DOF Subsea DOM-A-Rev 0 Air & Emerg Proc
DOF Subsea DOM-A-Rev 0 Air & Emerg Proc
DOF Subsea DOM-A-Rev 0 Air & Emerg Proc
This document contains information that is confidential and proprietary to DOF Subsea Pty. Ltd. It may be copied in part or in whole and used by the addressee named (Client) above for purposes directly related to the original reason for its publication. This document or its contents may not be disclosed to third parties without the express written approval of DOF Subsea Pty. Ltd. Unauthorised use, disclosure or copying is strictly prohibited.
Diving Operations Manual Annexe A Air Diving Operations and Emergency Procedures
TABLE OF CONTENTS
1.0
1.1 1.1.1 1.1.2 1.1.3 1.2 1.2.1 1.2.2 1.2.3 1.2.4 1.2.5 1.2.6 1.2.7 1.2.8 1.2.9 1.3 1.3.1 1.3.2 1.3.3 1.3.4 1.3.5 1.3.6 1.3.7 1.3.8 1.3.9 1.3.10 1.4 1.4.1 1.4.2 1.5 1.5.1 1.6 1.6.1 1.6.2 1.6.3 1.6.4 1.6.5 1.6.6 1.7 1.7.1 1.7.2 1.7.3 1.7.4 1.8 1.8.1
2.0
2.1 2.1.2 2.1.3
Diving Operations Manual Annexe A Air Diving Operations and Emergency Procedures
2.2 TABLE SELECTION...................................................................................................................................36 2.2.1 Selection of Decompression Schedule ..........................................................................................................36 2.2.2 Ascent Procedures............................................................................................................................................38 2.2.3 Diving At High Altitudes....................................................................................................................................39 2.2.4 Unlimited / No-Decompression Limits and Repetitive Group Designation Table for NoDecompression Air Dives..............................................................................................................................................40 2.3 US NAVY STANDARD AIR DECOMPRESSION TABLE ...................................................................................43 2.3.1 Table US Navy Standard Air Decompression Table ..............................................................................43 2.4 SURFACE DECOMPRESSION TABLE USING OXYGEN ..................................................................................54 2.4.1 Procedure...........................................................................................................................................................54 2.4.2 Oxygen System Failure (40-FSW Chamber Stop).......................................................................................55 2.4.3 CNS Oxygen Toxicity (40-FSW Chamber Stop). .........................................................................................56 2.4.4 Convulsions at the 40-FSW Chamber Stop. .................................................................................................57 2.4.5 Repetitive Dives. ...............................................................................................................................................57 2.4.6 Table Surface Decompression Using Oxygen ..........................................................................................58 2.5 SURFACE DECOMPRESSION USING AIR ....................................................................................................63 2.5.1 Table Surface Decompression Using Air ...................................................................................................64 2.6 OMITTED DECOMPRESSION .....................................................................................................................73 2.6.1 Planned and Unplanned Omitted Decompression.......................................................................................73 2.6.2 Table Management of Asymptomatic Decompression.............................................................................74 2.6.3 Omitted Decompression Procedures .............................................................................................................75 2.6.4 USN Table 5.......................................................................................................................................................77 2.6.5 USN Table 6.......................................................................................................................................................79
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3.1 3.1.2 3.1.3 3.2 3.2.1 3.2.2 3.3 3.3.1 3.3.2 3.3.3 3.4 3.4.1 3.4.2 3.4.3 3.4.4 3.4.5 3.4.6 3.4.7 3.4.8 3.4.9 3.5 3.5.1 3.5.2 3.5.3 3.5.4 3.5.5 3.6 3.6.1 3.6.2
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4.1 4.2
Diving Operations Manual Annexe A Air Diving Operations and Emergency Procedures
4.2.1 4.2.2 4.3 4.3.1 4.3.2 4.4 4.4.1 4.4.2 4.4.3 4.5 4.5.1 4.5.2 4.5.3 4.5.4 4.5.5 4.6 4.6.1 4.6.2 4.6.3 4.6.4 4.6.5 4.7 4.7.1 4.7.2 4.7.3 4.8 4.8.1 4.8.2 4.8.3 4.8.4 4.8.5 4.8.6
Expired Air Resuscitation (EAR)...................................................................................................................127 Cardiac Resuscitation.....................................................................................................................................127 BLEEDING AND SHOCK ..........................................................................................................................128 Controlling Massive Bleeding ........................................................................................................................128 Shock ................................................................................................................................................................128 TEMPERATURE RELATED INJURY ...........................................................................................................129 Hypothermia.....................................................................................................................................................129 Heat Stroke ......................................................................................................................................................130 Treatment for Heat Exhaustion (Hyperthermia)..........................................................................................130 MARINE ANIMAL INJURIES ......................................................................................................................131 