Dive boat procedures for administering O2

[Thalassamania]

Hi, Thalassmania! I answered step by step in this post, so I think my opinion starts to shift more as I progress below. I thought I’d leave it as is for “efficiency” sake

I know the problem.

Very interesting indeed. You obviously have an understanding of the isolation of these scientific sites that I do not. I come from the perspective of tropical thinking. The Philippines kind of mandates that. At the same time, I also viewed the report and your comments from an “evacuation” mindset, also symptomatic of someone who considers getting any hit diver out and to safety ASAP or having a recompression chamber handy as normal, something that obviously costs a great deal of money.

I appreciate that you understand the impracticalities of a chamber (although I am still on the fence about whether not to accept the cost and hassle of an on-site chamber being impractical) and that you see the best solution is one that must be provided on site.

This idea of yours is a clever concept by the way, a way to maintain an agreed upon suggestion offered by UNOLS while also noting the realities of a very cold dive site.

Money be damned, what we’re trying to preserve is the science and while we will not permit someone to deteriorate in order to get it done, a death at sea does not automatically end the cruise.

… training on land beforehand as a far better cost effective way to reduce the risks of DCS and other injuries on board. This makes sense even to my skeptical self. If money and time are spent on insuring that divers really know what they are doing before they step onboard the boat and thus are not stretching their limits on these important expeditions, the risk of DCS becomes far less of a potential threat to life and ultimately to the research being done.

From this consideration, I’d have to agree with you that carrying a large piece of equipment, replete with operations personnel would be overkill and extremely costly. This would have to mean then that the training provided the divers and crew would be strictly adhered to. There was nothing I saw to indicate otherwise in the report. In fact, the gist I got was that this training and the agreed to procedures would be treated as sacrosanct once the boat was underway. Correct me if I am wrong.

You are right. Training on the beach and good planning can get us a long way. Consider though, what use a science party member or crew member who was trained sometime ago in hyperbarics and who does not deal with it and with the chamber on a daily basis would be. More dangerous than useful if I may be so bold. Conversely what use would a chamber operator and tender be to either the ship’s operation or the science party? ‘bout like teats on a bull.

I’m reading through your points step by step in between classes. It seems this comment above underscores an emphasis on procedure and safety beforehand. And it also goes back to that notion of what “normal” is. As long as this idea of normalcy stays in check and is not assumed flippantly then I can see some merit in this practice.

Normal is as normal does and life can be like a box of chocolates.

I also wanted to ask you something that I mulled over last night. Aren’t there oil rigs out there in the North Atlantic that have chambers for their diving welders? I seem to recall reading that somewhere. If so, would these be accessible?

We have the location of all the rigs (they often have choppers and can refuel the birds) and of all the operational chambers – look at the cruise planning section.

Again, I would not want to place myself in a position of arguing against any of these highly accomplished people. My only point was to respond to what I considered an interesting case study that you offered and to do so as an objective layman for lack of a better term. Sometimes having a set of eyes outside the field specific eyes looking at the issue can shed some light on what is going on (Remember the anecdote about a little girl in a car telling all the engineers trying to figure out how to get a stuck long haul truck out of a tunnel to let some air out of the tires?). I may not shed light on anything, but I believe I am benefiting greatly from the exchange all the same.

Objective layman looking it over is always good. I already see where a bunch of basic concepts that are such dogma in the scientific diving community were glossed over out of a lack of appreciation that not everyone is already sitting in the pew.

Okay good. So in the end, the panel seems to think that efficiency in cost and safety is best served through the training of all members of the crew and in making sure everyone on board has a good understanding of what needs to be done for a host of scenarios. Safety then is a question of making sure things don’t get too compartmentalized in practice or people on these boats. Am I correct in seeing things this way?

Yes.

As things stand now, perhaps you are right in suggesting this. The caveat I would offer is that no one should ever allow this assumption to dwell for too long in their heads so as to become complacent. That could be a costly mistake for someone down the line. If as you say each expedition is viewed anew before it goes out to sea, it seems that this hubris has not taken hold. That would mean that “normalcy” is not assumed going in but earned as the UNSOLS recommendations run their respective courses. Correct?

Yes.

Could a person survive for four days with this condition? This seems an impossibility to me.

Depends on how badly bent.

