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On Thu, 8 Dec 1994, Kevin-Neil Klop wrote: [ SNIP ] > > While Christina is possibly correct and that the time between the call to > the Coast Guard and the time that the patient actually begins recompression > in the chamber is longer than 30 minutes, it's not as clear a question as > it first appears. > > The only time that counts, as far as I'm concerned, is the time until a > patient can get picked up for transport to the chamber. Seems to me the only time that REALLY counts is/are 1) the time until oxygen is administered (in-water or not), and 2) the time until recompression. > "What if that > person is in for a two hour ride to the chamber after that, though? > Doesn't mean that the person is, for all intents and purposes, untreated > for 2 hours?" Yes, it does. However, at that point you're balancing two > things. First, it is a given that treating DCI as soon as possible after > the onset of symptoms is a "good thing". On the other hand, treatment with > professionals in controlled circumstances is also a "good thing". Let's > assume that you the coast guard could get to you in 1/2 an hour (because > they have a base nearby), but that it will be 1 + 1/2 hours before you can > enter a chamber (because the nearest available chamber is 1 + 1/4 hours > flight time and it takes 1/4 hour from landing to entry into chamber). > Should you have the helicopter standby (or not call them) and attempt IWR > instead? Why not, if O2 is available, have the afflicted person wait for the helicopter at breathing O2 underwater, rather than sitting in the boat? Best of both worlds. If IWR is working, maybe have the helicopter wait for a bit.... IWR & chamber treatment are not mutually exclusive. In fact, a visit to the chamber should ALWAYS follow IWR. > > I have a gut instinct that says "no". What if it will be 4 hours until > entry into the chamber? Now my instincts say, "Depends on the severity of > symptoms". We each need to make that call for ourselves. I've seen the miracles that IWR can produce, so for me it's half an hour. For others, it may be 2 or 4 or 6 hours. Others may decide to NEVER attempt IWR under any circumstances. There are no rules...there really isn't even much in the way of good advice... Aloha, Rich deepreef@bi*.bi*.ha*.or*
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