Last weekend I attended the UHMS workshop on In-water recompression. I am 
please to report that, in my impression at least, the workshop was a 
great success.  A vast range of viewpoints from one polar extreme to the 
other were represented, and other than a few jovial exchanges, there 
wasn't any time-wasting bickering.  Perhaps what was most significant (in 
my estimation) was that everyone (including both ends of the spectrum) 
seemed to agree on these fundamental premises:

1) IWR is a useful and valuable tool in some circumstances to some divers.
2) IWR is not the optimal response to DCI symptoms for all divers in all 
circumstances.
3) Before we can determine the appropriate divers and appropriate 
circumstances, we need to get a better record of actual IWR attempts, 
that is more than just retrospective and/or anecdotal incident 
documentation.

What was most significant to me was number 1 above. While there were 
certainly differing opinions on what realm of divers should consider IWR, 
and what specific techniques should be used, I didn't hear anyone claim 
that is a completely invalid procedure.  Nor did I hear anyone suggest it 
should be as standard a response to all DCI circumstances.

It would take too long for me to recount all of the details discussed 
during the all-day workshop.  Anyone interested in further details can 
obtain a set of audio tapes of the full session from:

Tree Farm Communications, Inc.
23703 N.E. 4th Street
Redmond, WA 98053-3612 USA
Phone: (800) 468-0464
Fax: (425) 868-2495
email: audiotapes@ms*.co*
Web: www.treefarmtapes.com

The IWR workshop spans 5 tapes, and the number for the set is: 
UH85-291/295. The order form I have says that a 5-tape "session" costs 
$40.00 plus $8 S&H, but there is a comment that: "Tapes ordered after 
June 24, 1998 Add $1 per session" (whether that means you'd need to add 
$1 or $5, I don't know). There are other sessions from the UHMS annual 
meeting that were recorded on audiotape, so you might want to look into 
the other stuff that is available.

Also, there will eventually be a proceedings published from the IWR Workshop. 
My contribution to that will include a full description of my own IWR method,
including a decision-making flow-chart. 

Perhaps the most important outcome of the workshop is that the stigma 
associated with attempts at IWR has been lifted.  I got the strong 
impression that the importance of gathering data on actual IWR attempts 
vastly exceeds the need to scold divers who attempt this non-standard 
procedure. After the workshop ended, Bill Hamilton came up to me and 
asked how we could convince the technical diving community to carefully 
document and report cases of attempted IWR to proper data repositories. 
Dick Vann indicated that the standard DAN accident report form included 
fields for information on IWR attempts.  So, my hope is that the 
technical diving community will be extremely diligent in documenting any 
attempts at IWR, and reporting them to DAN. Now that the stigma is gone, 
it is in our best interests to start the data gathering process.

Major points of information that should be acurately and precisely 
recorded for any IWR attempt include:

1) Characteristics of the diver (age, sex, physical build, dive 
experience, etc.)

2) Characterization of dive situation (location, water temperature and 
other environmental conditions, distance to nearest chamber, availability 
of equipment, etc.)

3) Precise documentation of dive profiles leading up to the IWR attempt 
(including gas mixtures, ascent rates, etc.)

4) Detailed description of nature of syptom onset, including time after 
surfacing before first symptoms, nature of symptom progression, etc.

5) Detailed description of IWR procedure, including time after symptom 
onset
until re-imersion, depth profiles, gas mixtures breathed, equipment used,
environmental conditions, etc. 

6) Any events or other complications that occurred during the IWR attempt 
(e.g., problems with currents, ability to maintain depth, thermal 
problems, adverse marine life, etc.).

7) Detailed account of events following IWR attempt, including subsequent 
treatment (e.g., surface O2), symptom progression, and subsequent 
transport to chamber.


So...this is not to encourage anyone to attempt IWR who wouldn't have 
attempted it anyway.  If you don't know what you are doing, DO NOT try 
it!  However, this *is* to encourage anyone who does attempt IWR to 
PLEASE PLEASE PLEASE record as many specific details as possible, and 
report it to DAN or some other database repository.

Thanks for your attention.

Aloha,
Rich

Richard Pyle
Ichthyology, Bishop Museum                deepreef@bi*.bi*.ha*.or*
1525 Bernice St.                          PH: (808) 848-4115
Honolulu, HI 96817-0916                   FAX: (808) 841-8968
       "The views are those of the sender and not of Bishop Museum"

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