Doing some catch-up reading here:
You sir are a master of understatement.
Are there any that have a pressure vessel certification that anyone cares about like:
No offense to my ancestors but there aren't very many vessels of opportunity under the Italian flag. The only one I can think of is
FlexiDec, which is certified by RINA (Registro Italiano Navale) only. We had some RINA-only certified chambers onboard and the vessel's captain (via the owners and insurers) wouldn't let anyone pressurize them. Maybe the different certification agencies and marine insurers are playing nicer these days?
(discussion and perspective, not argument) The world's navies are the only place I can think of were a hyperbaric doc is onboard during diving operations. The problem is most (not all) get the diver many hours or days after symptoms appear. I can only assume that the much more favorable outcomes that are common in the offshore commercial diving industry are significantly influenced by very short "time to treatment". This is my main motivation behind supporting IWR. As mentioned before, everyone
walked out of treatments joking. We had some pretty terrible experimental tables in the early days so one would think that more diver's careers would have ended.
IMHO, even the most conservative and simple IWR, like 20' on an O2 stage bottle, should be done at the first suspicion. You have to over-treat often and early to avoid the much rarer frustration of a hyperbaric doc left to deal with damage that has already been done.
Going below deck and lying down after a dive rather than voicing concerns appears to be a recurring thread in incidence reports.