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Stodelle
09-25-2003, 09:47 PM
There has been much talk about hyperbaric chambers. While I hope none of you get to take a ride in the chamber, you may be surprised to know there is a chamber close by.

Many people are not aware that their local hospital may have a chamber or 2. While these are not the large walkin chambers we see pictures of in the dive magazines, they are none the less just as effective. Many hospitals now use small, single person hyperbaric chambers to treat a large number of medical illnesses, not just dive related injuries. Some hospitals use their chambers for anything from diabetic wounds that will not heal to burn victims who need an oxygen rich environment to promote healing.
But, just because your local hospital may have a chamber, this doesn't necessarily mean they can treat dive injuries or have staff that can. However, they can be a great first response with a little coaching.

The Divers Alert Network can advise a chamber operator on a basic treatment, long enough to prolong an extensive injury until a trained doctor can evaluate the diver. In fact, it is often times much faster, and cheaper, to have a dive specialist come to the injured person rather than the other way around.

I 1st learned of this while diving for the Sheriff's Department. We often times dove at depth and at altitude. It was not uncommon to do a 150' dive at almost 8000' asl and unfortunately, we had some of our deputies who had to be chambered from an accident. The problem we ran into was that the common protocol for a dive injury is to airlift the injured diver to the closest dive chamber. Well, for us it would have meant an almost 1 hour helo ride, not to mention having to climb to altitude for the helo to clear the mountains. This is one of the worst things you can do is take an injured diver to altitude as it can cause more problems (ie. no flying after diving). We learned of a local hospital that had 2 of these solo chambers. The deputies were taken there, put in the chamber, DAN was called, computers were reviewed, and soon the dive doctor was there to assist in the treatment. No doubt that adding those additional risks, along with the delays, could have spelled havoc on the divers. But by doing it this way, their treatment had already been started at the doctor's directions, before he even got there.

Some recommendations for all divers:

1) If you are not a member, or do not have any dive related insurance, check into it. Carl Huggins who runs the Catalina Chamber in California estimates the average chamber treatment at close to $10,000. A $64 a year policy at least covers that, and gives you access to specialists who can answer ANY dive related injury questions.

2) Before your dive, call DAN, or your local hospital, and ask where the nearest chambers are located. You do not have to be a member to get this info. While a dive specific chamber is great, just knowing where the closer, smaller chambers are can save your life too. Not to mention, you or your dive partner can tell the medics where they should head and be on the way that much quicker. DAN tells people to call if there is an emergency, but when minutes count, a little pre-knowledge can be beneficial.

3) Don't be macho! If you think there is a problem, don't play the "I'll see if it gets better" game. Every year there is a story of someone who dies later from a dive injury when all the signs were present. While noone wants to look like a fool and "jump the gun", noone wants to be dead either for their image.

Be safe and remember that the sport we all love can also be dangerous.

ogredive
09-26-2003, 07:39 AM
D.A.N. is an outstanding organization. I have been a member for over 10 years and thankfully have never had to use them for accidents. Their staff is top notch and have physicians that are famial with diving physiology. Most primary physicians have no clue about diving medicine or phsyiology and can actual give you advice that can be fatal. DAN is there even for the small stuff. Once I was doing a lot of diving off the beaches on Fl East coast. I was only in 20' but was getting serious vertigo whenever I surfaced. Made a free call to DAN and was put in touch with one of their physicians. He said I probably had an inner ear imbalance and to take some Bonine. I did, it worked, never had a problem again. All it cost me was the few bucks for the over the counter drug and my life was back to normal.

I think another great advantage of DAN is when you travel. A lot of these great dive destinations around the world wont have a chamber for hundred sometimes thousands of miles. If there is an accident DAN will make sure you get the treatment you need and immediatly.

chris allen
09-26-2003, 09:02 AM
Very good post, but depending on the area you live, you may have a local chamber that you will not be allowed to use. In the Tampa area, St.Joes has one, but refuses to treat any diving related injuries. The closest is in Orlando. They do not consider being bent as a "life threatening" injury and will refuse to treat you. I am not sure how they can refuse treatment, but they just did to a friend of mine. Stodelle makes excellent points to gather such info before you need it.

fishhunta
09-26-2003, 09:11 AM
I was talking to a local cop and he told me that there are 3 chambers in boca, where i live. that was interesting to me because i always thought i would have to go to st mary's in wpb. i guess there are more of them than we think. i have 4 friends who have gone, it doesn't sound like fun at all......

Stodelle
09-26-2003, 10:23 AM
As far the hospitals turning someone away, this is probably because most of their hyperbaric medicine techs aren't familiar with dive accidents. Again, a call to DAN who can get a top notch physician on the phone, and explain the procedure, may help. A hospitals biggest fear is liability and that is possibly why they say "no dive injuries", however, think of the liability they face if they say "NO" and then you keel over right there for their refusal to treat you.

DAN really is a great group to be a part of and the benefits they offer far outweigh the annual fee.

Doyle
09-26-2003, 10:25 AM
If anyone out there works for a hospital that has one or more of these small chambers, please tell me if this is true. I heard once before that some of these mini-chambers are not suitable for diving injuries because they are limited to about + 1 atmosphere. Hyperbaric medicine for the treatment of burns, diabetic circulation, etc. requires putting the patient at a pressure at less than + 1 atmosphere and feeding them pure O2 in order to saturate the tissues with oxygen. Therefore, the chambers don't need to be designed to handle the pressures required for DCS. Does anyone know if this is true?

