Why not treat DCS yourself?

[KenGordon]

This should be a significant factor in decision making in deciding to attempt IWR:

How bad is the DCS hit?

Missed safety stop, within NDL, and with no symptoms = no IWR

Did safety stop, within NDL, mild symptoms = surface O2, seek medical care, no IWR

Exceeded NDL just a little, mild symptoms = this one's a toss up, leaning toward O2, medical care and no IWR

Exceeded NDL significantly, mild to severe symptoms, chamber far away, got all the right equipment and support for IWR= now leaning more toward IWR

Major deco obligation missed, severe symptoms, got all the right equipment and support for IWR = IWR probably best bet, but big risk of drowning if symptoms worsen needs to be considered

Please do not construe the above to be recommended medical advice. This is all just hypothetical off the top of my head.

Have you considered consulting your training manuals?

 

[GJC]

Have you considered consulting your training manuals?

There are IWR manuals?

 

[Searcaigh]

There are IWR manuals?

IANTD has one

 

[GJC]

IANTD has one

I had no idea that this even existed

IANTD World Headquarters - In Water Recompression Provider

 

[jadairiii]

....Personally saw a guy nearly paralyzed completely resolved and returned to diving the next day on 2 occasions, not my idea nor condoned by me.He is still doing 300 plus dives a year without any further issues.

Trouble with even using this as an example for IWR is like using Alan Magee as an example why you dont need parachutes when jumping out of a plane.

Alan Magee - Wikipedia

 

[RyanT]

The DHM papers are usually embargoed for a year, but I got our department to pay the early release fee because there have been a lot of discussions about in water recompression IWR recently.

Thanks Simon, much appreciated; open access fees can be significant!

 

[charlier]

Simon, thanks to your department for providing open access fees. Excellent article.

 

[KenGordon]

There are IWR manuals?

Actually I don’t mean those. I mean follow your training for when to give o2 and how to handle a diver in those circumstances. If you read Simon’s paper there is only a small set of circumstances when that might not be ideal, you ought to be doing serious planning in those circumstances anyway.

The real solution is to avoid getting bent in the first place, especially if the concequences will be particularly severe due to location.

If you go a liveaboard somewhere moderately awkward they will not want you pushing your luck wrt DCS as if someone gets bent it is an enormous hassle for everyone. I suspect turning up with an IWR kit might make them a bit suspicious of your intent.

However, it looks like proper expedition diving would benefit.

 

[GJC]

Actually I don’t mean those. I mean follow your training for when to give o2 and how to handle a diver in those circumstances. If you read Simon’s paper there is only a small set of circumstances when that might not be ideal, you ought to be doing serious planning in those circumstances anyway.

The real solution is to avoid getting bent in the first place, especially if the concequences will be particularly severe due to location.

If you go a liveaboard somewhere moderately awkward they will not want you pushing your luck wrt DCS as if someone gets bent it is an enormous hassle for everyone. I suspect turning up with an IWR kit might make them a bit suspicious of your intent.

However, it looks like proper expedition diving would benefit.

Understood, and agree with everything you are saying. Thanks for the feedback.

 

[Searcaigh]

Personally having done the IWR course with Don Shirley, I wouldn't want to be doing IWR for real unless is was with a competent crew who are also trained. Therefore when we did the course we did this as a group and purchased two Kirby Morgan FFMs as well as down lines, switch blocks, QC cables etc., in order to manage everything should we need to do this ourselves.

As a tech diver group we always carry additional 100% besides the usual gases, but had to add tanks of air for the air breaks.

We do have a practice session planned in October / November.

Why did we do this course?

Well we did have a Type 1 hit with one of our guys last year after a 70m dive on a rebreather and despite breathing 100% on the surface for over an hour we still had to drive over a 500m mountain pass to get to Abu Dhabi where the nearest chamber was available and this took over 3 hrs.

Despite the patient breathing 100% all the way during the journey there was a significant increase in pain crossing the mountain.

I sincerely hope we never have to do the IWR for real, but we are prepared and trained for it.