Bites ..................................................................................................................................................................131 Puncture Wounds............................................................................................................................................134 Stings ................................................................................................................................................................134 Electric Shocks ................................................................................................................................................136 Marine Animal Injuries in Remote Areas .....................................................................................................136 GAS POISONINGS AND OTHER RELATED PROBLEMS ...............................................................................137 Respiratory Emergencies...............................................................................................................................138 Oxygen Deficiency ..........................................................................................................................................139 Nitrogen Narcosis............................................................................................................................................139 Oxygen Toxicity ...............................................................................................................................................141 Drowning ..........................................................................................................................................................143 BAROTRAUMAS .....................................................................................................................................144 Squeeze............................................................................................................................................................144 Gas Expansion and Reverse Squeeze........................................................................................................145 Round Or Oval Window Rupture ..................................................................................................................145 MEDICAL EMERGENCIES REQUIRING RECOMPRESSION ...........................................................................146 Diagnosis..........................................................................................................................................................146 First Aid.............................................................................................................................................................148 Recompression Therapy ................................................................................................................................149 Recompression Treatment ............................................................................................................................150 No Recompression Chamber ........................................................................................................................150 Decompression & Recompression Treatment ............................................................................................151
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5.1 5.1.1 5.1.2 5.1.3 5.2 5.3 5.4 5.5 5.6 5.7 5.8
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Diving Operations Manual Annexe A Air Diving Operations and Emergency Procedures
1.0 1.1
1.1.2 Access To The Job Site The distance from the diving platform to the water will determine how the diver will enter and exit and for distances of up to three metres, a diving ladder may be utilised. For distances beyond three metres, for example, from a jack up rig, a diver's stage (which must comply with the DOF Subsea DOM section 7.4.7.2) shall be used. Whenever a diver is deployed, a down line to the job site shall be used. The down line must be at least 12 mm diameter for a diver, or 18 mm diameter for a stage, and shall be secured to the job site with a shackle and an eye on the rope end. It should be secured by means of a weak link. If diving is taking place from a fixed platform and a stage is utilised, a tugger wire, if available, is the preferred option for down line purposes. A dive ladder must be of sufficient size and build to support a fully dressed diver whilst allowing the diver to descend or ascend with or without fins. It must also be able to be secured in such a fashion to the dive platform that it will not move excessively due to the swell or motion of a vessel or through use by the diver. 1.1.3 Dive Tables Unless directed otherwise by the Operations Manager, the dive tables used on all DOF Subsea air diving work sites will be current US Navy Air Standard Diving Tables with the exception of surface decompression where USN (Modified) Tables will be used. Refer to the Tables in section 2.0 of this Annexe.
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1.2
MOBILISATION - REQUIREMENTS
1.2.1 Safety Meeting Vessel Induction Prior to setting up and function testing the dive system, the diving crew must be inducted onto the worksite, whether it be a barge, vessel, platform, wharf etc. Apart from safety and procedures relevant to the site, the Diving Supervisor must discuss general diving procedures and safety relating to diving with the Site Safety Officer and PIC. All relevant legislation shall also be highlighted. The diving system will not be set up until these matters are finalised. 1.2.2 Dive Spread Setup Once mobilised onto a diving platform, the following must be adhered to: System set up and function tested. System sea fastened, if required. Safety railing installed, if required. Appropriate operational tags installed. In particular, "Do Not Touch" signs for divers' electrical compressor power outlet switch. System Function Testing
1.2.3 Time Keeping And Recording All DOF Subsea dives will be conducted on an elapsed time basis, using a stop watch in conjunction with real time notation. Divers' times, tasks, decompression, etc., will be recorded in the following: DOF Subsea Dive Log Book; DOF Subsea Daily / Narrative Job Log Book; DOF Subsea Supervisor Deck / Narrative Log Book; and will include all incidents and occurrences pertaining to the dive.
