Therapeutic treatment for DCI

[Phill]

Have just been reading a lot of your posts on various angles of chamber treatments, and find some conceptions ....hmmm...interesting. Though I'd post a brief run down of therapeutic chamber call out and use.
England and Scotland have similarities, and vast diferences, but basically:-
In England the government is in the process of bringing in "care standards", this was written for the granny farms, but encompases all chambers used to treat NHS patients, and remember if you're not an NHS patient you get the bill ! All chambers have to be examined, annually, under this in order to accept patients. In Scotland we pre-empted this and have been NHS audited for more than 3 years. All approved chambers are also members of the British Hyperbaric Association, which has enabled the set up of the two 7/24 helplines.
Now solely Scotland. The audit doesn't just look at the pot, but at your staff, training, hospital, links with SAR units, treatments etc. The NHS authorised chambers, that are currently functioning in Scotland are at Aberdeen, Orkney, Shetland, Dunstaffnage (Oban), and Millport. We all link up as a unit, and match patients to chambers. (Big difference inbetween Sc & En is that work together, as a unit with satellites - south of the border they all act independantly). We have all agreed upon "best practice" with the NHS and are upgrading to that level (Aberdeen and Oban have achieved this, Millport will when the new chamber arrives next month and Orkney will be there later this year), at this point only the lack of intensive care medical staff will limit any chamber from any air treatment. (Whether we want to do it or not is a different question !, to date Millport's longest treatment has been 47 hours - and I really would rather not go there again.
Call outs. Normally via the Coastguard - Ch16, GMDSS, or 999. The sooner you get to a chamber, the better. However many don't know/admit that they are bent for a period of time. In this case 999 coastguard will put you through, via the ops room tto one of the two helpline numbers. These are not solely for emegencies, feel free to use them for medical advice also. You may also call them directly yourself. In England the no. is 07831 151 523, this is directly to the duty doctor. In Scotland 01224 681 818, this gets you a switchboard, ask for the duty hyperbaric doctor. They will then send you to the nearest A&E unit, and arrange for the nearest available chamber to stand up (with emphasis on available, only the CG know when chambers are busy/undergoing maintenance etc).
Then all you've got to do is get repaired.
Please don't delay, we are not judgemental and early presentation makes life a lot simpler - but it's your body (and you've only got one), as I always say, it doesn't hurt me, I keep my fingers out of the way when I shut the door. It is always somewhat frustrating to get the history off the patient, and a totally different tale from the partner/PDC download.
PFO's, one in five of you have got it, usually it's a gee whizz phenomenon. Testing is available at all main cardiology units, but unles you're getting bent at 20m for 20mins with no yoyoing or rapid ascents etc. do you really want a syringe full of aerated saline injected into a vein ? (By the way Tom Shields retired some 10 years ago, last heard of drifting around somehere off Marseilles in his yacht - lucky swine).
Sorry its a bit long, promise never to go on as much again.

[peter k]

Hi Phill,
Don't know whether you are big, medium or small Phill, but thanks again and I hope your plans work out over the next 4yrs.
Peter

[Jay]

Hi Phil and welcome to the boards. Don't complain about the length of your post mate - all good stuff and, as you say, contains a lot of correcting of mis-information within diving circles. Cheers for all the phone numbers etc.

[Mr T.]

Hey Phill,

Absolutely no apology needed mate. The level of detail and the fact that it corrects a number of misconceptions is what's important - and thanks again for that!

Welcome to YD, and look forward to reading your future posts.

Cheers,

[Phill]

Thanks Peter, big one (or, as apparently I'm now titled "Hyperbaric Therapy Provider", dunno what's wrong with Chief Diver).
Dive Computors, read the instructions, they all tell you not to rely on them totally for decompression information (and one tells you that if you do you will suffer from DCI at some point). They're a very useful tool, but remember you're carbon based - they're silicon based and humanity hasn't evolved (although kit has) since the basic laws of physics and physiology were worked out (when tables were calculated by putting people in chambers and bending them!). They are specifically banned from use for sole decompression information in the Diving Operations at Work regulations 1997 (and no aspect of the industry objected to this in the regulation writing period).
In 1989 two things happened of significance in the recreational diving world, and sports bends in Scotland statistically trebled that year. This has been maintained ever since - with the obvious steady upward trend accountable for by the increasing popularity of the sport. BUT we are all seeing a steady increase in the severity of the type of bend.
Think that's covered most of the uncertain remarks over the last couple of days - probably not though.

[Dr Stevil]

Good stuff Phill, nice to have the gen from "the horses mouth".

BTW, you're not Philip Smith from Millport are you? Your profile doesn't give your surname.
Chee-az
Steve

[Phill]

Nope, Phil Smith is training up as an internal attendant though. He's the "mid Phil" Peter K refered to.

[Dr Stevil]

Ah.. so going by that, you are at Millport then, are you the guy who told me (this was 1999) about being involved in testing the submarine escape hood? Plus you're a good friend of Chris Frid if my memory serves me correctly ?
Chee-az
Steve

[Phill]

Yup, 150m+ on air (v.v.v.briefly) long after I'd stopped diving, and yup to Friddy.

(Edited by Phill at 12:17 am on Jan. 30, 2003)

[Dr Stevil]

Yeah I remember you well Phill, I think I've still got a crick in my neck from having to look up so far to talk to you (Hey, YD-ers, don't upset this guy, he's massive ;)      )

I was at Millport with Chris & Co in 1999 supervising some undergrads. I remember another diver, think his name was Hugh (not sure), used to have that ex-military (SBS?)skiff for fishing from. I heard the G'vnt gave him some grief like "where did you get this from..."

Bet everyone's intrigued now by your "150M on air"  ;)
Chee-az
Steve




(Edited by Steve W at 10:20 am on Jan. 30, 2003)


(Edited by Steve W at 10:41 am on Jan. 30, 2003)