Inside Tender

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Author:
ftc0369
ID:
56992
Filename:
Inside Tender
Updated:
2011-01-06 12:31:57
Tags:
Navy Diver
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Description:
Basic Inside Tender
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  1. DMO Subspeciality Codes
    • 16U0
    • 16U1

    *only DMO's w/ these codes may modify Tx tables w/ concurrence of CO/OIC.
  2. availability of AED
    w/in :10 keep on surface

    press to 60; w/in :20 surface @ 30fpm

    *do not compress pulseless diver
  3. Type II categories
    • Neurological
    • Inner Ear (staggers)
    • Cardio Pulmonary (chokes)
  4. Type I
    • full neuro on surface
    • complete relief w/in :10
  5. Type II
    significant relief w/in :20

    if unchanged or worsen; DOR not to exceed 165/ TT6A
  6. Symptomatic Omitted D
    50fsw or shallower - TT6

    deeper - compress to significant improvement not to exceed 165/ TT6A

    deeper 165 - DOR not to exceed 225/TT8
  7. Patient observation
    Pain only - 2 hours

    serious Sx - 6 hours

    *do not release w/o DMO consult
  8. Air Tx Tables
    1A - pain relieved less than 66fsw

    2A - relief greater than 66fsw

    3 - relief w/in :30 @ 165

    4 - greater than :30 @ 165
  9. TT5
    • - Type I DCS (full neuro/complete relief w/in :10)
    • - Asymptomatic Omitted D
    • - resolved Sx after in-water Tx
    • - follow-up for residual
    • - CO poisoning
    • - gas gangrene
  10. TT6
    • - AGE
    • - Type II DCS
    • - Type I DCS (no neuro on surface/no relief w/in :10 but significant improvement w/in :20)
    • - Cutis Marmorata
    • - CO, cyanide, smoke
    • - Asymptomatic Omitted D
    • - Symptomatic uncontrolled ascent
    • - recurrance shallower than 60fsw
  11. Px sleeping
    anyitme except on O2 deeper than 30fsw
  12. Vital signs
    Pulse 60-100

    Respirations 12-16

    BP 120/80

    Temp: 98.6 (+/-2)
  13. Chamber manning requirements
    3 minimum

    2 emergent

    4 optimal
  14. CO2 chamber levels
    1.5 SEV (11.4 mmHg)

    • 0.78 - 30fsw
    • 0.53 - 60fsw
    • 0.25 - 165fsw
  15. Permissable Chamber Temperatures
    • over 104F - intolerable/no Tx
    • 95-104F - 2 hrs / TT5,9
    • 85-94F - 6 hrs / TT5,6,6A,1A,9 under 85F - all
  16. IV drip rate
    w/o guidance from medical:

    75-100 cc/hr normal saline/lactated ringers solution
  17. adequate urine output
    .5cc/kg/hr

    clear/colorless urine
  18. Inside Tender Responsibilities
    • - release door latches (dogs)
    • - communicate w/ topside
    • - first aid as required
    • - Tx gas
    • - hearing protection
    • - Px position
  19. Non-diver IT requirements
    IT PQS complete

    pre-req:

    • dive physical
    • Navy physical standards
    • pressure test
  20. Specialized medical care
    A qualified IT is req to be inside chamber to handle system related requirements.
  21. IT tending frequency
    18hrs - 1A,2A,3,5,6,6A

    48hrs - 4,7,8

    5,6,6A w/in 18 require O2 / 30fsw ^

    SI inforced for 1A,2A,3,4,7,8
  22. Tx gases used w/ TT's
    • 0-60 100% O2 (ppO2 1.0 - 2.82)
    • 61-165 50/50 N2O2 (ppO2 1.42-3.0)
    • 166-225 64/36 HeO2 (ppO2 2.17-2.81)
  23. Procedures for CNS O2 Tox.
    • 5,6,6A
    • 1st:
    • - off O2
    • - :15 after Sx completly subsided
    • - resume POI

    • 2nd(or 1st convulsion):
    • - off O2
    • - Sx completely subsided (fully relaxed and breathing normally); up 10fsw (1ft/min)
    • - resume POI

    • 3rd
    • -DMO for modification


    • 4,7,8
    • - off O2
    • - DMO for modification
  24. Loss of O2 to Chamber
    • - repair w/in :15
    • - resume POI

    • - before 2hrs
    • - max extensions
  25. Medical kits
    • primary - immediately available
    • (diagnostic equipment)

    secondary - equipment/meds
  26. Types of Thermometers used in the Chamber
    • alcohol
    • bi metalic
    • led
    • electronic

    *not mercury
  27. Permisable polyester/cotton blend?
    65/35
  28. When is a pressure test required for a chamber?
    • 2years
    • initial
    • overhaul
  29. What are the ventilation rates for air/O2 (@ work / @ rest)?
    AIR: 2@rest / 4@work

    O2: 12.5@rest/25@work
  30. What are the symptoms of Hypoxia?
    • Loss of concentration
    • Inability to perform delicate tasks
    • Drowsiness
    • Weakness
    • Agitation
    • Euphoria
    • Loss of Consciousness
    • ^ pulse rate
    • ^ BP
    • General cyanosis (lips, nail beds, skin)
  31. What are the symptoms of Hypercapnia?
    • ^ breathing rate
    • Euphoria
    • ^ sweating
    • Drowsiness
    • Headache
    • Loss of consciousness
    • Convulsions
    • ^ breathing rate
    • ^ pulse rate
  32. Name 5 POIS's
    • interstitial emphysema
    • AGE
    • mediastinal emphysema
    • pneumothorax (simple/tension)
    • subcutaneous emphysema
  33. Lvls for Hypoxic Sx's
    • .21 ppO2 normal
    • .16 ppO2 onset of hypoxic symptoms
    • .11 ppO2 helplessness
    • .10 ppO2 unconsciousness
  34. Chamber lvls for O2 & CO2
    19-21% O2

    1.5 SEV CO2

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