Note: For diving conducted under the jurisdiction of the P(SL)Diving Safety Regulations 2002, an audio tape will be used to record the dive. If no incidents occur during the dive day, the tapes may be reused on the following day. All divers are to record their own personal dives on a daily basis in personnel dive log books whilst paying attention to the detail required in logging of dives as per DOF Subsea DOM, AS/NZS2299.1: 2007 and the P(SL)(Diving Safety) Regulations 2002.
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Supervisor and diver log books, Australian certification, current medical qualifications, current divers medical and (T)BOSIET certification, must be carried by all members of the dive team on all DOF Subsea jobs. 1.2.4 Air and Oxygen Requirements For all dives, two independent air supplies shall be available. These supplies can be either: Supply Type 1 2 Primary supply LP compressor, and Reserve supply HP air Primary supply LP compressor, and Reserve supply LP compressor
NOTE: If LP compressors are used as primary and secondary air supply they shall have independent power sources or back up power sources. 3 Primary supply HP air, and Reserve supply HP air,
The supply source must be capable of delivering a minimum volume per diver of 42.5 litres/min/depth bar absolute, to a maximum depth of 50 msw (165 fsw). Air supplies to the deck decompression chambers should be arranged in such a manner that pressurisation or ventilation of the chamber does not deprive the working diver of his supply The following minimum quantities of air and oxygen must be available on site; Sufficient compressed air to perform a planned dive of normal duration to a chosen depth. Additional reserves of air for two emergency dives to the same depth. Air to pressurise the DDC to a maximum treatment depth of 50 msw and complete a full US Navy Treatment Table 6A with necessary ventilations. Oxygen for three complete surface decompressions. Reserves of oxygen for two divers on an extended US Navy Treatment Table 6.
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1.2.5 Purity of Air Supervisors must ensure that careful attention is paid to the sighting of compressor inlets to prevent dangerous gases being drawn into the compressor inlet. On worksites where only air diving is taking place it may be necessary for the Supervisor to increase the frequency of air purity testing. Neither of these requirements however, negate the need for air from all worksites to comply with the specifications detailed within section 7.4.1 of the DOF Subsea DOM. 1.2.6 Bail-out Bottle See Section 7.4.2 of the DOF Subsea DOM for details of bailout requirements for air diving operations. 1.2.7 Air Quads All air quads to be analysed for O content. Quads which are not filled with an HP compressor must be changed out at least once every 24 months. Check quad air analysis certificate is in date. All valves actioned at least weekly during a period of non use.
Minimum four bottles opened on HP air supply, pressures noted and regulator set to a minimum of 180 PSI. Regulator to be backed off at nights if not in use and whips bled down. 1.2.8 Stage Onboard Air Supply Where a stage is used it will be fitted with onboard air reserve to support a diver at the maximum working depth for a period of not less than 10 minutes. This will normally be by provision of 1 G size bottle. 1.2.9 Diving Breathing Hose A divers umbilical shall: Have a minimum internal diameter of 8mm.
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1.3
7 8
10
Once the system has been function tested, the inner lock will be pressurised to a sufficient pressure to take the outer lock to a depth of 50 feet without assistance from HP or LP sources. For all DOF Subsea chambers, 75 feet in the inner lock is sufficient to achieve this.
