scubadoc Ten Foot Stop

February 28, 2006

Baptist Hospital Chamber in Pensacola Readies for Oriskany

Filed under: Uncategorizedscubadoc @ 4:26 pm

Hospital trains for Oriskany diving injuries
Sean Smith@PensacolaNewsJournal.com

The soon-to-be-sunk aircraft carrier Oriskany is expected to become a prime divers’ playground, but Pensacola hospitals and emergency officials are bracing for dive injuries. Baptist Hospital will be the only local facility with a hyperbaric chamber to treat civilian dive injuries. The chamber at Pensacola Naval Air Station is for military divers.

The Baptist chamber, currently used to treat wounds and other ailments, will be ready for dive injuries by April or May, Dr. Kelli Wells said. The treatment of dive injuries is a very involved process that requires enhanced training as well as 24-hour staff, she said. “What we’re doing is increasing the level of training,” she said. “We’ll treat dive injuries as they occur, but my real desire is that we get information out there to prevent the injuries.” Currently, emergency crews divert dive-injury patients to hospitals in Mobile and Panama City, which each see about a dozen dive-related injuries a year.

The 32,000-ton, 888-foot long Oriskany, to be sunk before June 1, is expected to rest at about 210 feet down, 22 miles southwest of Pensacola Pass. The superstructure will be at about 60 feet and the flight deck at about 130 feet — the limit for recreational divers.

See remainder of article at http://snipurl.com/n1ge .

United Companies Brownie’s Third Lung Experiences Increased Interest in Its Nitrox Maker(TM) System

Filed under: Uncategorizedscubadoc @ 4:13 pm

Retrieved from “Market Wire”

FORT LAUDERDALE, FL — (MARKET WIRE) — 02/28/2006 — United Companies Corporation Subsidiary Trebor Industries Inc. dba Brownie’s Third Lung (OTC BB: UCPJ) is preparing to install another of its Nitrox Maker™ systems on a luxury yacht. In the last year, Brownie’s has experienced increased interest in this onboard Nitrox generation unit as general knowledge about the advantages of diving Nitrox becomes more recognized worldwide. Divers who use Nitrox instead of standard compressed air experience many advantages including reduced post-dive fatigue and reduced risk of decompression sickness when diving conservatively.

Brownie’s Nitrox Maker™ is a modular system, which aids in installation of the unit and makes it relatively easy to operate. To select a gas mixture, the operator simply uses the dials on the unit to choose the desired oxygen percentage for the final mix. The Nitrox Maker™ uses two independent oxygen analyzers to ensure the accuracy of the final mixture. The gas produced can either be used to fill scuba tanks directly or stored in a series of high-pressure tanks for future use. All of the components of the Nitrox Maker™ are encased in a King Starboard® cabinet that allows for easy installation and an attractive finish.

Brownie’s custom designs each Nitrox Maker™ to accommodate personal diving needs and the vessel’s available space. Many existing air compressor systems can be upgraded to include a Nitrox Maker™, offering the numerous benefits of diving Nitrox, without the need to invest in a new air compressor. Brownie’s also offers a full line of air compressors systems that can be upgraded to include the Nitrox Maker™.

Brownie’s designs, builds and installs diving solutions from floating recreational hookah diving systems to a full-line of state-of-the-art air compressors and mixed-gas blending stations. For more information on Brownie’s Third Lung, please visit us online at www.browniedive.com and www.tankfill.com. Stock Symbol: (OTC BB: UCPJ).

Links to Nitrox on scubadoc Diving Medicine Online

Nitrox Diving
Basic information about nitrox diving. … Recreational nitrox diving has in common with traditional compressed air diving the use of nearly all the same …

Nitrox Links
I’m very interested in learning cave diving, nitrox (and other mixes) diving. … Nitrox &&Technical diving in Coron More &&more divers are getting …

February 27, 2006

Debate: The relative safety of forward and reverse diving profiles.

