In-water recompression to decompress - what are your thoughts?

[Kevrumbo]

IWR is never required btw, its a choice among alternatives (some better than others)

When you say IWR is never required, what do you mean by that?

There is a situational social group welfare context to be considered as well. . .

If you're on a very remote liveaboard expedition (i.e. Bikini Atoll in the Marshall Islands) with no airborne medevac provision and 30 hours minimum ship's passage back to port: even with a shipboard 6ata fully capable auxiliary lock/multiplace Recompression Chamber and an attending Hyperbaric Physician, and say you get a type one DCS hit on Day 1 out of a scheduled 10 consecutive dive days, then all diving activities for your fellow dive mates on the trip are suspended indefinitely, pending resolution of your symptoms -if you decide to utilize the onboard chamber.

If you elect to undergo riskier O2 IWR instead with successful resolution of the type one symptoms, your dive activities for the rest of the expedition itinerary are essentially over, but at least those of your dive mates are not. And more importantly, the limited shipboard chamber gas logistics in support of a more seriously urgent type II or emergency AGE potential incident for the remaining divers are conserved, because you chose to use IWR instead.

 

[rjack321]

When you say IWR is never required, what do you mean by that?

You can:
1) Deny your symptoms (probably most common)
2) Recognize you might have DCS but just "tough it out" (happens a lot when the symptoms are minor, can involve continued diving or staying out of the water. Some commercial fishermen just keep diving and fix their bend on the next dive. I've seen this attitude a lot with urchin and geoduck divers because if they admit their symptoms and go to the chamber they lose out on income for weeks. So its not uncommon to do another dive and just come up slower even though they aren't supposed to be doing deco dives.)
3) Deco out on surface O2
4) IWR
5) Transport to a chamber

Can't think of any more off the top of my head but there are various combinations of course. Some symptoms may call for one over another while past experiences, distances involved, and a myriad of other factors play a role as well. I.e. transporting 2 or 3 days to a chamber for an uncomplicated skin bend is probably an imprudent use of resources. Jumping back in for IWR in really cold water with a flooded drysuit isn't wise either. Anyway you get the idea, IWR vs chamber is not a binary decision.