chamber sup Flashcards
Who is authorized to modify a recompression treatment? which treatment tables require DMO concurrence?
UMO Code 16UO, 16U1
4, 7, require DMO
A pilot started to have a 6 out of 10 pain scale in his right knee mid flight and he had complete relief prior to landing. what is your
Diagnosis?
Course of Action?
Treatment/ Post-Treatment considerations?
Diagnosis: altitude DCS type 1
Course of Action: since the pilot only had joint pain and had complete relief before landing treat with 2 hours of 100% O2 and observe for 24 hours.
treatment: 2 hours of 100% 02 and observe for 24 hours
describe in detail a patient’s return to diving requirements post treatment.
Divers diagnosed with any POIS or DCS shall be referred to a DMO for clearance prior to returning to diving.
In most cases, a waiver of the physical standards will be required from BUPERS via BUMED.
can a TT-5 be extended?
Yes, TT5 can be extended up to 2 additional 02 periods at 30ft
patients that have been treated for DCS or AGE should not fly for _____ hours after treatment
72 hours
Can TT-6 be extended?
- 2 25 min periods at 60ft (20 mins on O2 with 5 min air breaks)
- 2 additional 75 min periods at 30ft (60 mins on O2 with 15 min air breaks)
- Or both
during treatments all chamber occupants may breathe 100% O2 at depths of ___ feet or shallower without locking in additional personnel.
45 feet
tenders hold bibs to face
If a pulseless diver with no respiration is brought to your chamber, how long should you wait before beginning recompression and why?
DO NOT RE-COMPRESS A PULSELESS DIVER.
- if the diver is pulseless and not breathing ACLS is a higher priority than recompression. (ACLS) advanced cardiac life support
- CPR must begin immediately and an AED should be placed on the victim as soon as possible.
- If the pulseless diver regains vital signs continue, or begin, transport to the nearest critical care facility prior to recompression.
What are the three primary objectives of recompression treatment?
R-R-R
Recompress the bubble
Resorption of bubble
Repair- Increase O2 pp to damaged tissue
What is the treatment of severe mediastinal emphysema?
shallow recompression may be beneficial. Re compression should only be carried out upon the recommendation of a Undersea Medical Officer who has ruled out the occurrence of pneumothorax.
what are the procedures for CNS O2 tax in the chamber?
If symptoms of CNS oxygen toxicity develop again or if the first symptom is a convulsion, take the follow action:
- Remove O2 bibs and breath chamber air
- wait 15 mins after all symptoms have subsided resume breathing at point of interruption for 5,6, 6a
Remove>decompress>Resume>contact DMO
Remove the mask.
After all symptoms have completely subsided, decompress 10 feet at a rate of 1 fsw/min. For a convulsion, begin travel when the patient is fully relaxed and breathing normally.
Resume oxygen breathing at the shallower depth at the point of interruption.
If another oxygen symptom occurs after ascending 10 fsw, contact a Undersea Medical Officer to recommend appropriate modifications to the treatment schedule.
If a pulseless diver with no respirations is compressed and ACLS arrives explain the procedures for administering ACLS. (depth is 60ft)
If ACLS arrives, surface the chamber at 30fpm (2 mins) and apply the AED (not authorized at depth)
Let the qualified team try and revive the patient.
stay with the patient to the hospital
What is the minimum number of personnel required to conduct normal and emergency recompression chamber operations?
minimum: 3-chamber sup, inside tender, outside tender
ideal: 7- DO, MDV, UMO, Chamber sup, IT, OT, Com/logs
emergency: 2- Chamber sup, IT
you are treating a patient on TT-5 for type 1 in his right elbow. At 32’ on ascent from 60-30, he tells you that his right elbow is starting to hurt again. COA?
Treat as symptoms of recurrence
- press back down to 60ft
- complete 3 20 min O2 breathing
- decompress TT-6
What % levels must the chamber 02 and C02 be maintained during a treatment?
O2- 19-25%
CO2- Below 1.5 SEV
Below .78 @30
Below .53 @60
Below .25 @165
When would you conduct a neuro prior to treatment?
Type 1 dcs (expect for cutis marmorata)
Dcs type 2 minor numbness not spreading
No deterioration
Explain in detail the procedures for loss of O2 during a treatment in the following situations.
