MalaysianUnderwater.com (MUW) • View topic - dive accidents to learn from

dive accidents to learn from

Any information attained from this forum is for general knowledge only. Please seek professional advice for further diagnosis.

dive accidents to learn from

Post Number:#1  Postby sheik » Thu Nov 09, 2006 5:44 pm

Hi DiveDoc:
I have been wondering about the people who had dive accidents and treated at your hyperbaric center (hospital).
What was the worse case you have you seen? Kindly share and what can we learn so as to not do it.
Diving: A Serious Play
User avatar
sheik
Administrator
Administrator
 
Topic author
Posts: 2865
Joined: Fri Aug 18, 2006 10:51 pm
Location: at ease
Gender: None specified

Re: dive accidents to learn from

Post Number:#2  Postby divedoc » Tue Nov 21, 2006 5:47 pm

Hi sheik,
Sorry for the late reply, I just got back from Sabah doing dive medical check-ups for our Bomba diving team.

With regards to your question, we had a case early this year, (actually he presented to us late last year, but his treatment continued until february this year...), 40+yr old man, commercial diver, brought in unconscious to Hospital Lumut. He did a provocative repetitive dive using a single tank, 3 dives in total, with short SI, 45-50 metres each dive. Also had a small pneumothorax...Diagnosis : Acute Neurological Decompression Illness. He had both elements of DCS and Arterial Gas Embolism based on the history given by the dive supervisor. I mean too long a dive, too deep, and PLUS, he ran out of air during his last dive, which made him shot straight up to the surface...

He completed about 30 sessions of hyperbaric oxygen therapy (HBOT), of which 5 sessions lasted about 5 hours...In the end, he was left paraplegic from the waist down, had minimal muscle power of his legs, but was able to control his micturation and bowel habits.

Although that was one of the severe cases we have had since the inception of this department, the worst cases have got to be those involving underwater loggers AKA divers in Temenggor dams and Banding dams. They were usually brought in unconscious, one had both-sided chest-wall pneumothoraces, but AMAZINGLY, after less than 20 sessions of treatment, they recovered well enough to even resume diving again!!! What amazes me even more is that the equipment they used, were not even meant for diving!! They had an air compressor with a garden hose attached to it, and modified the 2nd stage regulator to attach it to the hose, and Whalla!! You have yourself a Surface-supplied breathing apparatus!!

BUT PLEASE, DON'T TRY THIS WHEN YOU GO DIVING!!

Like all diving buffs, I always like to remind myself, as well as you guys, to dive according to your dive table...Don't depend too much on your DC. I never do!! Dive tables were formulated after years of research on the human body's capabilities to absorb inert gas...so to be safe, memorize your dive table, or if you can't, then bring it along during any of your dive excursions...
User avatar
divedoc
Sport Diver
Sport Diver
 
Posts: 97
Joined: Mon Nov 06, 2006 10:33 pm
Location: Somewhere in Damansara
Gender: None specified

Re: dive accidents to learn from

Post Number:#3  Postby HollowMan » Tue Nov 21, 2006 6:10 pm

doc, 1 question from me  :D how much the cost per session ?
User avatar
HollowMan
Founder
Founder
 
Posts: 857
Topics: 2
Joined: Thu Aug 03, 2006 11:00 pm
Location: Paya Kerchut Pendang
Gender: None specified

Re: dive accidents to learn from

Post Number:#4  Postby divedoc » Tue Nov 21, 2006 6:28 pm

Yo bro,

Kalo tak salah I lah kan, about RM10 per session for our clinical hyperbaric cases, which is about 2h15m duration...tapi kalo diving recompression treatment I guess slightly higher kot...kitorang kat department tak brape tau sangat hal2 bayaran nie, but I'll check it up for u, okay!
User avatar
divedoc
Sport Diver
Sport Diver
 
Posts: 97
Joined: Mon Nov 06, 2006 10:33 pm
Location: Somewhere in Damansara
Gender: None specified

Re: dive accidents to learn from

Post Number:#5  Postby HoleMaster » Tue Nov 21, 2006 6:36 pm

Doc thanks for sharing dude...its really scary when ppl dive without proper diving apparatus. However, they might be lucky now but might not later
Rilek la bai...agak2 la diving. Kang tersekat kat lubang susah plak
HoleMaster
Global Moderator
Global Moderator
 
Posts: 1324
Joined: Sun Aug 27, 2006 12:50 am
Location: Kay Yell
Gender: None specified

Re: dive accidents to learn from

Post Number:#6  Postby HollowMan » Tue Nov 21, 2006 11:37 pm

Thanks doc!  :D
HollowMan
 

Re: dive accidents to learn from

Post Number:#7  Postby anas » Wed Nov 22, 2006 5:45 am

Thanks Doc, for the input. Certainly appreciate it. It should serves us a reminder to us that, if any of us, those stunts are not worth a dime.

Hope those incidents don't strike any of us.

Like all diving buffs, I always like to remind myself, as well as you guys, to dive according to your dive table...Don't depend too much on your DC. I never do!! Dive tables were formulated after years of research on the human body's capabilities to absorb inert gas...so to be safe, memorize your dive table, or if you can't, then bring it along during any of your dive excursions...


Doc, in these days of diving, I see more and more of us are relying on DC and less and less checking on dive tables. Including yours truly...  :-[  

Is that because we are growing more and more comfortable with our equipment and relying much more on electronics?

Maybe I should do some muhasabah (look back and calculate) on those dives that I have done and next dive trip I should promise myself to use both DC and dive table.
anas
 

Re: dive accidents to learn from

Post Number:#8  Postby divedoc » Wed Nov 22, 2006 10:19 am

sheik,

good thing to hear that you nak muhasabah diri...our ppl nowadays depend too much on electronics, but they dont take into account the dives that we make, whether it's a conservative or provocative dive.

One more thing, for HollowMan...
Regarding the cost of treatment per session, it's RM40.00 per session of diving emergencies treatment...
divedoc
 

Re: dive accidents to learn from

Post Number:#9  Postby SeaDemon » Wed Nov 22, 2006 11:42 pm

Haha...a DC calculates algorithm. It doesn't know how your body behaves
SeaDemon
 

Relying on electronics

Post Number:#10  Postby drhalimm » Sun Jan 07, 2007 9:00 pm

An alternative view from me: It is okay to rely on your DC only, without looking up your dive tables AND be just as safe.

How? 1. Know how your DC behaves in comparison with established No-D tables. 2. And then put in a reasonable safety margin.

Some DC's are quite conservative - short bottom times, fun-killer. Some give loooong bottom times - nice, but risky. It all depends on which algorithm is used. You'll need to know whether your DC is relatively conservative or liberal. This will determine how you use it:

Next, put in a reasonable safety margin. How?
1. Try not to extend your bottom time right to the DC's No-D limits - the DC's No-D limits are usually very liberal compared to tables, because many DC's take into account your multi-level profiles - so while you gain extra bottom time with a DC, you actually lose an extra safety margin against developing decompression sickness. (There is no such thing as a free lunch). So depending on your DC, you may want to put in a safety margin of say 15 - 25% of the bottom time and leave bottom before you hit your No-D limits.
2. Do a safety stop. The mathematicians and physicists amongst us will tell us how much this will reduce bubble formation. But, I still see many divers confuse a Safety Stop with a Deco Stop. Bad, bad, bad.
3. Vary your safety margin with your other risk factors: Multiple dives, Multi-day dives, dehydration, cold water, strenuous dives, old age, poor physical conditioning, obesity. If you have any of these, increase your safety margin some more.

Lumut often see sick divers who says "But... my DC tells me that I'm still within my limits". (The poor diver dived the computer to its No-D limits for 4 days in a row, 3 dives a day. He was also tired, dehydrated and had several strenuous dives - which the computer can't factor in).

A thought: When you switch on your Dive Computer, don't switch off your brains.

And then we get some sick divers who says "But... if I dive according to the DC's recommendations, then I should NOT get Decompression Sickness".

A thought: If you want a guarantee, buy a TV.

I love my dive computers - they are wonderful tools, better than fiddling with tables. But being user-friendly, they sometimes allow divers to completely avoid thinking. To illustrate, I have actually seen a diver hang his dive computer 5 metres below surface for a "required deco stop" while he is having a ciggy on the boat. Hmmm...

