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SEE #1

You are diving on an active ICCP?

Divers working within 15' of active system must wear a full drysuit, unisuit, or wet suit with hood and gloves. ICCP must be secured and tagged before divers work on it.

Does a chamber have to be certified?

In an emergency any operable recompression chamber may be used if deemed safe by a diving supervisor.

List two types of authorized thermometers for recompression chambers?

Electronic or alcohol.

When chamber temperature is above 85 degrees, patients should drink how much water?

1 liter per hour. ½ liter per hour if temperature is below 85 degrees.

What treatment tables require an outer lock?

TT 4,7,8. Never attempt a treatment longer than TT6 unless there is access to inside occupants.

How long should an inside tender or DMT wait between tending on treatment tables?

12 hours between all air tables (1A, 2A, 3) and oxygen tables 5, 6 and 6A.
48 hours between tables 4,7,8.
Chamber repeats may be done on tables 5,6,6A if 02 was breathed 30FSW and shallower on previous Treatment Table.
Minimum surface intervals will be adhered to for tables 1A,2A,3,4,7 and 8.

You lose 02 during a treatment on tables 5,6,6A but it is restored within 15 minutes?

Maintain depth until repair is completed, after 02 is restored resume treatment at point of interruption.

You lose 02 during a treatment on tables 5,6,6A but it is restored after 15 minutes?

Maintain depth until repair is completed. After 02 is restored, if original table was 5,6,6A complete treatment with max number of 02 extensions.

You lose 02 during a treatment on tables 5,6,6A and it cannot be restored after a two hour delay?

Switch to comparable air table at current depth if 60FSW or shallower.
Rate of ascent one ft/min.
If an increase deeper than 60'is needed use TT4 with DMO concurrence.

What are the standard mixes for treatment gas?

61-165FSW 50/50 HE02 or 50/50 N202
166-225FSW 64/36 HE02

What is the minimum surface interval for inside tenders or DMT's on tables 5, 6, 6A, or air tables 1A, 2A or 3 prior to diving?

12 hours for no 'd' diving, 24 hours for decompression diving.

What is the minimum surface interval for tenders or DMT's on tables 4,7,8 prior to diving?

48 hours for tenders on tables 4,7,and 8 prior to diving.

For treatment of Type 2 residual symptoms daily treatments should be...?

Table 6 is preferred but twice daily treatments on table 5 and table 9 may also be used. Take 1 day break every five days. Treatments are prescribed by a DMO.

How long are patients observed after the treatment?

Patients treated for Type 1 DCS should remain at the facility for 2 hours
Patients treated for Type 2 DCS, AGE or TT6 for Type 1 should remain at the facility for 6 hours.
DMO can alter time provided the patient stays with someone, thirty minutes away from facility who can recognize recurrence of symptoms.
Patient should remain within 60 minutes of facility for 24 hrs.
Any recurrence of symptoms within these time periods are treated IAW figure 21-5, pg. 21-38.

Your inside tender /DMT wants to go on liberty after the treatment?

Tenders will remain at facility for one hour after treatment.
If tending on a TT 4, 7, or 8, the tender will remain within 60 minutes of the facility for 24 hrs.

Your patient wants to fly home after his treatment?

Patients treated for AGE/DCS should wait a minimum of 72 hours before flying..
In an emergency with the concurrence of a DMO, an aircraft pressurized to one ATA or flown no higher than a thousand feet is authorized. The patient will breath 02 while flying.

Your Diver tells you he has a plane to catch after the dive?

Refer to table 9-5 ascent to altitude before letting him fly.

Your tender/DMT wants to fly home on leave after the treatment?

Tenders on tables 5, 6, 6A, and air tables (1A, 2A, or 3) should wait 24 hours before flying.
Tenders on tables 4, 7, or 8 should wait 72 hours before flying.

Return to diving after TT5?

Complete relief: 7 days.

Return to diving after TT6?

Complete relief: Four weeks follow up with DMO.

Return to diving after TT4 or 7?

Complete relief: Three months follow up with DMO.

What does the primary med kit consist of?

Diagnostic and therapeutic equipment

What does the secondary med kit consist of?

Medicines

How often are unopened kits inventoried?

Every four months.

When do CO toxicity symptoms occur and what are they?

Unusual sweating
Headache / Tightness across forehead.
Drowsiness / Lack of Concentration
Dizziness / Neausea /Vomiting
Convulsions - Shift to secondary air without hesitation!
Cyanosis
Unconciosness - Shift to secondary air without hesitation!

