Big tank to borrow?

General banter about diving and why we love it.
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CaptnJack
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Re: Big tank to borrow?

Post by CaptnJack »

LCF wrote:I will tell you, from the viewpoint of the person working IN the ER, that if you are presenting to an ER in a major city (like Seattle) you will immediately be entered into a triage process. Triage means sorting patients by the perceived urgency of their medical problem. People who are having heart attacks or acute strokes, or who are bleeding to death or seriously infected, will be seen first. People who MIGHT be having those things, but it isn't clear, will be seen second. If your elbow hurts, even though there is an appropriate treatment for this which is curative, it's still going to get triaged to a low level, which means waiting. When you add that to the fact that few ER physicians or nurses know ANYTHING to speak of about DCS, you have a recipe for a problem.

You would think it could be solved by being insistent -- but it is an unfortunate fact of life that the patient who is being annoyingly pushy about what appears to be a minor problem is pushing himself DOWN the triage ladder.

That's one of the reasons I think DAN is so fabulous. You can activate them yourself; you can get a trained medical professional on the phone who can speak to the people caring for you and convince them, in their own language, that your problem has the potential to become much more serious, and that there exists a truly curative option -- that's something we love in the ER, because so much of our work consist of propping up people who will never truly be well.

But the bottom line of all this discussion is that an ounce of prevention is worth a pound of cure. If you are going to dive in remote area (and God's Pocket certainly qualifies) use the principle you were taught in your OW class -- make your dive 10% or so more conservative than you would make it, if you were diving somewhere closer to home. Use Nitrox where you otherwise wouldn't; keep your depths reasonable (and up there, there's no reason to go deep, really, to see cool stuff), and skip a dive now and then if you aren't feeling absolutely sparkly.
Sounder wrote:Under normal circumstances, I would never tell another man how to shave his balls... but this device should not be kept secret.
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CaptnJack
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Re: Big tank to borrow?

Post by CaptnJack »

The port hardy hospital has about 25 beds. I can see waiting behind an car or industrial accident victim but the community is so small I don't think the triage line is likely to be long. I know they have xrays and ultrasounds. I'm not sure about a CT or anything more sophisticated like an MRI (seems unlikely but I can ask my friends up there sometime). If for instance you had appendicitis up there. God's Pocket isn't even in Port Hardy though, its a goodly boat ride away.
Sounder wrote:Under normal circumstances, I would never tell another man how to shave his balls... but this device should not be kept secret.
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LCF
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Re: Big tank to borrow?

Post by LCF »

You're actually sometimes better off in a small ED than a big one, if your problem is routine. You're going to get a cut sewn up much faster in Ellensburg than at Harborview, for example. You'll probably get a simple fracture x-rayed sooner, too.

I was addressing the issue of the person who is evacuated out of a remote location with DCS symptoms that aren't profoundly neurologic. That person isn't going to impress the triage agent. As I said, many if not most ED providers know little or nothing about DCS, let alone how to try to decide whether someone actually has it (for which there is no definitive test, so it's all clinical judgment).

You can argue back and forth about what is or is not available in a specific site, or how things ought to be managed. The simple reality is, if you dive in remote places, dive conservatively. If you get a major medical problem in the US or Canada, you will eventually be treated completely appropriately. But have a big heart attack at God's Pocket, where you are unstable? They will do everything right, but you may or may not make it. Would you rather spend your life sitting in front of the TV, lest you end up sick in the boonies? Not me!
"Sometimes, when your world is going sideways, the second best thing to everything working out right, is knowing you are loved..." ljjames
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CaptnJack
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Re: Big tank to borrow?

Post by CaptnJack »

Yeah we have discussed bringing an AED on trips in the past. But the reality is that you are highly unlikely to have it handy when you need it which is out hiking in the bush or in a cave. Although I have felt the symptoms of an MI after a bacon laden breakfast in camp :burntchef:

We have also discussed a satellite phone (not something you need in God's Pocket for goodness sakes). There's not even cell reception along the highway nevermind in the woods. The problem is imparting the seriousness of the DCS case and getting the right resources deployed. I have never had to call the BC PEP, which is the regional coordination center for all backcountry incidents. The BC Speleological Federation is their on-call contact for all cave (including cave diving) incidents. In case you are curious, this is the BC PEP number. http://www.embc.gov.bc.ca/em/about_embc/emergency.html

Flying out of Comox, these guys come and extract you from remote sites: http://www.rcaf-arc.forces.gc.ca/en/air ... h-149.page

Presumably if you are in critical condition and not near an airport this is how you get out. Realistically DCS is the least of our worries. The cave fatalities I'm aware of were all rockfall related. But there are very few cave divers up there and while long decos are the norm, the DCS rate for remote cave sites is non-existent for now. There was a caver trapped in a cave last year by rising water. He stayed in the cave, in the dark for about 14-16 hours before they could drain the passage (with a pump) enough so that he could crawl out with an air space to breath. He's a young guy but I'm impressed by their response. His headlamp had flooded and it was dark, but they got some space blankets into him to help him survive. This is the closest to a cave diving incident I know of.
Sounder wrote:Under normal circumstances, I would never tell another man how to shave his balls... but this device should not be kept secret.
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CaptnJack
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Re: Big tank to borrow?

Post by CaptnJack »

Some might find this thread useful
http://www.cavediver.net/forum/showthre ... as-routine

CNS hit to spine
Diver arrives unconscious at chamber via helo med evac.
Alone and unknown. No gear, no wallet, no ID, no contact info, no history.
Sounder wrote:Under normal circumstances, I would never tell another man how to shave his balls... but this device should not be kept secret.
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ScubaJess
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Re: Big tank to borrow?

Post by ScubaJess »

I made it back safe & sound and had a great time!!! It was so beautiful above and below the sea!
All our dives were 60 min or less, I used Nitrox in my HP 117 the whole time and never went below 70 feet!
19 dives in 6 days!! It was spectacular!

Thanks for all the feedback! I hope everyone stays safe out there!
Gods Pocket was fantastic! I can't wait to go back!
Live Long And Prosper!!!

Stay Warm underwater with the Weezle Extreme Plus undergarment! Please let me know if you would like to order one or have any questions. :luv: :partydance: :eric: :taco:
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