Filed under: Uncategorizedscubadoc @ 3:59 pm

Scuba instructors and dive masters all over the world are in a quandary about the proper method to teach and do diving profiles - with conflicting recommendations by the Smithsonian Reverse Diving profile Workshop in 1999 and a recent study reported in the UHMS Journal, supporting forward diving profiles already found to be safe over many years.

We have provided the abstract of the new article by McInnes, Edmonds and Bennett reported in the Undersea and Hyperbaric Medical Journal, Nov/Dec 2005. In addition we have obtained material reflected in the references to the article that gives most of the salient features of the workshop. Finally, we have provided you with a critique of the workshop and article so that you may personally take part in the debate. This is a pragmatic debate, as it affects every dive operator in so far as the safety of the diver is concerned. I specifically ask that you read the comments of Dr. Simon Mitchell linked to the bottom of this article.

S.McINNES, C.EDMONDS, M.BENNETT
1 Department of Diving and Hyperbaric Medicine,Prince of Wales Hospital,Sydney,2 Consultant Diving Physician,3 University of NSW,Sydney,Australia
McInnes S,Edmonds C,Bennett M.The relative safety of forward and reverse diving profiles.Undersea Hyperb Med 2005;32(6):421427.

A recent workshop found that with nodecompression dives,“reversed dive profiles ”(RDP) did not increase the risk of decompression sickness (DCS).Thus in multilevel dives, the deeper part of a dive may be performed later in the dive,and repetitive dives may progress from shallow to deep.This contradicts the conventionally recommended forward dive profile (FDP) when the deeper dive, or deeper part of the dive,is performed first.The RDP Workshop recommendations were made despite the absence of adequate data. We performed two groups of experiments to test this hypothesis. We exposed two matched groups of 11 guinea pigs each to forward and reverse multilevel diving profiles to determine any substantial difference between FDPs and RDPs.There was no evidence of DCS in any of the FDP animals,while six (55%) of the RDP animals exhibited symptoms of severe DCS and died. This difference was statistically significant (P =0.01). We then compressed two groups each of 11 guinea pigs to repetitive dives to determine any substantial difference in the risk of DCS when two equivalent sets of three dives were conducted from the deepest to most shallow on the one hand (FDP),and from the shallowest to the deepest on the other (RDP). Over two such series of dives (the second extended in time and depth to increase DCS risk), there was a significantly higher incidence of severe DCS in those animals in the RDP group. Seven of 21 exposures (33%) in the RDP group resulted in severe DCS versus none in the FDP group (P =0.01). Our findings suggest that multilevel and repetitive dives performed in the established FDP manner are less hazardous than those performed in the reverse profile mode, at least for the exposures we chose. We believe the recommendations of the workshop should be reexamined.

1.Lang MA ,Lehner CE.Proceedings of theReverse Dive Profile Workshop 2930 October1999.Undersea and Hyperbaric Medical Society,

http://www.soc.soton.ac.uk/OTHERS/SDSC/dn1_00a.html

Workshop Sessions

In the first session, a discussion of the literature revealed that the prohibition against reverse profiles probably related less to safety issues than to “optimizing” bottom time over a series of dives. This comes from gas-loading considerations that allow more usable bottom time by making the deep dive first.

The next two sessions concentrated on physics, physiology, and modeling. Among the modeling approaches, bubble formation and growth models were prevalent. Although there was diversity among the bubble models, they tended to arrive at similar conclusions. For example, most call for lower allowable supersaturation gradients on the initial stops (deep stops) and shorter no-decompression limits than conventional dissolved gas models. The bubble models included David Yount’s varying permeability model (VPM), also known as the “tiny bubble” model; Bruce Wienke’s reduced-gradient bubble model (RGBM); the Duke University bubble-volume model; the DCIEM bubble evolution model based on Doppler scores; a gas-dynamics model by Valenie Flook based on Van Liew’s concepts; and Michael Gernhardt’s tissue bubble-dynamics model.

