Gradient factors - deep stops thread in DIR forum

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Dr Simon Mitchell

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Hello

I find that I cannot post in relevant thread in the DIR forum, so I thought I might put a post here. I don't want this to turn into a deep stops debate. We have been through enough of that already.

I have read the article by Jarrod Jablonski linked to in that thread and I just wanted to share an important perspective. My concern is that the article title puts the question "are deep stops dangerous"? Although the article is typically (for Jarrod) well written and thoughtful, I firmly believe that this title frames the issue in a way that risks inferring that there is a right or wrong answer to the question. It is far more nuanced than that.

The truth is that every decompression needs a deepest stop. The real question is "how deep should that deepest stop be"? Throughout the debate on deep stops, the position I and my colleagues have taken revolves entirely around the concept of decompression "efficiency". If you have X amount of time that you are going to spend decompressing, then what is the optimal distribution of decompression stop depths and times that will give you the safest outcome? Succinctly, the safest decompression for X amount of decompression time.

We have imperfect answers to that question of course, but the fact is that the only human evidence available at this time suggests that bubble models such s VPM and RGBM impose stops that are too deep for the most efficient decompression. In other words, if you spent the same time decompressing as proposed by those algorithms for a particular dive, but de-emphasized the deepest stops and spent more time shallow stopping (I reiterate, for the same total decompression time), then you would probably reduce the risk associated with the dive. This, of course, unveils the potential flaw in the argument that you can do bubble model style deeper stops but do longer shallower stops as well to make up for the extra uptake of gas during the deeper stops. Maybe, but it may also be that if you took this now longer decompression, did the same decompression time but less deep stops and decompressed shallower for longer, then that might be more efficient too.

But this does not mean that "deep stops" per se are bad (I reiterate every decompression has to have its deepest stop), or by inference that decompression plans should be moved shallower and shallower (eg if you believe the answer to "are deep stops dangerous" is yes). Indeed, if you progress too far down the latter path, then efficiency will start to fall and decompressions will become less safe. Unfortunately, the bitter nature of the debates on this matter, and the need to defend the human data against irrational attack, has tended to make the issue seem more polarized than it really. It has risked creating a belief that endlessly shallower is better. No one has ever said that, and the position that I and my colleagues have taken should not be interpreted that way.

Simon M
 
if you spent the same time decompressing as proposed by those algorithms for a particular dive, but de-emphasized the deepest stops and spent more time shallow stopping (I reiterate, for the same total decompression time), then you would probably reduce the risk associated with the dive. This, of course, unveils the potential flaw in the argument that you can do bubble model style deeper stops but do longer shallower stops as well to make up for the extra uptake of gas during the deeper stops. Maybe, but it may also be that if you took this now longer decompression, did the same decompression time but less deep stops and decompressed shallower for longer, then that might be more efficient too.

I would argue that the issues associated with (theoretically unnecessarily) longer schedules are a whole different discussion. And so mixing that with "for the same total decompression time" in the same paragraph only adds to the confusion. I'm sure some of those issues are common to both, but IME limiting the scope and dealing with one clearly defined small chunk at a time does more good than harm. Usually.

$.02
 
I would argue that the issues associated with (theoretically unnecessarily) longer schedules are a whole different discussion. And so mixing that with "for the same total decompression time" in the same paragraph only adds to the confusion. I'm sure some of those issues are common to both, but IME limiting the scope and dealing with one clearly defined small chunk at a time does more good than harm. Usually.

$.02

Hello dmaziuk,
the whole point of the study was "for the same decompression time". The aim of the study was identify what was the most efficient decompression schedule. Redistributing the time toward deep stop would only increase the DCS risk.

As such if you do not limit the decompression time making it equal you would loose the point of the study.

In fact you can start decompressing as soon as one of the compartments is supersaturated .... but you would have others ongassing. Therefore you limit supersaturation on that first compartment but you would increase the gas loading of the others and keep increasing time to surface.

But this is exactly the point it was made in the discussion that took place here 2 and half years ago ... (edit actually more than four years ago)

I guess it can be diggen out and referenced.
Deep Stops Increases DCS
 
As such if you do not limit the decompression time making it equal you would loose the point of the study.
That sounds like a very reasonable choice for such a comparison. I presume one could have also chosen “for the same amount of deco gas” as the limiting factor, but that would make matters only worse for the deep-stop dives.
 
I have been bothered lately by some long time divers that have had serious dcs events that have ended or limited their diving and perhaps worse. Trace Malinowski is in a serious situation. Steve Bogaerts has just announced that he can never dive again. The three events that ended his diving career were all conservative dives with little or no mandatory deco to shallow depths. John Adsit took a hit but I have no details about it. There are others. Is it possible that we are accumulating damage without knowing it that is creating later susceptibility to dcs? Will we later learn that deeper stops with longer deco schedules and less “efficiency” is what we should be planning for? What don’t we know?
 
Oh my, I had not heard of any these. Trace, Steve, John? Oh my.
 
With all of these unexplained DCI’s I’m beginning to take the view that science has yet to catch up on the the effects of rebreather technology and frequent long run time diving, on our bodies.
 
No computer or table can predict how your physiology reacts during diving. Decompression diving is inherently riskier compared with "no decompression" diving. You can model the various human tissues with respect to decompression but it will be very difficult to have a concrete answer anytime soon.Not only is our physiology different that our fellow divers, but our own phyiologic state is variable itself.

Thank you Dr. Mitchell for your post.
 
Minimizing decompression time is particularly important when other risks are relevant. Were there no marine life hazards, or other time-related hazards (like temperature), and if we had infinite gas to use, longer times would merely be inconvenient. We all want to get out of the water as quickly as possible consistent with reasonably balanced risks, I think.

That deep stops might be safer ovrtall when followed by additional shallower stops ignores holistic risk optimization. I want to know what the (reasonably) safe minima are. I can always pad them to improve risk management when other risks seem less important.

This is why I think it's good understand the efficiency of different approaches to decompression planning. Maybe I'm not thinking clearly about this. (It would hardly be the first topic for which that turned out to be true.) But many seem to ignore this balance of risk in their assessments, and I think that might be, um, "suboptimum."

Just another 2 PSI.
 
When we take the “bend and mend” approach, do we truly mend?
 
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