Shallow depth DCI

[String]

A may simply be the mindset of medical system to err on the side of caution. Someone comes in with symptoms that resemble DCI and has been diving. There is no clinical way such as xray, CT scan or MRI or other test to positivly determine it is DCI so they treat it as DCI and it goes on record as DCI. It could be if those same people went home and took a nap the result would be the same as the DCI treatment.

If someone comes in with DCI symptoms (one case was a skin bend, another a neural) and its resolved with chamber treatment there's not a lot else you can conclude other than DCI. Its no less clear cut than someone with the same symptoms who has missed stops or similar.

 

[String]

Thats fair enough and its your choice but im going to side with the people who have the PhDs, MDs and 30+ years experience of both navy and civilian hyperbaric medicine over that.

 

[Nemrod]

Thats fair enough and its your choice but im going to side with the people who have the PhDs, MDs and 30+ years experience of both navy and civilian hyperbaric medicine over that.

Thing is, they don't either. Today liabiliy is the driver, not science. PHDs, lol, hmmmmmm .

N

 

[fisherdvm]

Thing is, they don't either. Today liabiliy is the driver, not science. PHDs, lol, hmmmmmm .

N

Lots of truth in that. I saw a lawyer in my office once. He had a rash. It did not look like anything bad at all. Next day, he called me from the hospital, saying that he had disseminated herpes zoster and was admitted for iv treatment. Of course, I was worried of a lawsuit. Fortunately, I did my job, and did do a skin biopsy (concluded it wasn't herpes zoster). About two months later, he came back in, and told me they also concluded it wasn't herpes zoster (probably after about $9000 in drug, labs and hospital fees). But $9000 is probably cheap insurance for a lawsuit.

Bottom line is, sometime doctors act differently, when you are a lawyer, or when you are at risk for getting sued. I'll bet 1 out of 4 admissions to a chamber is for a questionable case of DCS.

 

[DandyDon]

I spoke with a physician in Lubbock once who owned a clinic of hyperbaric beds being used on wonds and CO poison I think. We tried it on my dad's wound, but that was a last-days struggle and he refused to continue it so I don't know if it would have helped him. I started being suspicious when the doc told me he'd once treated a college kid for bends after riding the elevator out or Carlsbad Caverns. :silly:

 

[MattC007]

Sounds like an embolism to me.

 

[fisherdvm]

I spoke with a physician in Lubbock once who owned a clinic of hyperbaric beds being used on wonds and CO poison I think. We tried it on my dad's wound, but that was a last-days struggle and he refused to continue it so I don't know if it would have helped him. I started being suspicious when the doc told me he'd once treated a college kid for bends after riding the elevator out or Carlsbad Caverns. :silly:

I don't think you need a degree or qualification in hyperbaric medicine to own and operate a chamber. I think wound care centers often use such device (and bill a good fortune for it too). If the elevator was going too fast, perhaps you can get the bends? I do recommend that folks stop half way up a tall building, and wait for a 1 minute safety stop for every 10th floor you are going to ascend. I think this is what Naui teaches now.

 

[DandyDon]

I don't think you need a degree or qualification in hyperbaric medicine to own and operate a chamber. I think wound care centers often use such device (and bill a good fortune for it too). If the elevator was going too fast, perhaps you can get the bends? I do recommend that folks stop half way up a tall building, and wait for a 1 minute safety stop for every 10th floor you are going to ascend. I think this is what Naui teaches now.

After talking to him, I wondered if I wouldn't be safer making my own chamber in the barn with some heavy duty PVC pipe, pressure valve and guage hooked up to the compressor we use to air up low tires, and a mask hooked up to my cutting torch oxygen. If I took a hit after driving home from Santa Rosa NM, surely DAN would not send me to his place. :dunce:

 

[captain]

If someone comes in with DCI symptoms (one case was a skin bend, another a neural) and its resolved with chamber treatment there's not a lot else you can conclude other than DCI. Its no less clear cut than someone with the same symptoms who has missed stops or similar.

I think I possibily had a case of skin bends years ago, could also have been a rash from something I unknowing contacted. Without a better discription of what the neural symptoms who knows, mini strokes resolve themselves pretty quickly with no treatment.
I have to agree with Nemrod. If such a small change in pressure could cause DCI pilots of military fighter air craft would be prime candates for DCI when making high speed climbs to 40,000 feet as most fighter aircraft are not pressurized to that altitude which is more of a pressure drop than 4 feet to the surface.

 

[Charlie99]

I have to agree with Nemrod. If such a small change in pressure could cause DCI pilots of military fighter air craft would be prime candates for DCI when making high speed climbs to 40,000 feet as most fighter aircraft are not pressurized to that altitude which is more of a pressure drop than 4 feet to the surface.

I do know an Air Force jet jockey that got DCS during his annual chamber ride at Hollis AFB. He privately admits that he went off the 100% O2 prebreathe for a while, which is probably the aggravating factor that caused him to get bent. IIRC, the profile he "flew" was a run up a few thousand feet and then back down to check sinuses,then to 8,000. After a while at 8,000 they rapidly ascend to 18,000 for a minute or so for hypoxia check and O2 mask checks then on up to 25,000' for a while.

He started having symptoms a few hours after the test and went to the infirmary, where they basically said "take 2 aspirins and see the doc in the morning". He was kind of surprised considering all the warnings he had been given before the test, but shrugged his shoulder and took off with his girlfriend for a night on the town. Shortly thereafter, the duty doc heard about the case and decided to get him recompression treatment. Since he had taken off to Las Cruces, this resulted in a massive manhunt and a bewildered aviator getting pulled over by a New Mexico cop that knew nothing other than the Air Force wanted him. Badly.

It isn't just the absolute pressure changes that cause the problem. It's more directly related to pressure RATIOs, and popping from surface to high altitude is more akin to popping up rapidly to sea level from a days or months long dive in the 20-25' range.

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As for the scuba incidents under discussion, I see three possibilities ---

1. It was truly DCS/bends.
2. It was embolism/AGE.
3. It was not truly DCS, but the treatment is low risk and non-harmful so why not recompress just to be safe.

Like many incidents, I doubt that anybody will ever actually know. My bet is on #3 for the 4' incident.