Stodelle
09-26-2003, 12:44 PM
I know the hospital we took our guys to had them back at almost 3 atmospheres since they had made an emergency out of air ascent from about 80 feet. They were small solo size tubes with a sliding table like a morgue cabinet. They were pretty much shoulder width, but the tube was definitely built tough. They also had a small tv so that the person inside could at least watch a movie during the treatment.

richhermes
09-26-2003, 02:46 PM
I hear they don't even staff the chamber at St. Joe's anymore

Bottom Dweller
09-26-2003, 11:40 PM
Doyle,

What you have said is true. I have a friend who runs the wound care unit at Ed White Hospital in St. Pete. He discussed this with me and you are correct about the limitations of 1 atm or close to that. They could be used for some cases but definetly not all.

The chamber at St. Joe's is not currently staffed. My friend used to staff it but I think it was possibly a budget issue for the hospital to stop staffing it, but I'm not sure.

TGuthrie
09-27-2003, 07:47 PM
I know a guy who took a ride in the "Chamber" , and the nurse got narked out and started stripping. Screw the TV, I would opt
for the stripping nurse.

Tom

IyaDiver
09-29-2003, 05:40 PM
I guess I am lucky. There is a Navy hospital in my city who has a few chambers. I been in the chamber 3 times. No, there was no nurse to keep me company.........:D.

Once was for fun at 60 feet, 1 hour. I know it is stupid to do it for fun, but then I didn't know it shouldn't be done for fun even at 60 feet.

Second was for mild bends, 5 hours at 160 feet equivalent.

Third was to keep a friend company, another 5 hours at 160 feet equivalent.

If you look for a chamber, make sure look for one with an air conditioning set or else it feels like a sauna. Bring lots of water and a blanket or coat for those A/C chambers.

If you want to talk like a duck, a chamber is a good place to practice, at 120 feet or deeper we all sound like Donald Duck.

I swear I never want to go to any chamber anymore, not even for the biggest fish. It is boring and the equalizing in air pressure is so much more difficult and so often for my bad ear, compared to in water.

pristine
09-29-2003, 08:12 PM
I spent two days totaling 13.5 hrs in the one in Jax Fla. I could not help to question the 160 depth. They put me on pure oxygen almost the entire time and had always been told 20 ft was max for pure o2. They did start me at 60ft but only stayed there one hr then to 30 ft for the rest of the time. I don't believe one wouldn't acquire oxygen toxcicty at 160 on pure o2

Chad Carney
09-29-2003, 09:34 PM
Tommie,

It's funny how the story changes over the years.

Our friend that took the chamber ride with "Tanya the Medic" was too busy drinking fluids and pissing in the urinal to enjoy her company. She just didn't want to sweat her ass off in there, and I can't blame her. Imagine being inside that tank you're filling!

BTW his chamber ride was at Shands in Gainsville after 8 dives in the Grounds, and already showing signs on previous trips.

The schedule from the dive computer on board:

30 min. @ 160 ft. (6 ATM)
75 min. @ 60 ft. (3 ATM)
30 min. ascent to 30 ft. (2ATM)
78 minutes @ 30 ft before the computers memory maxed out. (I think I remember it was about three hours at 30 ft.)

Guys,

Don't think any 2 ATM burn unit chamber is going to help you out after the kind of diving we all know you're doing!

My thinking is to prevent , not treat.

Chad

IyaDiver
09-30-2003, 12:22 AM
I don't know about hyperbaric medicine but the doctor always asked, how deep was your deepest dive ?.

They have this set of tables and I got to get threatment for the 160 feet, because that was the max depth I did.

The pure oxygen comes from a mask, not pumped into the chamber. They will announce on the PA when to inhale it. As far as I can remember, there is no O2 intake at deeper than 60 feet and in that 5 hours, only about 2 hours are 02 intake and they split in like every 30 minutes or so. The 160 feet treatment will be only at 160 feet equivalent maybe only 1 hour of the total 5 hours.

If you guys want to bring a dive computer in a chamber, make sure put it in a jug of water. Direct air makes the computer goes weird, I think the pressure sensor got confused.

webers
09-30-2003, 08:20 AM
I've been on a chamber ride at St. Joes. They put an MD in there with me. It was damn hot. I realy didn't care to see him strip. I recall they cranked me down to 180 or more. Was too busy trying to suck on that mask to pay attention to many details. At least they had books in there to read. One on diver safety no less.

In the end, it turned out that it was probably food poisoning, not the bends.

Stodelle
10-02-2003, 12:53 PM
I had the joy of doing a chamber ride in Catalina. it was for a class for the Sheriff's dive team to show the effects on the body and mind at depth. We hit 165' with 5 of us in the chamber, and the nurse/chamber attendeant. We had to do a bunch of little tests (ie. put shapes in the holes, answer math/tables questions). Our team did great but the nurse was absolutely wasted. It was weird because going down (to depth, not the other you sick dogs...) the room was really warm. As soon as we started the ascent, the room got freezing cold. It was an interesting experience. Enough to know I'd hate to ever do it again.

Steel Shootin'
10-02-2003, 01:04 PM
Chad,

Don't ruin it for me! I like the "stripping nurse" version better! :D Next time it's told, it'll be the nurse that stripped and then performed unspeakable acts on the bent diver. :eek:

richhermes
10-02-2003, 02:10 PM
It's the Mons Venus Deco Chamber.

You get a t-shirt after every visit that says "I got bent at the Mons!"

cavedivr1
10-30-2003, 01:33 PM
I was in the chamber in Orlando it took awhile for me to get in but after I got in it wasn't to bad besides being cold and loud and nothing to read (bring a book if you have a chance) a nurse was in there with me but all she did was sleep not strip.

Adam