CO toxicity is most likely seen on ascent and affects both divers. Shifting to secondary, ventilating the divers, and aborting the dive shall be done immediately.

What are signs of CO2 toxicity symptoms?

Unusual sweating
Headache
Drowsiness / Lack of concentration
Dizziness / Nausea / vomiting
Shortness of breath / heperventilation
Convulsions - Shift to secondary air!
Cyanosis
Unconciousness - Shift to secondary air!

Hypercapnia can occur anywhere in the water column. Ventilating the divers rig or a decrease in depth will clear up symptoms immediately.

What are signs of Hypoxia symptoms?

Agitation
Weakness / lack of muscle control
Drowsiness / Lack of concentration
Unconsciousness - Shift to secondary air!

Hypoxia is seen with near drowning and breath holding accidents. Their will be an increase of blood pressure and heart rate as the heart tries to offset the hypoxia by circulating more blood through the body. Cyanosis may be seen in the nail beds, lips and skin. However the signs of cyanosis may also be seen when exposed to extremely cold temperatures.

What is the procedure for pain under pressure when conducting air diving?

The supervisor may elect to pull the diver from the water and treat in the chamber if decompression risks are acceptable. If not...

Recompress the divers 10'
30' and shallower shift to 100%O2
If significant relief is not seen he may recompress the diver an additional 10'
Remain at TX depth 30 minutes in addition to the required stop time at the decompression stop.
Decompress by multiplying subsequent stop times by 1.5.
Use the first (deepest) stop time in the schedule to decompress if none are available.
Take a stop every 10 feet.
If no SX present on surface TX on Table 5 (1A)
If SX are present on surface TX on Table 6 (3).
Do not treat unaffected diver.

What are the tender considerations for tables 5,6,6A,4?

TT5:

Tenders breath 02 ascent to the surface (30minutes).
Previous hyperbaric exposure in last 12 hrs: Tenders breath oxygen when arriving at 30 FSW for 20 minutes and ascent to the surface.
Two extensions may be performed at thirty feet. The tender does not require additional oxygen breathing than currently prescribed.

TT6:

Tenders will breath 02 last 30 min at 30FSW, and during ascent to surface (30 minutes), for an unmodified table or a single extension at 30 or 60'.
More than one extension: Tenders will breathe oxygen for 60 minutes at 30 FSW and ascent to the surface.
Previous hyperbaric exposure in last 12hrs: Tenders will breathe oxygen for 60 minutes at 30 FSW in addition to the last 30 minutes at 30FSW and ascent to the surface.

TT6A:

Tenders breath 02 during the last 60 minutes at 30FSW and ascent to surface, for an unmodified table or a single extension at 30 or 60'.
More than one extension: Tenders will breath oxygen at 30FSW for 90 minutes and ascent to the surface.
Previous hyperbaric exposure in 12 hrs: Tenders will breathe oxygen for a total of two hours when arriving at 30FSW and ascent to the surface.


TT4:

Tenders breath 02 for 2 hours before leaving 30' and 2 hours from 30' to the surface.

Gas mixtures for nitrox range from?

75% N2 - 25%02 to 60% N2 - 40% 02

Nitrox is limited to what depth?

140 FSW

Normal working dives will not exceed what PPO2 for
nitrox?

1.4 ATA to avoid the risk of CNS 02 toxicity.

When is pulmonary 02 toxicity a concern in Nitrox diving?

Long series of repetitive daily exposures.

Repetitive nitrox diving produces what symptoms?

Fatigue (tired)
Headache
Flu like symptoms
Numbness of fingers and toes

Procedures for switching to air during Surface Supplied Nitrox Diving?

Use the divers max depth and bottom time and follow the standard air decompression table for the actual depth of the dive.

Asymptomatic Omitted Decompression for Nitrox diving?

Use divers actual depth and follow the 'air' management of asymptomatic omitted decompression procedures.

Who's permission is needed to exceed normal working limits for nitrox diving?

CO's authorization and restricted to SSD only.

Are nitrox repetitive dives authorized when exceeding normal working limits?

No

When are nitrox SCUBA bottles analyzed for 02 content?

Before each dive.
Can any regulator or SCUBA bottle be used for nitrox?

A: No, nitrox regulators are identified on the ANU list.

Advantages of Nitrox?

Extended bottom times for 'no d' diving.
Very little decompression time.
Very little RNT
Reduced DCS and N2 narcosis.

Disadvantages of nitrox diving?

Risk of CNS 02 toxicity
Long duration nitrox can result in pulmonary 02 toxicity.
Nitrox requires special mixing and cleaning equipment.
Nitrox is expensive.

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