And thank you for the education. As ridiculous as this topic change will sound to close things out, the writer in me has to wonder what novel lies hidden in these science trips.

A deep sea expedition in the North Atlantic… the captain of many years on his last sojourn…the young and beautiful scientist, Rebecca, on the verge of discovering (insert your favorite mystery)… and the rebel deckhand, Jean M, an embittered loner who never knew love until he met Rebecca. What will they do when… happens? Will it be life or the expedition????? Okay, a bit cheeky, but it has potential.

I'm not much on writting fiction, but here’s a cruise story I posted a while back: Cruise Story.

Thanks for the exchange. I’ll read deeper into the report later on. I have my living to earn at the moment.

I’ve enjoyed it and learned a thing or two to boot.

P.S. Given your sign out quote, are you a fan of Sam Harris, Christopher Hitchens, Richard Dawkins, etc.?

Less of a fan and more a fellow traveler of Samuel Clemens.

 

[DeepSeaDan]

...from a Diver-Medic:

> At first notification, several things should happen concurrently:

* The subject diver's chief complaint should be assessed, O2 applied via non-rebreather mask, baseline vitals taken, accurate dive history retrieved, S.A.M.P.L.E. interview & a rapid neurological performed with the patient supine & limbs extended

* A running log of the incident details begun, concurrent with a chronology of the casualties information

* D.A.N. notification

* All divers returned to the vessel, advised of the situation & given basic instruction as to their role(s)

* An action plan developed in concert with D.A.N. to fascilitate prompt evac. of the patient to definitve care.

With a diver complaining of such S&S as described in this incident, EVERY EFFORT must be made to inform the diver of the POTENTIAL DRASTIC CONSEQUENCES of inaction.

In my experience with denial, I usually default to the logic of the "test of pressure" - recompression / re-evaluation at hyperbaric depth to confirm or rule out baratrauma.

Regards,
DSD

 

[Ed Palma]

... Anyway our buddy is fine, I dove with him 2 weeks ago, he got checked out and his condition is not related to diving from what his MD told him.

Out of curiosity, did your buddy tell you what his diagnosis was? He may have been aware of a pre-existing condition - hence his initial reluctance to raise a fuss.

 

[tracydr]

Thanks for what ranks amongst the best and most thoughtful analysis of the UNOLS report that it has been my pleasure to read.

There’s general agreement that as a tropical remote site measure in-water recompression can be an expeditious technique of last resort (especially when diver can be provided pure oxygen through a full face mask with coms), but it is not an “approved” procedure and is not practical in polar regions. I have an idea of running a hose from the vessel’s domestic hot water out to a perforated tube that could be inserted through a wrist or neck seal that might result in a temperature controlled water bath inside the dry (now wet) suit for the stricken diver. I’ll have to play with this one.
The context of “unduly imped[ing] scientific efficiency” was a concern that the deployment of a chamber on a vessel would mean either giving up two science berths for a chamber operator and tender who would be useless to the science party except in an emergency or the need for two members of the party to obtain and maintain those skills on top of everything else that they already had to obtain and maintain.
No one was suggesting making cuts, they were (and are) suggesting resisting the suggestion of mobilizing chambers for all NSF diving cruises. To date, I believe, there has been only the decompression incident that is discussed in the report and the moral of that story is to “stick by your guns” after disqualifying a diver or, perhaps, if such an individual is an essential element to a research program to go thorough the expense and “scientific inefficiency” to mobilize a commercial chamber and crew for a cruise that individual was on.
Please note that there was universal agreement amongst the attendees who included scientists, hyperbaric experts, institutional administrators, institutional marine superintendents, diving safety officers, and ship’s masters.
While the discussion has, of course, continued. In fact the issues are rehashed, in detail, during the planning for every diving cruise that goes out. There has been no call for revisiting the issue nor has there been, to the best of my knowledge, an incident that would lead me to see the need for formal revisitation.
Or perhaps, as is rarely the case, the panel got it right … history would favor that conclusion.
Got to have some wiggle room, the example presented would be considered “normal.” Abnormal would be the kind of stuff that went on with, say, the Monitor Project or any of what we would today refer to as “technical” diving.

(continued)

Could we please split this thread. I have no idea what this has to do with the original and having trouble following. Thanks!