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From: "Ingemar Lundgren" <ingemar.lundgren@mb*.sw*.se*>
To: "Sean T. Stevenson" <ststev@un*.co*>, <techdiver@aquanaut.com>
Subject: SV: Cold water risk
Date: Sat, 5 Sep 1998 02:45:06 +0200

The majority of the deco in Plura takes place 950m in to the system as teh
first part of the cave is shaloow. Any kind of habitat is impossible to
use. As you understand this cave presents some speciall problems not
normaly encountered. For this cave i will probably just have to accept the
risk as i have already done on previus dives. In OW there are ways however
to reduce the risks. 
Skipped deco is something that we can consider as a last case but to get in
to the water again might sometimes  bee dificult due to hypotermia
dependent on time needed to get to the surface. 

There is a device that is widely available to permit 
> core rewarming on site, which is powered by a rechargeable battery and
which will accept the flow 
> from your oxygen kit, heat and humidify it to saturation before
delivering it to the patient.  In 
> my experience this has been very effective in preventing the advancement
of hypothermia while 
> transporting a patient.

This is interesting as we have experienced loss of heat when braethin 02 
on the surface. Thanks a lot for your information.




> 	With direct reference to your post, Ingemar, I don't know how far from
the cave entrance 
> your decompression stops begin, so the following text may be
inapplicable.  If, as you suggested, a 
> habitat is required for this contingency, I think a dry habitat would be
best, not only 
> logistically, but for the fact that core rewarming (discussed below) as
well as other medical 
> treatments can be administered during the decompression.  Cave diving
certainly does pose some 
> unique problems.  I have assembled some thoughts on the suit flood
problem, although they are 
> probably more applicable to divers who can get to the surface reasonable
quickly...
> 
> 	As with any system component failure, the loss of suit integrity is
something that will 
> almost certainly occur at some point in time.  Many methods of decreasing
the probability of a suit 
> failure are in widespread use; however, most off these produce
characteristics that are detrimental 
> to the normal operation of the diver, such as excessive drag, non-ideal
buoyancy or increased 
> system complexity.  The probability of a suit failure is best reduced by
selection of a suit 
> appropriate to the environment (and consistent with all other suit
selection criteria), with good 
> puncture and abrasion resistance, and possibly reinforcing panels in
areas where abrasion is 
> anticipated.  Having said that, management of a flooded suit is something
we should all be prepared 
> for, specifically in cold water environments where heat loss can become
critical in a short period 
> of time.  Suit undergarments should be fabricated from non-absorbent
material.  In the case of a 
> slow or minor leak, such an undergarment will still retain much of its
insulating value.  The 
> undergarment should also be properly fitted.  This will not only
facilitate full mobility of the 
> diver, but in the case of a complete suit flood will limit the amount of
water circulation proximal 
> to the diver's skin.  A diver with a significant decompression obligation
who encounters a flooded 
> suit will immediately begin to exhibit physiological changes due to the
onset of hypothermic 
> conditions, which will reduce the effectiveness of the decompression.  In
cold water where the 
> advance of hypothermia is quite rapid, the diver is best to follow a
bailout involving the use of 
> %100 oxygen to get out of the water (before the onset of any critical
symptoms) and seek medical 
> attention.  Obviously, a portable surface recompression chamber would be
an invaluable asset in 
> this case.  Alternately, when an additional suit and set of undergarments
is available, the diver 
> may opt to interrupt the decompression to don the second suit and return
to the water to deco, or 
> to attempt in-water recompression.  For the details of both of these
practices as I would employ 
> them I refer you to one of my old posts with the subject :Interrupted
Deco.  I wish to make clear, 
> however, that this should only be attempted if the diver is not
exhibiting any apparent symptoms of 
> hypothermia (probably rare given the scenario).  As regards the treatment
of the hypothermic diver 
> at the surface, care should be taken not to apply heat to the
extremities, as this could result in 
> a shunt (due to enlargement of previously restricted blood vessels) of
cold blood to the core, 
> which can induce or speed up core cooling.  There is a device that is
widely available to permit 
> core rewarming on site, which is powered by a rechargeable battery and
which will accept the flow 
> from your oxygen kit, heat and humidify it to saturation before
delivering it to the patient.  In 
> my experience this has been very effective in preventing the advancement
of hypothermia while 
> transporting a patient.
> 
> -Sean
> 
> 
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