In-water Recompression has been an interest of mine since I first began decompression diving, and even more so since I began working my way deeper on mixed gas CCR. When I first began to learn about it, there was little published information, and almost no open discussion of it in the "technical ranks". That, fortunately, has changed in the past few years.
There were two central questions attached to it which were finally answered. One, is it effective? The answer, of course, is yes. Two, is it easy? The answer, of course, is no.
If we examine any of the published IWR methods, we find that there are many considerations, both strategic and tactical, which must be taken into account.
For instance, the major strategic question is that of how close is the nearest chamber? If transport time is minimal, and the patient can at least be stabilized, the best chance of a succesful outcome may be to elect immediate transport. The chamber personnel, and medical support staff have more "firepower" at their fingertips than we do on-site.
If we are a long way from the chamber, and the patient's condition is critical, our next questions are tactical in nature. Do we have the required equipment, such as a seat or sling, and FFM rigged for O2 on a long enough hose? Do we have the required gas? Do we have personnel who are not fatigued and/or inert-gas loaded themselves to help with the patient? Do we have water and weather conditions that will allow our patient and attendant to remain in the water long enough to do the job? These questions, and many others like them must be answered before we can have any chance of a successful outcome.
We would all like to think that we could just hand the afflicted diver another cylinder or two, and have him (or her) drop back down the shot-line to do the deco! Unfortunately, the vagaries of off-gassing and bubbles in the circulatory system, as well as the unknowns of diver pain and fatigue make the chances of this technique having a successful outcome extremely low. Not to say it hasn't been done, mind you! A story by Dr. Richard Pyle comes to mind.
On the whole, however, IWR is a protocol that takes a LOT of work to make the Six-P Rule come into play! :book2:
There were two central questions attached to it which were finally answered. One, is it effective? The answer, of course, is yes. Two, is it easy? The answer, of course, is no.
If we examine any of the published IWR methods, we find that there are many considerations, both strategic and tactical, which must be taken into account.
For instance, the major strategic question is that of how close is the nearest chamber? If transport time is minimal, and the patient can at least be stabilized, the best chance of a succesful outcome may be to elect immediate transport. The chamber personnel, and medical support staff have more "firepower" at their fingertips than we do on-site.
If we are a long way from the chamber, and the patient's condition is critical, our next questions are tactical in nature. Do we have the required equipment, such as a seat or sling, and FFM rigged for O2 on a long enough hose? Do we have the required gas? Do we have personnel who are not fatigued and/or inert-gas loaded themselves to help with the patient? Do we have water and weather conditions that will allow our patient and attendant to remain in the water long enough to do the job? These questions, and many others like them must be answered before we can have any chance of a successful outcome.
We would all like to think that we could just hand the afflicted diver another cylinder or two, and have him (or her) drop back down the shot-line to do the deco! Unfortunately, the vagaries of off-gassing and bubbles in the circulatory system, as well as the unknowns of diver pain and fatigue make the chances of this technique having a successful outcome extremely low. Not to say it hasn't been done, mind you! A story by Dr. Richard Pyle comes to mind.
On the whole, however, IWR is a protocol that takes a LOT of work to make the Six-P Rule come into play! :book2:
