ࡱ> yx`!GTZz[yzOk\5xXMlE]:N8X)@Rr\E-ROD`%JJT8z@&*U ɗġB|;~dmEB"x=ͼo޾jg˚h57STgT/h74R(HGHm@}~PLGת|3'cud&bXĴmkEUScٷY\)6?rw?v_Bk[?U`q|I|jJ|.,^|&_H%!o!o7Rhk_>h݌iLXP_1^) @bԳ{MHLhgKV6ж-! b +Bh+^ }~m5Cvcq +BD^pO41u@:FCߝeb`/[:R-uh;Msn-S'{Z4[:K~m"21uw5#6FCvco:  G}1uZK]y9r<74\}>(3 A1l@`}cF[!XdqIh6[akM&e$E4ĩy%;1zv7G<ʊ;i"{]D\(z8z9Uعuݣ\i\\I(SJ8NV9@/Bvl'V n7'CFf`& Mf=3W;x씻iV<(4(P    0b Chart MSGraph.Chart.800Microsoft Graph 97 Chart/0(  0;[0 0 000$([\{b00 000000000  0=] 0 0 0000 2 3 !A0C0E0G0I0c00000000000000000!%),.:;?]}acdeghijklmnop0DTimes New Roman8b8b`b0bb0DArialNew Roman8b8b`b0bb0" DMonotype Sorts8b8b`b0bb00DVerdana Sorts8b8b`b0bb0"@  @@``  @n?" dd@  @@`` X*(/      !"#$%&'(),2$GTZz[yzO 01?@ g42d2db0b xppp <4BdBd$8bf\ ?", Bends #O =,BENDS IS NOT A DIRTY WORD:Pj(*A Practical Look at Decompression Illness +0d+0,History%During 1994-1996 City Island Chamber in NY was operated by the Extended Range Diving Organization Inc. A not-for-profit diver company. The facility operated on a 24 hour a day 7 day a week basis exclusively for the treatment of recreational divers. This program was developed as a result of what City Island Chamber learned during the treatment of over 56 divers on over 200 treatments. City Island Chamber is not in operations today. It was a stop gap measure during a critical time in East Coast Diving. Hospital facilities now serve that need. *&$What is The Bends?6It is the syndrome of joint pain, numbness, paralysis and other symptoms caused by the release of gas dissolved in tissues, which forms bubbles in the blood upon surfacing after a scuba or compressed gas dive. Bubbles forming in tissues near joints cause the pain of classical  bends. When high levels of bubble formation occur, complex reactions take place, which can cause other symptoms.6  ^ When does it show up?6VSymptoms and signs can appear within 20 minutes to 48 hours after surfacing from any dive. Severe cases can show symptoms  in-water or immediately upon surfacing.6b I   HWho is thought to be a  Bent Diver? %%(Divers who exceed no-deco limits Deep divers Cold water divers Inexperienced divers Divers with  risky profiles  Stupid divers  Bad divers a$ $CITY ISLAND CHAMBER 1994 STATISTICS0%$$ 0 % Technical Diver 17% Deeper than 130 fsw 17% No Timing Device 41% Multi-day Trips 48% Caribbean/Mexico 52% Fly < 24 hrs. after diving               Sources of Myths6^Instructors Retailers Resort Operators Medical Personnel Training Agencies Poor Press Coverage_ a_  Emotional Issues6Anxiety Shame Humiliation Guilt Incompetence Exaggerated fears of treatment Fear of inability to dive again Real concern for physical well-being a" Diver Denial HJ  The diver may mobilize defenses and engage in behaviors that temporarily ease the psychological burden. Jennifer C. Hunt, Ph.D. aquaCorps, N5>0d2(, >Injured Diver s First Reactions 0 Not me, I m a good diver.  Only bad divers get bent.  It s only a sprain.  I probably have the flu.  I m just tired.  I m within the tables.  My computer says I m O.K.  I don t want to ruin the trip.  a$ Secondary Reactions0t Maybe I am hurt.  It will probably go away.  I don t want to go to a chamber.  Can I afford treatment?  Am I insured?  If I am bent can I ever dive again?  I m probably not bent.  a$ DCI Signs and Symptoms0UDisorientation Dizziness Fatigue Hearing Difficulties Muscle Pain Numbness Joint PainV V$ Treatment Delays055 % delayed treatment for 48 hours or longer. 38 % had signs and symptoms that forced them to seek treatment in under 24 hours. 