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To follow-up on an interesting discussion from a few weeks ago, I'd like
to draw everyone's attention to an article in the most recent issue of
AquaCorps Journal (N5, BENT, pp 46-50).

The article, "In-Water Oxygen Recompression: A Potential Field Treatment
Option For Technical Divers", by Dr.  Carl Edmonds, discusses the pros
and cons of reimmersion recompression.  The article concentrates on the
Australian In-Water Therapy method, but also discusses other oxygen
therapys. There is a strong emphasis on the use of OXYGEN as the
recompression gas, and the need for access to a supply that will last
anything from 2-6 hours, at depth.

A second article, "In-Water Recompression: The Hawaiian Experience", by
Richard L.  Pyle, discusses the relatively high success rate found by
Hawaiian fisherman who have used a modified Australian method to
completely eliminate DCI symptoms in 462 out of 527 reimmersions.  As
the article states, an 88% success rate.  The article also indicates
that in 78% of the remaining cases, the condition was so improved that
no further treatment was sought.  (These fishermen frequently make
multiple daily dives below 40 meters, including some to as deep as 107
meters. Apparently, they consider DCI an occupational hazard, and expect
to have DCI several times, during a career averaging 11,000 of such
dives.)

These articles make one point: that in-water treatment can and does save
lives. One of the articles indicates that treatment in ANY case of DCI
should be commenced within 5 minutes of the onset of symptoms, because
this greatly increases the effectiveness of all subsequent treatment.

The articles, and earlier discussion here, do both highlight the need
for divers to understand the physiology of nitrogen absorbtion, and the
need to have to ability to determine the most appropriate course of
treatment for the problem that you have encountered.  There is no
simple treatment plan that will guarantee a cure.  In some cases, it
may be necessary to reimmerse on oxygen to 50m; in other cases, 9m 
may be OK.  The articles do give an insight into the theory of the
methods.

To me, this reinforces the need to carry supplementary oxygen tanks that
are not considered to be part of the dive plan.  I am tempted also to
carry a spare tank of a high NITROX mix, such as 60-80%, for use if
deeper treatment stops become necessary.  I submit, and I counter Bill
Mayne's point in an earlier article, here, that NONE of us here really
do dive sufficiently close to a recompression chamber to be able to rely
on making it to the chamber for treatment.  I would much prefer to have
the option of commencing a treatment program myself, than to not be
prepared to do so, and be forced to suffer potentially dehabilitating
consequences.

	-jr

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