given (not offered) when any diver shows signs of being hit in much the same way that RPJ suggests earlier on. Then the banka b-lines it for the shore to be sure that if things get worse they can get rolling and take the diver where he needs to be.

Perhaps this Pinoy procedure is a third world consideration given that things like evacuations to compression chambers take much longer than they do in places like the USA. At the same time, I prefer a policy of O2 first ask questions of acceptance later over a wait and see protocol. And I definitely prefer it over one that actually suggests that divers go into the water for a 45 minute second dive when another diver is having problems. I thought we were supposed to care about each other a bit more than that. I would never leave him for a leisure dive under no circumstances and I would harry the captain instead to give the man O2 and make like a banka back to shore.

Cheers!

 

[Land Locked]

I'm confused, I'm obligated to ask a diver if they want my assistance, with these symptoms I think I would be forcing the obligatory question not wanting to take no for an answer!
They called DAN??? I'm sure if there were any doubt they "DAN" would have made a recommendation on the side of safety for the diver....

 

[Thalassamania]

Unbelievable and irresponsible.

 

[Dadvocate]

Yes, of course, you have a point LL. One can't really force the O2 on someone if they don't want it, in the same way that an emergency responder can't force assistance on an injured person in other crisis contexts if they refuse.

But to me there is a lot of real estate between that initial refusal per se and simply saying “well, he’s refused, let's continue diving”. For instance, the captain could say that as policy any diver with conditions such as non-functioning legs, numbness, discoloration, etc. after a dive means the boat goes back...period! In the meantime an aptly inclined person such as a DM or another diver such as TSandM could drop hints along the lines of what might happen if the diver doesn’t take the oxygen (i.e. spinal injury). If Marvel is right and his refusal is based on a bit of embarrassment, noting that it could have been anything that caused his symptoms might help persuade the diver to be reasonable. In other words, short circuiting his ego by deed and conversation might lead to him taking the oxygen and saving himself and those who care about him a whole heap of woe. The captain heading the boat back to shore and others stressing the importance of the oxygen could underscore the severity of the situation, hopefully enough to get the hit person to take the necessary precautions.


Even if the diver refuses the O2 while conscious and being lectured, the boat would be moving in a direction that could be beneficial if things get worse. And an unconscious diver doesn’t refuse O2 if the situation comes to that while en route.

Cheers!

 

[ClayJar]

Those symptoms scream DCS. There may be some other cause, but if I had someone present them after such a dive, there is no way in the 7-layer salads of hell that we're not heading back in at flank speed. (And once you're steaming full bore back to shore, there's not much point to refuse O₂, is there? Everyone already knows there was a suspected hit or whatever, and if it happens not to be DCS, well, at least you get that O₂ lift.)

If there were divers in the water, I'd *absolutely* expect the recall to be sounded or someone to be sent to collect them (as the case may be for the boat), and I certainly wouldn't be putting divers in the water.

(I'm with Thal, although I think it may need to be red and blinking, too.)

 

[Thalassamania]

...
(I'm with Thal, although I think it may need to be red and blinking, too.)

Made it red, to dumb to make it blink.

 

[JayJudge]

OK, I'll start with this. I would never get on a boat that pulls a stunt like this. Every DM and Rescue certified diver has been taught the benefits of O2. It can't hurt, and even when looking at a CNS clock, if the victim goes into convulsions, they are not in water, so there isn't the normal chance of drowning. The most recent incident I have been around, the diver came onboard with his computer screaming. Now, he had entered the water 5 minutes after me, and ascended at the same time, also he never hit the depth I was at (he was spearfishing and I was artifact hunting.) We knew he was using a very conservative computer, and the likelyhood of a hit was very low. However-he was still put on O2. Felt fine, but like I said, it won't hurt. We pulled anchor, and away we went. No one on the boat was mad, only worried. I have yet to meet a diver that wants to see someone hurt. The crew in the original posting should be fired.
-J