Hugh Van Liew argued that they need experimental validation to confirm the existence and role of micronuclei for bubble formation, including whether such gas nuclei can be “crushed” to the point of elimination or inactivation. Another presentation showed that, although the reverse dive profile may have a higher predicted incidence of decompression sickness (DCS), the differences were trivial for pairs of no-stop dives, and decompression using the U.S. Navy tables would be adequate. However, for dives involving decompression stops or for more than two dives in a row, these tables might not provide a reliable decompression. All of this pointed toward an urgent requirement for more information and, to this end, Alf Brubakk suggested an animal model that might at least show which profiles result in the most bubbles.

Another session included a discussion by several dive-computer manufacturers. Many older computers on the market use conventional dissolved-gas (Haldanian) algorithms that take into account only gas loading and supersaturation limits (M-values) and do not specifically consider the order in which dives are conducted. In these cases, the user manuals accompanying the computers may recommend against reverse dive profiles. Some of the latest dive computers incorporate algorithms based to varying degrees on bubble models. These computers have specific warning features or penalties for dive patterns associated with increased risk (bounce, yo-yo, repetitive dives with excessive pressure differentials, etc.).

Many horror stories have been associated with reverse profiles, the classic one being the instructor making a short, deep dive to release the anchor chain after a day of diving and getting severe DCS. Such situations are hard to interpret because the number of subjects is very small and buddy divers doing the same profile may be unaffected. Other data show that studies of 100 dives may be insufficient for statistical analysis, but one comment put this issue into perspective: “We are better off having that 100 dives than no observations at all.” Many participants reviewed data from the U.S. Navy, commercial diving records, decompression chambers, DAN records, and various recreational dive sources.

An argument can be made that the present lack of data proving whether reverse profiles are dangerous could be due, in part, to the arbitrary prohibition against such profiles for many years — in other words, not many of these dives have been done.

Although there were some problems with reverse dive profiles in isolated examples, the conclusion drawn from the analysis of actual diving data was that reverse profiles have not shown a higher risk for DCS than forward profiles. However, this holds most confidently when the differential pressure for the reverse profile is not too great — one cannot get big differentials without having significant depth. It appears that decompression tables, algorithms, and dive computers adequately handle the issue of reverse dive profiles.

Another observation is that this subject may be a matter of repetitive diving and, in general, this is handled differently across the many decompression algorithms.

The discussion turned to the participants to arrive at findings and conclusions, and the discussion got heated. Several people who work with bubble models had serious reservations about a “complete retraction” of warnings against reverse dive profiles since the bubble models suggest that you might get into trouble on an improperly planned or executed reverse dive profile. Many were concerned that divers, especially inexperienced sport divers, would get the wrong message about reverse profiles and think that it was okay to do them without any special consideration.

The bubble modelers obtained a couple of key concessions. Practical diving experience showed few problems with reverse profiles, but bubble models showed there could be. Thus, they adjusted some wording to make it clear that it was only in the diving experience that there had been few problems, not that there’s a lack of evidence that reverse profiles are or could have a higher DCS risk. The sentiment prevailed also that there should be a pressure differential limit, noting that most of the safely executed reverse profiles were in 40 fsw or less between the repetitive dives. Another point of agreement was that the sport diving limit of 130 fsw should apply to any relaxation of current prohibitions on reverse profile diving.

Findings and Conclusions

Neither the U.S. Navy nor the commercial sector has prohibited reverse dive profiles, and they are performed in recreational, scientific, commercial, and military diving. Since the prohibition of reverse dive profiles cannot be traced to any definite diving experience that shows an increased risk of DCS and no convincing evidence was presented that reverse dive profiles within the no-decompression limits lead to a measurable increase in the risk of DCS, the workshop participants found no reason to prohibit reverse dive profiles for no-decompression dives less than 130 fsw and depth differentials less than 40 fsw.

Summary

* Historically neither the U.S. Navy nor the commercial sector have prohibited reverse dive profiles.
* Reverse dive profiles are being performed in recreational, scientific, commercial, and military diving.
* The prohibition of reverse dive profiles by recreational training organizations cannot be traced to any definite diving experience that indicates and increased risk of DCS.
* No convincing evidence was presented that reverse dive profiles within the nodecompression limits lead to a measurable increase in the risk of DCS.

