My friend took a bad hit.

[Quarrior]

Good job Kevin and I hope Paul recovers ok.

 

[pufferfish]

Excellent save Kevin and sounds like text book perfect first aid applied. Here's to a speedy recovery.

In these instances of Type 2 DCS or neuro DCS people should be thinking about rapid application of O2 and transfer to a chamber asap. The longer the delay prior to recompression with bubbles lodged in the CNS tissue, the greater the chance the immune system will be activated resulting in permanent neuro damage. In these *rare* type 2 DCS cases 'time is brain' so the shorter the boat to chamber time, the better the outcome. Sounds like your friend will do well.

As Big Jet mentioned there is a very strong possibility this diver has a patent foramen ovale (PFO) assuming he was not assessed for one after the first hit in Fiji. A PFO allows silent bubbles on ascent to cross from the right to left sided circulation. These paradoxical emboli can then obstruct blood flow to the brain or spinal cord resulting in stroke like symptoms.

Here is a case of a 32 year old fellow with a PFO found later who also presented with Type 2 DCS on ascent. Several points to notice in the article.

Sadly it took nine hours and three hospitals later until he was in a chamber. This is why one should always call DAN if the local hospital doesn't have someone knowledgeable in dive medicine.

It also mentions the fellow had possibly had four previous episodes of Type 1 DCS which should have raised some red flags.

A PFO is detected with a echocardiogram where bubbles are injected into the venous circulation following which the heart wall between the right and left atrium is watched for bubble shunting from the right to left side. There is an excellent video of this here showing the bubbles crossing the PFO. On the video your left is the right heart as the heart is upside down. The white material that appears in the right heart after a few seconds are the bubbles injected. It appears this is done twice. Figure 2 shows the heart's orientation and the green arrow is the PFO and the red arrows show the bubbles in both sides of the heart.

DCS 2/PFO Case

 

[BigJetDriver]

Anyway, I was planning a 3 day weekend of nonstop diving, possibly 5 or 6 dives in 3 days. Nothing deeper than 40 feet. But now I'm not so sure.

I would not change plans. Just do as previously mentioned, and don't short-change yourself on surface intervals. If you are a nitrox certified diver, that will help.

Cheers! Enjoy your diving!

 

[eponym]

My best wishes to Paul and his family for a good outcome and a speedy recovery.

Thanks for the detailed post, Kev. It speaks volumes about a good buddy relationship.

Bryan

 

[BigJetDriver]

Here is a case of a 32 year old fellow with a PFO found later who also presented with Type 2 DCS on ascent.

Sadly it took nine hours and three hospitals later until he was in a chamber. This is why one should always call DAN if the local hospital doesn't have someone knowledgeable in dive medicine.

Excellent case study. Thanks for presenting it. Excellent advice as well.

Cheers!

 

[BigJetDriver]

My friend took a bad hit today.---He's in the chamber right now.

I will let others read the entire post at the start of this thread, but I will add my complements to Kevin. He certainly did an excellent job of assisting his friend.

I echo the thoughts of the Most Ancient and Honourable Uncle Pug, in that I too believe, given the facts, that the man would be dead without the splendid performance of Kevin. I sincerely hope your friend will again be well, Kevin!

Well done, sir. Well done!

BJD

 

[sharkdiver00]

Kev, My thoughts and prayers are to your friend for a speedy recovery. Even in the face of a bad incident like that, he is so lucky to have had a buddy like you. Just think that had it been different, he would not even have a chance to recover.

Thank you for sharing with us what most definitely is a very sobering experience. Please let me know if there is anything at all I can do to help.

Don't overanalyze and be glad you were there for him.

cheers,
Maria

 

[Debraw]

Yikes. One more area (now I'm up to 3 or 4 major areas) in which I feel seriously shortchanged in my PADI OW training. From what I've read here, good hydration prior to diving is very important. If we covered that in our training (I don't even recall it being mentioned as a serious factor), we certainly didn't stress it as possibly being a critical factor in your safety. Thanks to all of you on this board I'm learning a LOT.
<SNIP>

Proper hydration is covered in the PADI OW manual and the DVD. All aspects of scuba diving are serious and should be considered a critical factor in your safety. The risk and assesment release you signed prior to class should have given you a pretty good idea of the enormity of the situation. It is terrible you feel "shortchanged" in your training. If you think you have some how missed more than what was covered in your OW class ("3 or 4 major areas"), you should stop diving immediately and go take another course wth a different training agency. To put a lot of the incidents and reports you read here into perspective you should do some research and realize the percentages we are talking about are very small. If you think Scubaboard is bad don't read Alert Diver magazine from DAN you will never get in the water again! I am serious man, if you really feel like you are missing something from your training don't dive. I am totally shocked you are thinking about doing 4 or 5 dives a day this weekend and you are literally afraid of what you may not have learned. You are setting yourself up for a panic dive moment if something, or anything goes wrong. You should feel confident in your training and you can tweak that confidence level by reading Scubaboard and other people's experiences. Good luck from a concerned fellow diver.

 

[Scubakevdm]

Okay, I can't figure out how to export the dive, but here's the numbers on the ascent:
Total ascent time was 8min,40 sec from 60' (6.9 fpm). This includes a 3min 32 sec ascent from 60' to 20' (11.3 fpm), a 3 min 20 sec stop at 20' and a 1min 48 sec ascent from 20' to the surface (11.1 fpm).

 

[pufferfish]

Okay, I can't figure out how to export the dive, but here's the numbers on the ascent:
Total ascent time was 8min,40 sec from 60' (6.9 fpm). This includes a 3min 32 sec ascent from 60' to 20' (11.3 fpm), a 3 min 20 sec stop at 20' and a 1min 48 sec ascent from 20' to the surface (11.1 fpm).

Looks good. A very nice slow ascent with safety stop. Please keep us posted on the diver's recovery progress.