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At 04:07 PM 5/3/98 -0400, you wrote: >Also on oxygen tolerance, a god way to avoid the need is to (let the slams >come) use eAN 80 on training dives begining at 30 feet. Why just training? <*For the record: I use O2*> >Tom Mount >-----Original Message----- >From: Bill Wolk <billwolk@ea*.ne*> >To: wwm@sa*.ne* <wwm@sa*.ne*>; Cavers List <cavers@ca*.co*> >Cc: Techdiver List <techdiver@aquanaut.com> >Date: Saturday, May 02, 1998 9:19 PM >Subject: Re: New Requirements > > >>On 5/1/98 1:36 PM, wwm@sa*.ne* wrote: >> >>>In speaking to a friend of mine who advises insurance carriers I learned >>>that some new requirements may be coming down on the tech diving >>>industry. >>> >>>It seems that given the shocking record of accidents and fatalities of >>>late one means of diminishing some of the risk may be to require Stess >>>testing in conjunction with PFO and oxygen tolerance testing. >>> >>>In my opinion it is very wise to perform these tests regardless of >>>whether they are a requirement or not. The commercial diving industry >>>considers this form of testing to be a mandatory prerequisite. Tell me >>>why we shouldn't follow suit? >>> >>>Bill >> >>Bill - >> >>I was going to respond to this when Dan Volker first posted the idea of >>mandatory PFO screenings. In principal, it's a very good idea -- >>especially for any kind of decompression diving -- but lets put a >>practical framework on the PFO issue: >> >>First, based on DAN statistics, PFOs are present in an estimated 10%-15% >>of the population >> >>Second, diagnosing one requires -- at a minimum -- an echocardiogram with >>contrast (aka a bubble echo) which costs approximately $1,000.00. (I >>know -- I just had one done.) >> >>Third, even bubble echoes will not diagnose small PFO shunts because of >>interference from the rib cage. (This was surprise info from my >>cardiologist while the bubble echo was being performed.) To truly rule >>out a PFO, you have to get an endotrachial bubble echocardiogram in which >>a miniturized echo device is actually lowered down your throat to produce >>an internal picture of blood flow through the heart. I didn't look into >>the cost of this procedure, but since it involves intubation and >>anesthesia, I think it's safe to say that it won't be simple or cheap. Do >>you know of anyone who's taken it this far? >> >>That said -- it you can afford it or have medical insurance that will >>pick up the tab, it's not a bad idea. I though it was important to do >>before starting mix dives and squeeked mine through my PPO insurance, but >>it wasn't easy. As for Ox tolerance testing -- not sure it would show us >>much since the ox tox threshold varies so much from day to day and dive >>to dive even in the same individual. >> >>Perhaps rather than make it mandatory, a bubble echo should be strongly >>recommended by the tech certification agencies and this recommendation >>should be backed up with a full and medically graphic description of what >>can happen to a diver with an undiagnosed PFO on a deco dive. Think of it >>as an informed consent -- "we're recommending this procedure; it's your >>choice not to get it; but this is what can happen if you don't" -- with >>that, some divers will have the procedure done and those who don't will >>at least have made a decision based on a clear sense of the risks and >>benefits. (Personally, I think the risks of most diving are underplayed >>in order to increase the market, but that's another issue.) >> >>Based on the info you've posted in the past and the DAN accident reports >>I've read, it seems like the vast majority of scuba accidents and >>injuries are earned -- from improper training, poor equipment >>configuration, bad gas planning, diving beyond limits, etc. -- and not >>from unearned causes like undiagnosed PFOs. Certainly that much is >>obvious about West Palm. It seems to me that we'd save lives and reduce >>risks more by setting higher training and equipment standards -- as you >>and George have been doing all along -- than by requiring expensive >>medical testing. >> >>Just my $.04 -- Sorry about the length of the response -- it was a good >>question! >> >> >> >>Best Regards -- >> >>Bill >> > >-- >Send mail for the `techdiver' mailing list to `techdiver@aquanaut.com'. >Send subscribe/unsubscribe requests to `techdiver-request@aquanaut.com'. > > -------------------------------------------------- Kevin Connell <kevin@nw*.co*> Northwest Labor Systems http://www.nwls.com Bellingham, WA -------------------------------------------------- -- Send mail for the `techdiver' mailing list to `techdiver@aquanaut.com'. Send subscribe/unsubscribe requests to `techdiver-request@aquanaut.com'.
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