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Editors: Richard D. Vann, B.A., B.S., Ph.D. Divers Alert Network Center for Hyperbaric Medicine and Environmental Physiology Duke University Medical Center Durham, North Carolina, USA Simon J. Mitchell, M.B., Ch.B., Ph.D., DipDHM, FANZCA Department of Anaesthesiology University of Auckland Auckland, New Zealand Petar J. Denoble, M.D., D.Sc. Divers Alert Network Durham, North Carolina, USA T. Gavin Anthony BSc, MSc, CChem, CSci, FRSC QinetiQ Alverstoke, UK Technical Diving Conference Proceedings 7
Technical Diving Conference Summary TECHNICAL DIVING CONFERENCE SUMMARY Richard D. Vann, Ph.D. Divers Alert Network Center for Hyperbaric Medicine and Environmental Physiology Department of Anesthesiology Duke University Medical Center Durham, NC, USA The Divers Alert Network (DAN) held a two-day technical diving conference on January 18-19, 2008 in Durham, NC. Included were four half-day workshops that addressed relevant issues pertaining to physiology, decompression, rebreathers, and training. These proceedings are the written record of the conference. Presentations and discussions are also available as video recordings. 1 Topics covered in the workshops are described below. Physiology Workshop. The objectives of technical diving are to dive deeper and stay longer which exposes a diver to physiological stresses absent at sea level. Carbon dioxide is a particular concern. The lungs must be adequately ventilated with fresh gas to eliminate carbon dioxide or there are risks of headache, shortness of breath, unconsciousness, and increased likelihood of narcosis and oxygen toxicity. Many factors that influence the occurrence of oxygen toxicity, nitrogen narcosis and the high pressure nervous syndrome (HPNS) are well-understood, but their thresholds are illdefined. Hypothermia is exacerbated by long dives, and insight into its physics and physiology is useful for understanding new active and passive thermal protection. Decompression Workshop. Longer and deeper dives require slow ascent to avoid decompression sickness (DCS). Much is known but much is uncertain. Bubbles have acute physical effects and delayed biochemical effects. Mechanisms leading to objective signs and subjective symptoms differ in according to affected tissues. Several environmental factors can cause large increases or decreases in DCS risk. Available evidence concerning deep decompression stops does not support their effectiveness. DCS is probabilistic, not deterministic. Risks can be reduced but not realistically abolished. DCS severity differs widely with probabilities that depend on dive conditions and inert gas species. Recompression on oxygen remains the gold standard for therapy, but methods that provide rapid intervention, such as in-water recompression, deserve consideration. 1 The PowerPoint® and mp4 video files may be viewed on line at the DAN website (www.dan.org) or downloaded to your computer by right-clicking on the file name. A high-resolution DVD is available at no cost. Please contact DAN Member Services at (800) 446-2671, Option 3, and ask for Product # 171-0010. Technical Diving Conference Proceedings 8
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Decompression Workshop Risk Factors
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Workshop Rebreather Workshop: Chair
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Testing Divers’ Underwater Breath
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Appendix A. Glossary HSE IANTD ISO
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Appendix B. Schedule APPENDIX B. Sc
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Appendix C Attendees Dave Crockford
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Appendix C Attendees Tom McKenna Ne
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