If repair can be completed within 15 mins
if repair can be completed after 15 mins but before 2 hours
with in 15 mins:
- Maintain depth until repair is completed.
- After O2 is restored, resume treatment at point of interruption.
after 15 less than 2 hours:
- Maintain depth until repair is completed.
- After O2 is restored: If original table was Table 5, 6, or 6A, complete treat- ment with maximum number of O2 extensions.
list 5 times a TT-5 may be used
- Type I DCS (except for cutis marmorata)
- Asymptomatic omitted decompression
- Carbon monoxide poisoning
- Gas gangrene
- Follow-up treatments for residual symptoms
Define the following definitions
- Immediately available chamber
- ready chamber
- emergency chamber
Immediately- a navy certified chamber available with in 5 mins. may be extended to 7 mins with CO auth.
Ready- avalible with in 1 hour.
Emergency- with in 6 hours
Tenders on TT 5, 6, 6A, 1A, 2A, or 3 should have a minimum of a ____ -hour surface interval before no-D diving and a minimum of a ____ - hour surface interval before dives requiring decompression stops. Tenders on TT 4, 7, and 8 should have a minimum of a ____- hour surface interval prior to diving.
- 18 hours
- minimum of a 24 hour
- 48hours
Can non diving personnel be used as an inside tender?
Non-diving medical personnel must obtain -a current diving physical exam,
- conform to Navy physical standards,
- pass the diver candidate pressure test.
What type of chamber shall be painted IAW Recompression chamber paint process instruction (NAVSEA-00C3-PI-001)
NAVSEA carbon steel chambers
describe the recompression treatment procedure for an AGE and there is no 02 available. (not getting it back)
complete decompression in the chamber on 50% nitrogen 50% oxygen (preferred) or on air. If 50% nitrogen 50% oxygen is available, multiply the remaining oxygen time by two to obtain the equivalent chamber decompression time on 50/50. Air breaks are not required when breathing 50/50.
During a treatment What should the oral fluid intake be?
One to two liters of water, juice, or non-carbonated drink, over the course of a Treatment Table 5 or 6, is usually sufficient.
what is Pulmonary/ CNS O2 Toxicity? which is most likely to develop? what are the symptoms?
Pulmonary O2- Low O2 toxicity, Substernal burning, severe pain on inspiration (inhale), more likely to develop on long TT- 4,7
CNS O2- High O2 toxicity, 1.3 ata (wet) 2.4 ata (dry), VEN(twitching)IDC
CNS O2 is more likely to develop on shorter TT.
CNS 02 VENDTIDC, Pulmonary O2 CBS (cough severe, Breathing shortness of breath, substernal chest pain)
when is the use of a TT-6A mandatory?
is used to treat arterial gas embolism or decompression symptoms when severe symptoms remain unchanged or worsen within the first 20 minutes at 60 fsw.
What are the duties and responsibilities of the Chamber supervisor?
-Communicating with personnel inside the chamber.
-minimum manning levels for conducting recompression
treatment (Table 17-1).
-Ensuring every member of the chamber team is thoroughly familiar with
all recompression procedures.
- Undersea Medical Officer is contacted at the earliest opportunity during treatment and before release of any patient from the treatment facility.
- Make sure everything is LOGGED
- Ensuring details related to the assessment and treatment of the patient (e.g. condition prior to treatment, time and depth of complete relief, patient vital signs) are thoroughly documented in the recompression chamber log IAW section 5-5 and the command dive bill.
- Tracking bottom time and the decompression profiles of personnel locking in and out of the chamber.
- Ensuring the decompression profiles of persons locking in and out of the chamber are logged in the chamber log.
explain direct and indirect bubble effects.
Direct Bubble Effects-Bubbles forming in the tissues (autochthonous bubbles) and in the bloodstream (circulating bubbles)
indirect bubble effects- because a bubble acts like a foreign body. The body reacts as it would if there were a cinder in the eye or a splinter in the hand. The body’s defense mechanisms become alerted and try to eliminate the foreign body.
List the max permissible recompression chamber exposure times for the following temperatures.
greater than 104
95-104
85-94
less than 84
greater than 104 - intolerable no treatment
95-104 - 2 hours TT 5,9
85-94 - 6 hours TT 5, 6, 6A, 1A, 9
less than 84 - Unlimited all treatments