Conclusions: We find no reason for the diving communities to prohibit reverse dive profiles for nodecompression dives less than 40 msw (130 fsw) and depth differentials less than 12 msw (40 fsw).

2.Albano G.Principles and Observations on the
Physiology of the Scuba Diver .ONR Dept of Navy.

I was unable to find this reference.

3.Vik A,Jenssen BM,Eftedal O,Brubakk AO. Relationship between venous bubbles and haemodynamic responses after decompression in pigs.Undersea Hyperb Med 1993;20(3):233248.

We present a new pig model for studying relationships between venous gas bubbles and physiologic effects during and after decompression. Sixteen pigs were anesthetized to allow spontaneous breathing. Eight of them underwent a 30min exposure to 5 bar (500 kPa) followed by a rapid decompression to 1 bar (2 bar/min); the remaining eight served as controls. The pigs were monitored for intravascular bubbles using a transesophageal echocardiographic transducer, and bubble count in the twodimensional ultrasound image of the pulmonary artery was used as a measure of the number of venous gas bubbles. Effects on physiologic variables of the pulmonary and the systemic circulations were either measured or estimated. We detected venous bubbles in all pigs after decompression, but the interindividual variation was large. The time course of changes in the mean pulmonary artery pressure, in the pulmonary vascular resistance, in the arterial oxygen tension, and in the pulmonary shunt fraction followed the time course of the bubble count. In contrast, such a relationship to the number of venous gas bubbles was not found for the immediate increase in mean arterial pressure and for the changes in the other variables of the systemic circulation. We conclude that the number of venous gas bubbles, as evaluated by the bubble count in the ultrasound image of the pulmonary artery, is clearly related to changes in the variables of the pulmonary circulation in this pig model.

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4.Boycott AE,Damant GCC,Haldane JS.The prevention of compressed air illness .J Hyg

5.Berghage,TE,David TD,and Dyson CV.Species differences in decompression.Undersea Biomed
Res 1979;6:113.

In an effort to bring together the diverse laboratoryanimal decompression studies, a literature review and statistical evaluation were undertaken. Although 22 different species that had been used in decompression studies were identified, systematic data were available for only 7 of these species: man, goat, dog, guineapig, rat, hamster, and mouse. Mathematical functions using physiological data on these seven species were developed to estimate 1) saturation time (the time for the body to equilibrate after an increase in hydrostatic pressure), and 2) nodecompression saturationexposure limits (the maximum saturationexposure pressure from which an abrupt return to 1 ATA can be tolerated). Data from man, rat, and mouse were used to develop physiological relationships for two additional decompression variables: change in pressurereduction limits associated with increased exposure pressure and time to onset of decompression symptoms. Finally, data on rats for two other decompression variables, gas elimination time and optimum decompression stop time, are discussed in the hope that this will stimulate additional animal laboratory research in other mammalians. The general functional relationships developed in this paper provide a preliminary and rough means for extrapolating among species the decompression results obtained during animal laboratory experiments.

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6.Flynn,ET,and Lambertsen CJ.Calibration of inert gas exchange in the mouse.In:Proceedings of the
Fourth Symposium on Underwater Physiology , edited by Lambertsen CJ..New York:Academic, 1971,p.179191.

7.Hills B.Decompression Sickness,Volume 1 .1977.John Wiley and Sons.p.141.

8.Bert,P.La Pression Barométrique .Paris:Masson, 1878.Appendix I.[English translation by M.A.Hitchcock and F.A.Hitchcock ].Columbus, OH:College Book,1943.

9.Lillo RS Parker EC Evaluation of oxygen and pressure in the treatment of DCS in guinea pigs.
Undersea Hyperb Med .1998;25(1):5157.

