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On Thu, 8 Dec 1994, Robertson, Iain wrote: > > Rich, > Basically, BSACs attitude is : Inwater recompresion is a total no-no. > This may sound extreme, but their reasoning is as follows: > IWR on air has many problems. Uptake of N2 during the therapy, risk of > DCI getting worse, diver going unconscious, risk of DCI to support divers, > having enough air onsite to conduct therapy, hypothermia (especially in UK > waters!). > > IWR on O2. hypothermia etc as above, risk on convulsions if depth > limits exceeded ( not too bad if patiient has a full-face mask I suppose), > and again, the amount of oxygen needed to conduct what could be (if I > remember correctly) a 3hour + therapy. > > In any case, if you're diving the UK,you're not going to be *that* far > from a chamber, so putting the patient on 100% O2, and screaming for a > helicopter is a good option. > > In the UK case, I'd agree with them. If I was (say) in Truk 2000 miles > from a chamber, I may reconsider..... Iain, Thanks for the response. I received several others from UK divers, all of whom said virtually the same thing (whether or not they approve of IWR in general). Given the environmental conditions and emergency network, I'd almost certainly opt for the chamber. The story is quite a bit different throughout the tropical Pacific. It certainly would be nice to have the same level of chamber proximity and prompt emergency transport out this way (well, in Hawaii we do, but in most other places we do not). Now, for something completely controversial.... (Disclaimer: The following is MY OWN OPINION, and should NOT be taken as any sort of recommendation, advice, or endorsement...) It is well established, even by supporters of the practice of IWR, that there are many theoretical disadvantages to attempting IWR if only air is available as a breathing gas. Nevertheless, after researching the topic rather extensively, and in consideration of my own personal observations and experiences, these theoretical disadvantages are not substantiated by reality in the vast majority of cases. If I were much more than 30 minutes away from a chamber, and I began to experience potentially serious neurological DCI symptoms, and no oxygen was available (but air was), I probably wouldn't hesitate to jump back in the water. (Bear in mind that I NEVER intend to be in such a situation, as I almost always have Plenty of oxygen around when I conduct even remotely hazardous dives). I still maintain that I am not especially "pro-IWR". The decision to attempt IWR depends on MANY factors, and I submit that there are very few broad generalizations that can be made about the topic. Now THAT oughtta stir things up a bit! I'm wearing my asbestos suit, so fire away.. Aloha, Rich deepreef@bi*.bi*.ha*.or*
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