14 % had significant delays due to seeking help from non-diving medical personnel. `a--  ]DELAYING TREATMENT % of Divers with Post-Treatment Residuals as a Function of Treatment Delay*^,K  Incident Management,-At first sign - 100 % Oxygen. Tell someone (buddy, boat captain, etc.) DO NOT let anyone minimize your urgency. Monitor your changes. Call for help - 911 - USCG - DAN Drink plenty of non-alcoholic fluids. DO NOT take minor signs lightly. Never re-enter the water. Get to a recompression facility fast.X. R     How Recompression Works0gA room is pressurized with air while a diver and a medical tender relax inside. Most treatments are done at 60 fsw - 2.8 ata. The diver breathes 100 % oxygen by a mask/hood, producing a surface equivalent of 280% oxygen. Oxygen eliminates nitogen in the body and maximizes bubble resolution. Oxygenation of areas with compromised blood flow promotes healing. B~ Y_ pYA Yh,xrrTreatment Schedules0Average initial time at a hyperbaric facility 8 hours Repeat oxygen treatments last 2 hours. Depending on DCI severity, treatments can be from 2 to 36 hours . 8 @(Bends Prevention<Dive within your training level. Always do a safety stop. Limit decompression dives to one a day. Deepest dive first. Use conservative dive tables Take a day off every two on long trips. 24 hours minimum before flying. Stay well hydrated. NO ALCOHOL !  What you can do now6<< <XTraining / Attitude Community Participation Peer Support Organization Support Y Y0 Training  B CPR / First Aid Oxygen Provider Certification Advanced Diver Certification NAUI Nitrox training Rescue training Introduction to Hyperbarics ( Community Participation6Dive club meetings Tours of hyperbaric facilities Encourage oxygen availability Promote Responsible Diving Display safety signs and phone # s ( Peer Support < Learn signs of diver denial Encourage early treatment Don t promote myths Take  bends out of the closetm m,Organization Support<X Join UHMS Hyperbaric Resources DAN Help Maintain phone service Volunteer your time    6666  Decompression sickness is not an accident; a certain incidence of it is expected from practical diving R.W.  Bill Hamilton, Ph.D$q6 P The strong negative social reaction and stigma surrounding DCI increases the trauma, and jeopardizes the healing process. Jennifer C. 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Silversteinn6 SMicrosoft PowerPoint 4.0D@m-;g@@5Oϗ^@`(V_8G(o   0&z &&#TNPP0D & TNPP &&TNPP   z && "--&&<- $((<- $((PP;- $PPxx;- $xx:- $8- $7- $5- $@@3- $@@hh1- $hh/- $-- $,- $+- $00*- $00XX*- $XX&&& "- & $&7I&-&& &&-&&&&<- $((<- $((PP;- $PPxx;- $xx:- $8- $7- $5- $@@3- $@@hh1- $hh/- $-- $,- $+- $00*- $00XX*- $XX&- "--&&--H:-- - "Verdana - .$2 wA Practical Look at'""" "#!". .(2 Decompression Illness ,"#7$""$$".--(-- Y"Verdana0- .2 BENDSrv. .2 BENDSrv."Verdana - . 2  . . 2  ."Verdana0- .$2 IS NOT A DIRTY WORD"((!%'% #6(%(. .$2 IS NOT A DIRTY WORD"((!%'% #6(%(.--L-- "Ariala- .2 9Joel Silverstein     . .02 ?Scuba Training + Travel Co.        .--"Systemn-&TNPP &՜.+,D՜.+,   7 35mm Slidesν    Times New RomanArialMonotype SortsVerdanaRemovable Disk (E:)Microsoft Graph 97 ChartBENDS IS NOT A DIRTY WORDHistoryWhat is The Bends?When does it show up?%Who is thought to be a Bent Diver?%CITY ISLAND CHAMBER 1994 STATISTICSSources of MythsEmotional Issues Diver Denial Injured Divers First ReactionsSecondary ReactionsDCI Signs and SymptomsTreatment Delays^DELAYING TREATMENT % of Divers with Post-Treatment Residuals as a Function of Treatment DelayIncident ManagementHow Recompression WorksTreatment SchedulesBends PreventionWhat you can do now Training Community Participation Peer SupportOrganization SupportNo Slide TitleNo Slide TitleBENDS IS NOT A DIRTY WORD  Fonts UsedDesign TemplateEmbedded OLE Servers Slide Titles 6> _PID_GUIDAN{DC4507C0-CB1C-11D2-8A0D-F43006C10000}&_㪭bJ. 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