The Power of Pressure: One Doc's View

[HBDiveGirl]

Sitting at Ocean Adventures Dive Shop about to hear hyperbaric medicine specialist, Dr. Ralph Potkin, talk about diving's effect on human physiology.

More soon!

~~
Claudette

[HBDiveGirl]

I love a dive store that can:

A) pull in a top-shelf physician specialist to speak, and

B) pull in 30 dive club members and guests in Los Angeles... on a school night!

Steve Ladd, owner of Ocean Adventures Dive Company, offered up a smart night of diving information by inviting renowned specialist, Dr. Ralph Potkin, to talk about what he does and what he loves: Hyperbaric Medicine... and diving.

Dr. Potkin is the medical director of the Beverly Hills Center for Hyperbaric Medicine and the Malibu Hyperbaric Medical Center, (affliiated with Cedars Sinai Medical Center), Clinical Professor of Medicine at UCLA, team physician of the US Free-Diving team, and a lifelong diving enthusiast.

Dive club attendees were fascinated to learn about the differences between single-person 100% O2 hyperbaric chambers and the air-pressurized multi-person chambers (with oxygen delivered by mask or hood) more familiar to recreational divers.

Graphs, charts, and photos described medical HBO (Hyperbaric Oxygen) therapy's success in treating non-healing wounds, osteomyelitis, skin burns, and failing skin grafts. This stuff works by reducing inflammation in the injured tissue and limiting the white blood cell response that often causes delayed healing in wounds.

Non-diver medical patients often have to learn how to equalize their ears during treatments to avoid ear barotrauma, a skill all the divers in the room take for granted.

And who knew medical patients in multi-person chambers get their oxygen via clear vinyl hoods instead of the on-demand valve masks.... because most people in the world don't want to breathe through a regulator for hours at a time! Go figure!

This is serious stuff!!! And the divers pummeled the doc with enthusiastic questions.

And then it all came back to diving:

• Why high partial pressures of oxygen are tolerable in the chamber but likely to cause oxygen-toxicity when a diver's working underwater.

• How a record-breaking 20-minute static apnea breath-hold was accomplished after 30 minutes of pre-oxygenation... and that amazing mammalian diving response.

• Type I vs. Type II decompression illness, Arterial Gas Embolisms, and why early oxygen treatment is always a good idea for any diving decompression injury.

• That cardiac pacemakers have an MOD determined by the manufacturers!! (Where should we put the labeling tape?)

• And why this doc has seen enough to become very cautious, diving nitrox while limiting profiles to air tables.

Dr. Potkin is a consulting physician for DAN, specializing in asthma and diving.
He described the parameters that may allow someone with mild asthma under good medical control to dive wisely and safely.

Mildly asthmatic divers who have been cleared to dive under these protocols have shown no increased risk of drowning and no increased risk of arterial gas embolisms according to research studies quoted by Dr. Potkin.


What a cool night.
A wise dive shop trusting it's dive club members to be interested in challenging topics, and the divers stepping up.

And then there was pizza.

So glad I could be there!

Thanks, Ocean Adventures!

~~~~~
Claudette

[Fish Eater]

Sounds great. Wish I could have been there.


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[HBDiveGirl]

The stuff I didn't know.

Dr. Poktin spoke a little about his experiences as Team Physician to the US Free-Diving team.

"When a competitor surfaces, they have to do a couple of things in order for the dive to count in the competition. The diver has to surface conscious, remove his/her mask independently, and give a clear "OK" hand signal. If they can't do all this, the dive is disqualified. Fatalities are rare but loss of consciousness is not rare at all. As a doctor, when someone's not breathing, we want to jump forward and do something. The free-divers taught me their routines to arouse an unresponsive competitor..touching their face, calling out...several things that result in the diver spontaneously taking a breath and regaining consciousness. They looking for small rhythmic hand motions they call the "Samba" sign."


Wow. The stuff I don't know.

(Did I mention how much I love my regulator and portable breathing gas? Oh, baby.)

~~~
Claudette

[TobinGeorge]

The stuff I didn't know.

Dr. Poktin spoke a little about his experiences as Team Physician to the US Free-Diving team.