These experiments examined whether increasing the partial pressure of oxygen (PO2), hydrostatic pressure, or both were responsible for the improvement in effectiveness of recompression treatment previously observed in guinea pigs with increasing depths of air. Unanesthetized male guinea pigs (600700 g) were subjected to 8.6 atm abs (871 kPa) air dives for 60 min and then decompressed at 1.82 atm (184 kPa)/min to the surface. Subsequently, animals usually displayed hypotension, cardiac arrhythmia, and tachypnea, indicative of a fatal bout (> 95% death rate) of decompression sickness (DCS). Animals that developed DCS were treated by recompressing to depths ranging from 2.5 to 11.6 atm abs (2531175 kPa), with 14, 28, 42, or 100% O2/balance N2. This design produced PO2’s at treatment depth ranging from 0.4 to 3.6 atm abs (41365 kPa). Upon recompression, recovery of blood pressure, heart rate, and breathing rate generally occurred. The area under the breathing rate vs. time curve was used to examine the effectiveness of treatment over a period of 60 min. A dramatic improvement in recovery over time was observed with increasing recompression depth for all gas mixtures. Analysis indicated that the positive response to depth was related to increasing hydrostatic pressure, increasing PO2 had no statistically significant beneficial effect.

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10.St Leger Dowse M,Gunby A,Moncad R,Fife C, Bryson P.A prospective Field study of reverse dive profiles in UK female recreational divers.South Pacific Underwater Medical Society Journal .2004; 34(4):183188.

Reverse dive profiles– Dr Phil Bryson quoted from the UKSDMC

Current understanding of decompression physiology suggests that diving the deepest dive first is safer. In the UK the principal recreational dive training organisations recommend deepest dive first but anecdotally divers do not follow this recommendation. In 2000 the Smithsonian Reverse Dives Profiles workshop concluded “We find no reason for the diving communities to prohibit reverse dive profiles for nodecompression dives less than 40msw and depth differentials less than 12msw. The primary question posed is whether reverse dive profiles (RDP) incur a higher risk of DCS than nonRDP dive profiles. In a review of the literature there was no convincing evidence to indicate that a repetitive dive must be shallower than the dive that precedes it. The exception was in a direct ascent from deep repetitive dives that have been shown to produce a high incidence of DCI. Scientific and diving medicine litera ture is not always consistent with current grass roots thinking and recommendations have grown from anecdotal data.

We observed the every day diving habits of female recreational divers and compared our data with the recommendations of the Smithsonian workshop. The divers were asked to keep diving diaries for three consecutive years but did not know the aims of the project and therefore made no changes to diving habits as a result. Volunteers were asked to record basic dive information including maximum depth, total dive time, and if a decompression stop was added. Symptoms and complications of diving were recorded as described in page 11. We categorised the multiple dive day data as follows: ·The 2nd dive is deeper than the first and the depth differential was more than 12m ·The 2nd dive is deeper than the 1st and is more than 40m ·The 2nd dive is deeper than the 1st, deeper than 40m, and the differential is more than 12m. We did not restrict the definition to nodecompression dives since there was insufficient granularity in the data to do this. We also looked at a further three categories substituting 30m for the 40m described above. 570 women divers returned diving records for up to three consecutive years. The basic characteristics are described in page 11. 532 (93%) women recorded 16,706 multiple dive days (36,487 dives). 479 (84%) women recorded 4,972 days (9,944 dives) with second dives of the day with reverse dive profiles. 36% of women logged 576 days with the 2nd dive deeper than 30m. A breakdown of the frequency of untreated selfassessed symptoms is shown in tables 1 and 2. Using the stricted interpretation only 29 (5%) of women recorded 41 RDP days (94 dives) outside of the workshop recommendations, which is only 0.2% of all multiple dive days. The relationship between RDP’s and maximum depth ever dived is shown in figure 1 and figure 2 shows the relationship with the total number of dives. Both correlate significantly (p=0.0013 and 0.0012 respectively). This study supports anecdotal observations that the practice of RDP’s in one form or another is taking place widely. Around 30% of multiple dive days within the study involved some combination of RDP although only between 0.2% and 1.5% of multiple dive days fall outside the recommenations of the Smithsonian Reverse Dive Profiles workshop. Symptom rates are higher (but not statistically) when analysing data outwith the recommendations.