Tell me what you guys think.
drhalimm
 

Re: dive accidents to learn from

Post Number:#11  Postby deepblu » Sun Jan 07, 2007 10:45 pm

Haha...a DC calculates algorithm. It doesn't know how your body behaves


Silly question : isnt it the same with dive tables too - it not knowing how one's particular body behvaes? ;)


On a more serious note, however, how can we vary our own safety margin with our other risk factors: Multiple dives, Multi-day dives, dehydration, cold water, strenuous dives, old age, poor physical conditioning and obesity.

(as mentioned by caduceus)?

admittedly, i am also one of those who have long stopped using the dive table when planning dives  :-/
Last edited by deepblu on Sun Jan 07, 2007 10:49 pm, edited 1 time in total.
deepblu
 

Re: dive accidents to learn from

Post Number:#12  Postby anas » Sun Jan 07, 2007 10:52 pm

one day, i dream, that they will make a divecomp that allows you to enter variables such as age, height, weight, amount of water/alcohol/calories intake... and then append it together with dive table algorithm..  ::)

one day...
anas
 

Re: dive accidents to learn from

Post Number:#13  Postby mocha » Sun Jan 07, 2007 11:03 pm

one day, i dream, that they will make a divecomp that allows you to enter variables such as age, height, weight, amount of water/alcohol/calories intake... and then append it together with dive table algorithm..  ::)

one day...


bro, lagi best if got in-body transmitter.....  ;D
mocha
 

Re: dive accidents to learn from

Post Number:#14  Postby diveghost » Mon Jan 08, 2007 4:33 pm

Doc,
I got into an incident maybe 5-6 yrs back. Still dont know what actually happened but after some self research cudv been some kind of embolism. Heres wat happened:

It was a 5 day liveaboard to Tenggol. Been driving long hours the nite b4, not much sleep coz damn excited, very light breakfast the next day, dehydrated, smoking my lungs out while waiting for the damn transfer boat which was hours late. Finally reached tenggol in afternoon and immediately geared up for first dive (all rental stuff that time), no DC, maybe less than 20 logged dives that time. Wreck dive..max depth 30-31m. Bottom time bout 40mins. Did safety stop but surface swim was pretty strenous and cramped up before getting a lift on the chaser boat.

Upon gearing off on boat had piercing pain in my chest everytime i took a breath. So painful to breathe. Toes on 1 foot starting getting numb and the numbness eventually went up to my thighs over the next hour or so. So basically lost total control of my right leg thigh down. Felt like there was nothing there. Anyway had meal and drank gallons and gallons of water.

Story cut short - after all confusion not knowing wat else to do, just continued to drink water and eventually the numbness slowly went away and breathing was back to normal. Whole incident lasted round 2 hrs++. Went on for next dive without any problems. it was only after i got back and did some reading i found out i got hit, noting all the symptoms and events leading to it.

So what do you think Doc?

Diveghost
diveghost
 

Re: dive accidents to learn from

Post Number:#15  Postby Jim » Mon Jan 08, 2007 4:40 pm

..... if u dive U shape profile, u definitely decoed the dive.... PADI table says max time is 20mins...  if multi level dive, depends on yr the profile u did.....


my humble 2 rupiah....
Jim
 

Re: dive accidents to learn from

Post Number:#16  Postby diveghost » Mon Jan 08, 2007 4:44 pm

yup...anyway it was a multilevel dive. no way i'd stay at 30m for the entire 40mins. bengkok badan braderrr!!!...
diveghost
 

Re: dive accidents to learn from

Post Number:#17  Postby SeaDemon » Mon Jan 08, 2007 4:55 pm

Haha...a DC calculates algorithm. It doesn't know how your body behaves


Silly question : isnt it the same with dive tables too - it not knowing how one's particular body behvaes? ;)


On a more serious note, however, how can we vary our own safety margin with our other risk factors: Multiple dives, Multi-day dives, dehydration, cold water, strenuous dives, old age, poor physical conditioning and obesity.

(as mentioned by caduceus)?

admittedly, i am also one of those who have long stopped using the dive table when planning dives  :-/


Somehow I find dive tables even more conservative than DCs. I always end up with 3-straight 'Z' EPG whenever I dive using my DC and then use my Wheel RDP to find out my EPG after each dive.