"When a competitor surfaces, they have to do a couple of things in order for the dive to count in the competition. The diver has to surface conscious, remove his/her mask independently, and give a clear "OK" hand signal. If they can't do all this, the dive is disqualified. Fatalities are rare but loss of consciousness is not rare at all. As a doctor, when someone's not breathing, we want to jump forward and do something. The free-divers taught me their routines to arouse an unresponsive competitor..touching their face, calling out...several things that result in the diver spontaneously taking a breath and regaining consciousness. They looking for small rhythmic hand motions they call the "Samba" sign."


Wow. The stuff I don't know.

(Did I mention how much I love my regulator and portable breathing gas? Oh, baby.)

~~~
Claudette

I witnessed a couple "Sambas" when I took a PFI free diving class. It's not at all uncommon.

(I too like having *lots* of breathing gas with me )

Tobin

[LCF]

Sounds like a fascinating evening! Wish I could have been there.

[Mo2vation]

OADC is really starting to separate themselves as the destination dive shop on the westside, and most likely across SoCal.

Aside from the outstanding team that's assembled there, they also have the equipment we use (rare, as most of the people here will attest to), the classes we take (even rarer) and lastly - they have the gasses we breathe and use (rarest yet!) in stock and ready to fill. Nitrox, Argon, trimix banked. You know me, I'm not much of a 'shop guy' - but this place continues to distinguish themselves as the destination dive shop for the serious SoCal divers.

I've grown to love Steve, his crew and really appreciate these guys. They've come a long way in 4 years and are a model for a shop that is doing the right things right.


-Ken

[Fish Eater]

[snip]

I've grown to love Steve, his crew and really appreciate these guys. They've come a long way in 4 years and are a model for a shop that is doing the right things right.


-Ken

AND one of their instructors retrieved my prescription mask that had been in the clutches of the Redondo Beach Gear Monster for five days and returned it to me in NorCal. Well done!!

I'll be sure to pay a visit next time I'm down south again.


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[bleeb]

• And why this doc has seen enough to become very cautious, diving nitrox while limiting profiles to air tables.

Cautious in which sense? Dive times? Depths? Max ppO2?

[Peter Guy]

'Dette -- I'm beginning to think it is really amazing what "local gems" are scattered around but who may not be asked to talk to local groups. This does sound like a great night.

[kevrumbo]

Good report! Hope that motivates those who have time to actually take classes, volunteer and work (as well as the usual monetary contribution for Chamber Day) for our non-profit LA County Hyperbaric Facitlity on Catalina Island. Lots of excellent programs to enroll in which also support the operation of this Advanced Life Support base (an extension of the mainland LA County General-USC Medical Center Emergency Dept), and open to all divers across the country willing to volunteer for Chamber Crew:

http://dornsife.usc.edu/hyperbaric/e...onal/index.cfm

Mission Statement of the USC Catalina Hyperbaric Chamber:

The USC Catalina Hyperbaric Chamber is dedicated to the promotion of underwater diving safety and treatment of Southern California diving casualties and is part of the University of Southern California, a non-profit 501(c)(3) organization:

• The USC Catalina Hyperbaric Chamber's primary mission is the treatment of scuba diving casualties, and to this end the organization maintains the chamber facility and ensures crew availability 24 hours-a-day, 365 days-a-year
• The USC Catalina Hyperbaric Chamber provides educational programs focused on the promotion of underwater diving safety
• The USC Catalina Hyperbaric Chamber gathers information on diving casualties and standard diving practices, and reports unbiased information to the diving communities
• The USC Catalina Hyperbaric Chamber is a hyperbaric research facility available for underwater diving research projects to improve diving safety and test equipment

>

[Miss Scuba]

Claudette, thanks for the great write up! It was an amazing and fascinating presentation, you are right. I asked Ken and he gave the OK to republish this on www.miss-scuba.com So, I will share this with the girls and of course link it to Dive Matrix!

[Mo2vation]

Hey Szilvia - great to see you this afternoon!

Welcome to DiveMatrix!


-Ken

[HBDiveGirl]

Cautious in which sense? Dive times? Depths? Max ppO2?

I asked for specifics but no additional information was offered.

~~~
Claudette

[TobinGeorge]

Cautious in which sense? Dive times? Depths? Max ppO2?

Breathing nitrox while using Air Tables is by it's self a conservative approach.

Tobin