===============================================

11.Edmonds C,McInnes S,Bennett M.Reverse dive profiles.The making of a myth:South Pacific Underwater Medical Society Journal ,2005; 35(3):139143.

Background to the article (see above)
In 1999 the Smithsonian Institute held a workshop on RDPs which produced the following statement that many of you have heard of: “we find no reason for the diving communities to prohibit RDPs within the the no-decompression limits for dives less than 40 metres and with depth differentials less than 12 metres”.

The authors in the above article have nicely critiqued the workshop findings and also presented some new data refuting the recommendations supporting RDP.

Some key points include:

1) All at the workshop agreed that there was an absence of hard data to make recommendations either way but then went on to make recommendations.

2) At the workshop, there was a disparity of opinion between those who favoured inert gas tissue models (felt that RDPs and forward dive profiles (FDPs) should be equal); and those who favoured bubble models (eg VPM and RGBM) who felt that RDPs would be less favourable for safe decompression. It was Bruce Wienke (RGBM) who suggeted the 40m and 12m caveats to the final recommendation. He didn’t extend the concept to 3 or more dives or mutilevel dives.

3) There was some evidence of increased adverse outcomes with RDPs presented at the workshop (USN and Catalina Island) which was not brought out in the findings.

4) “The belief that FDPs were introduced only to obtain more bottom time is a myth that seems to have been developed at the workshop”. The authors of this paper support the claim that the initial concept of avoiding RDPs (in the 1960’s) was a safety issue.

5) The 40m depth and 12m differential is not clearly enough explained in the workshop findings, and that it can be manipulated in a number of ways to make deompression less effective. This was a recommendation put forward at the last minute without support and will most likely be forgotten.

6) Finally the authors present some new animal work they have performed which nicely shows a significantly worse outcome in their model using RDP.

There is an excellent discussion of this debate by Dr. Simon Mitchell at http://snipurl.com/mzx2.
He takes issue with Dr. Edmonds in the following quote: “However, the argument about reversing two profiles without adjusting either of them is to some extent an anachronistic throw-back to the days when all dives were planned with tables. It seems an academic exercise in the modern world of diving where virtually all dives are controlled by computers that derive adjusted no decompression algorithms in real time based on recent previous exposure. Almost by definition, computer users cannot perform true reverse profile dives. Another problem is that the reverse dive profile ban had reinvented itself over time as a total ban on any dive deeper than another during any single day of diving, regardless of any measures the diver was prepared to take to make the second deeper dive safe. Hence we were subjected to ridiculous practices like divers being banned from further diving just because a second dive was slightly deeper than the first, or worse, divers finding some deep hole to bounce down into on their first dive just to have “the number on their computer” which kept their depth options open for subsequent dives.

You can sum all this up by saying that divers want to do “reverse depth dives” with appropriate adjustment to the subsequent deeper dives to make them safe, NOT reverse profile dives in the strict sense.”

It would be my personal (ESC) recommendation that “if it ain’t broke - don’t fix it”. Forward diving profiles have a good track record. In addition, no decompression diving using computers would seem to be controlling, as stated by Simon Mitchell.

Let me know what you think!
scubadoc@scuba-doc.com

Related links on our web site

Reduced Gradient Bubble Model
… except for repetitive and reverse profile diving maybe. 9) the RGBM bootstraps parameters to diving data (DCS rate) using maximum likelihood, …

[PDF] REDUCED GRADIENT BUBBLE MODEL: DIVING ALGORITHM, BASIS, AND …
reverse profile exposures are tracked and impacted by critical phase volume reductions over appropriate time. scales. 7. Adaptation. Divers and caisson …

[PDF] DiveMedTFS Newsletter, Dec. 30, 2001
… Page 13. DiveMedTFS Newsletter, Dec. 30, 2001 agencies for all divers to use in their dive profiles. One would need to balance the …

[PDF] Ten Foot Stop Newsletter, July 31, 2004
… Ascents follow the same procedures as descents, in reverse. Our preferred dive profile follows multi-level diving outlines, with several minutes spent at 40 …