As for the physical factor, only we know how our body behaves, to a certain extent; unless we inherit certain peculiarities such as what the law students might recall: The Egg-Shell Skull Theory. Though I am less susceptible to cold, the extra lard that I carry in my body means the risk of forming microbubbles trapped in layers of fat resulting in DCS makes me plan my dives, especially the deep ones, more carefully.  Even when I use the V-Planner, I add a +3 safety buffer to it...and believe me, I'll be more conservative than my DC.

And even then, as you observe time and again, I'd do multiple stops instead of just one at 5 meters.  Because the only guarantee I'll get to NOT get DCS, is by NOT DIVING.
SeaDemon
 

Re: dive accidents to learn from

Post Number:#18  Postby drhalimm » Wed Jan 10, 2007 6:05 pm

On a more serious note, however, how can we vary our own safety margin with our other risk factors: Multiple dives, Multi-day dives, dehydration, cold water, strenuous dives, old age, poor physical conditioning and obesity.  :-/


Deepblu,
No hard and fast rules here. You'll need to just increase your safety margin with increasing numbers of risk factors. (Decompression theory is not an exact science yet).

A thought: If you are driving in the highway during a poor visibility, heavy downpour (a risk factor), to avoid an accident, you as a sensible person will drive at less than the 110km/h speed limit (similar to No-D limit). But the question is how slow? There are no straight answers here. I think it'll depend on your type of car, brakes, tires, how lucky you feel, time of the day, winding or straight road, your alertness etc (all risk factors). Your chosen speed might be 20 km/h or 90 km/h. Not an exact science.

I usually do 80% of my DC's No-D limit on my first dive. I'll then reduce it by 5% for each successive repetitive dive, another 5% if I do successive-day dives. But these numbers won't allow me to dive 3 times a day for 5 days in a row - I'll have very little bottom time time left! That is fine by me though - I enjoy a break after 2-3 days diving. If I go for a break of a day or more, I'll  reset. But then again, I'm old at 38. As for age, I have heard a good diving doctor mentioning something like taking 1 minutes off your No-D limit for every year after 30. Again, although this is good advice, it is purely arbitrary, and not exact.

So my advice would be: Know the risk factors for DCS, ask yourself if you have many (or none) of the risk factors, and adjust your dive profile as you see fit.

And don't forget to have fun down there.
Last edited by drhalimm on Wed Jan 10, 2007 6:09 pm, edited 1 time in total.
drhalimm
 

Re: dive accidents to learn from

Post Number:#19  Postby drhalimm » Wed Jan 10, 2007 6:25 pm

Diveghost,

Sounds to me like either:
1. A bubble in the blood vessel of the brain/spinal cord that came from a damaged lung (in doctors' silly-babble: Arterial Gas Embolism secondary to Pulmonary Barotrauma), or
2. A bubble in the brain or spinal cord from dissolved nitrogen coming out as bubbles (in doctors' crazy-talk: Neurological Decompression Sickness).

Difficult to say which one just from the history. Pain or discomfort in the chest on taking a breath supports 1., your provocative profile supports 2. You may have both, it is not uncommon.

I think most people who got this do not immediately get better after 2 hours. You did the right thing by drinking lots of water. You may have lied down as well (so the bubbles don't go up to the brain). But breathing oxygen would have been really good. In any case I'd recommend immediate recompression - even if the symptoms went away. It'll prevent the chance of a recurrence.

You are extremely lucky in that it went away totally by itself without oxygen, and did not recur.

"Things that did not kill you, makes you smarter".
Last edited by drhalimm on Wed Jan 10, 2007 6:25 pm, edited 1 time in total.
drhalimm
 

Re: dive accidents to learn from

Post Number:#20  Postby diveghost » Thu Jan 11, 2007 4:28 am

Hey Cadecaus...u can say that again. Ever since that happened i've been monitoring my body after every single dive till now. Take galons of water b4 and after dives hence pee in wetsuit quite a bit haha. I am extremely lucky thank god for that. phew!..
diveghost
 


Return to Dive Medicine & Fitness

Who is online

Users browsing this forum: No registered users and 1 guest