[PDF] REDUCED GRADIENT BUBBLE MODEL WITH BASIS AND COMPARISONS NAUI …
For reverse profile diving, the gradient is restricted by the ratio (minimum value) of … ambient pressure difference between reverse profile dives, ∆P, …

An Advanced and Practical Course on the Physiology & Medicine of Professional Diving,

Filed under: Uncategorizedscubadoc @ 3:16 pm

The Southern African Undersea and Hyperbaric Medical Association (SAUHMA) is proud to present the 2nd Bennett & Elliott’s Physiology and Medicine of Diving Course

Bennett & Elliott’s Physiology and Medicine of Diving

An Advanced and Practical Course on the Physiology & Medicine of Professional Diving,
Including Air, Mixed Gas & Saturation Procedures

12-19 August 2006

For any further information contact
Ms Antoinette Walters
Tel +27(0)12 335-1577
Fax +27(0)12 335-9994
B&E; P O Box 30880;
Wonderboom-Poort; 0033; SOUTH AFRICA

See the brochure at http://scuba-doc.com/Bennett & Elliott Brochure.pdf

Diving Medicine Courses in Thailand.

Filed under: Uncategorizedscubadoc @ 9:32 am

Here is a letter from Rowan Sanderson re Diving Medicine Courses in Thailand.

Dear Ernest,

I have attached below information about new diving medicine courses being
run by the Diving Disease Research Centre (DDRC from the UK) in Thailand.
This will be the second time these courses will be run over here.

Two courses will be on offer - Remote Emergency Medic, and a Basic
Hyperbaric Medicine CHT prerequisite course. Both courses are approved by
the NBDHMT and will be run in conjunction with the Royal Thai Navy and the
Badalveda Diving Medicine Network.

Hopefully you will be able to read this file. If you have any problems let
me know.

thanks

Rowan

http://scuba-doc.com/Diving Medicine Course Schedule2006.pdf

February 26, 2006

American College of Hyperbaric Medicine invitations

Filed under: Uncategorizedscubadoc @ 11:59 am

We received the following information from the UHMS and are transmitting it forward to anyone to whom it applies:

“On behalf of the American College of Hyperbaric Medicine, we would like to extend an invitation to the physicians in fellowship programs to attend (TUITION FREE) a satellite symposium of the DFCon Global Conference in Los Angeles, California entitled Expanding Your Wound Care Practice: Should You add Hyperbaric Therapy? March 22nd 2006. This is being provided in recognition of their commitment to the field of Hyperbaric Medicine.

A letter from the American College of Hyperbaric Medicine and the conference brochure are attached to this e-mail.

If you have any questions or concerns please feel free to contact me directly.

Regards,

Mary M Verhage BSN CWOCN CHRN
American College of Hyperbaric Medicine
Conference Coordinator
Ph# 414-385-8723
Fax# 414-385-8721
mverhage@hwca-inc.com

Oxygen and Stroke, Benefit?

Filed under: Uncategorizedscubadoc @ 11:28 am

An interesting article about O2 and stroke

Oxygen Shows Promise as a Stroke Treatment - Forbes
http://snipurl.com/mp66

This article touts the use of oxygen by mask as an early adjunct to treatment of stroke (not HBOT).

A recent Cochrane review is as follows:
“Little evidence that stroke patients benefit from hyperbaric oxygen therapy.

Hyperbaric oxygen therapy (HBOT) is a treatment designed to increase the supply of oxygen to the part of the brain affected by stroke and reduce the extent of irreversible damage. HBOT involves people breathing pure oxygen in a specially designed chamber (such as those used for deep sea divers with the bends). Our review found only three randomised trials with a limited number of participants. Too few patients have been studied to say whether or not HBOT decreases the chance of dying and only one trial suggested any improvement in the ability to do everyday tasks. Overall, there is currently little evidence to support the use of HBOT for stroke patients.”

Tympanosclerosis and Diving?

Filed under: Uncategorizedscubadoc @ 11:08 am

Question re diving with tympanosclerosis.
Can someone with tympanosclerosis ( no tubes) dive. He has some white hardness. And slow to equalize. No problems or infection for years.

Ron Durheim instructor

Alaska Aquatics

We sent the query to our ENT consultant, Dr. Allen Dekelboum. Here is his answer:

Mr. Durheim:

You question was referred to me for comment.

Tympanosclerosis is scarring in the tympanic membrane (ear drum) as you noted. It is the end result of infections in the middle ear with possible rupture. Since the diver has not had problems with his ears for many years (how many years?), and no tubes were placed, it is generally of no consequence, as long as he can adequately and timely equalize his ears. The ear trouble in the past was due to obstruction of the Eustachian tubes, which, if it only incurred in childhood, has probably resolved. I would recommend that he be examined by an ear doctor who can also evaluate his ability to equalize with a valsalva tympanogram. If he is slow to equalize, he should take his time and not be intimidated by his diving buddies.

These comments are for information only and did not consist of an examination of the patient.

Allen M. Dekelboum, M.D.

Immersion Hypothermia and Near-drowning

Filed under: Uncategorizedscubadoc @ 10:52 am

Good Morning Dr. Campbell.

I am writing a nursing article and would very much like to quote/use part of your article: Immersion Hypothermia and Near-drowning . Is this acceptable to you?? Of course, I would reference your work. Thank you very much. Please let me know.

Best Regards, Ann Milroy

Nancy Ann Milroy RN,MSN,M Ed Director, Pediatric Services International Medical Center Cairo, Egypt

================================================================================
Hello Ann:

Certainly, you may use my article with appropriate credit. If it is translated into another language (such as Egyptian, for example), I will need a copy of the article translated back into English - due to the frequent changes in syntax that completely alter the meaning of a phrase. I would like to see the article, in any event.

Best regards;

Ernest Campbell, MD, FACS
scubadoc Diving Medicine Online
http://scuba-doc.com

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Dr. Campbell, thank you for your gracious (and timely) response. This article will be in English (my Arabic is quite basic). I would be happy to forward you a copy after publication. Best Regards, Ann

Nancy Ann Milroy RN,MSN,M Ed Director, Pediatric Services International Medical Center Cairo, Egypt

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Great and good luck with the article.

scubadoc

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Other resources about hypothermia
Another Look at Hypothermia, by Jolie Bookspan, PhD

Acclimatization to Cold Water, by Joile Bookspan, PhD

February 25, 2006

UHMS Pressure, Jan/Feb 2006

Filed under: Uncategorizedscubadoc @ 10:16 am

Click the links and go to a PDF of the article in Pressure.

MESSAGE FROM OUR PRESIDENT ………………………… 1
Lindell K. Weaver, MD writes about the removal of the UHMS library to Duke University; a new UHMS web site soon; the search for a new Executive Director; Annual Scientific Meeting at the Hilton, Disney World Resort, Orlando, Florida; the decision to summarize Board decisions and activities, and send the synopsis to all members by email; the arbitrary, poorly informed changes made by three statew BC-BS in payment schedules for HBOT.

DON’S PERSPECTIVES …………………………………………… 2
From Don Chandler, Executive Director, UHMS

QUALITY ASSURANCE CORNER …………………………… 3
Tom Workman reveals that the 2006 Accreditation survey Schedule is filled!

ASSOCIATES NEWS ………………………………………………. 4
Kaye McClue, RRT, RCP, CHT Associates Chair www.uhmsassociates.org

SURGEON COMMODORE J J W SYKES appointed Medical

Officer in Charge of the Institute of Naval Medicine…………….. 5

BOARD OF DIRECTORS SYNOPSIS………………………… 6

CLASSIFIEDS

COURSES

MEETINGS

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UPCOMING ANNUAL UHMS MEETINGS

2006: Hilton, Walt World Disney Resort

Orlando, Florida

June 22-24

Breath-hold Diving Pre-Course: June 20-21

post-course: June 25

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2007: Ritz-Carlton

June 14-16

pre-courses: June 13

post-course: June 17

Maui, Hawaii

Reactivated and Maintained by Centrum Nurkowe Aquanaut Diving