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1.3.2 Deck Decompression Chamber (DDC) Operation The outer lock door will remain open when not in use. Once it is known that surface decompression is to be undertaken, the chamber operator, in addition to conducting the pre-decompression check, will place in the outer lock items required by the diver during decompression. (These may consist of a towel, items of clothing, a drink and reading material, etc.) If not told by the Diving Supervisor, the chamber operator will find out the decompression schedule to be used and enter it on the chamber dive log. The diver, once entering the chamber, will use the equalisation valve at the same time as the chamber operator pressurizes the outer lock by actioning the blow down valve. A tender on the outside will hold the door closed until a seal has been made. The diver inside the outer lock may have to assist by leaning on the door. A strong back shall be available if required. Immediately, once a seal has been made, the diver will go onto oxygen. This will necessitate both internal and external oxygen and overboard dump valves being open. Time spent on oxygen in the outer lock does not count as decompression time but is mandatory. As communication is difficult due to noise on blow down, the diver must indicate at the port that he is in a satisfactory condition. If he is experiencing difficulty with the pressurisation, he must immediately ask for it to be stopped until the problem is rectified. Once the chamber has equalised, the equalisation valve in the outer lock will be closed, oxygen and overboard dumps internally and externally closed, blow down stopped and the diver transferred to the inner lock. Immediately before any other action, he will go onto oxygen by opening both the oxygen supply and overboard dump valve and donning a bib. Only once the diver has transferred through and is preparing to don his bib, are the external, inner lock, oxygen and overboard dump valves to be opened. Once the diver is on oxygen, the outer lock is taken away in the following manner: The diver will close the door and lean on it to assist gaining a seal. The chamber operator will open the outer lock exhaust whilst simultaneously opening the inner lock blow down to accelerate a pressure differential. Once a seal has been made, the blow down is closed and the exhaust of the entry lock continued until it is on the surface. Remember, the entry lock must be kept on the surface when not in use.
NOTE: It is of particular importance that the pressurisation of the inner lock, whilst depressurising the outer lock to force a seal, does not exceed 1-2 FSW. Once the seal has been made, ensure the inner lock is brought back to 50 feet or the depth required by the tables being used.
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During the decompression, continually monitor the diver to determine he is not suffering any undue effects from the surface decompression. Monitor the oxygen content of the chamber regularly and, at least once in every twenty minutes, flush the chamber by operating the exhaust and blow down valve simultaneously for five minutes. Maintain pressure as close as possible to the required depth. Record the times and any unusual incident in the chamber log and report them to the Diving Supervisor. Follow the USN (Modified) Tables or other designated tables religiously during the decompression. NOTE: DCIEM Table Surface Decompression procedures vary significantly from listed here. On ascent, DOF Subsea policy is for a ten minute bleed from 40 FSW to the surface. Always check on the diver prior to ascent, to ascertain his condition and advise him that ascent is due to start. Control the rate of ascent by the use of the exhaust valve to maintain a rate of ascent of four feet per minute. Once the diver has reached the surface, the chamber operator will check that he is physically fit and record the result on the dive log. The operator will then close the oxygen and overboard dump valves on the outside, purge the oxygen internally and close both internal oxygen and overboard dump valves. Once purged, clean the bib used with a DOF Subsea approved disinfectant. Under no circumstances are oxygen and overboard dump valves, except for oxygen at source, to be left open when not in use. Conduct pre-decompression check before pressurising the inner lock back to 75 FSW. For cleaning, refer to the Maintenance Log Book for the individual DDC. 1.3.3 Air Sample Procedures When taking an air sample for analysis refer to DOF Subsea DOM E- Section 1.4.2. 1.3.4 Equipment/Machinery Container Ensure ship's electrician is informed of power supply requirements and checks the integrity of all power supplies before use. Do not plug into any electrical outlet before informing the Diving Supervisor.
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1.3.5 Compressors Site compressor so that only clean air is taken into the air intake. Carry out daily checks as per compressor maintenance log book. Display warning of compressor operation. Ensure the delivery hose cannot be damaged and is unlikely to be caught by any moving object, ie., crane hook, winch wire, hot areas, eg: exhaust, etc. 1.3.6 Video System Set up and run video system. 1.3.7 Launch and Recovery System Ensure platform is securely fastened to the deck before use. Chains may be substituted for welding, provided they are certified and attached to certified tie down points. Welds may be subjected to NDT. Set up and run LARS. Check for an alternate means of recovering diver or dive stage. This may include the following: Crane. Tugger. Cargo slings. Standby vessel. Ships rescue boat. Ladder. Alternate power supply for LARS winch.
Ensure alternate diver recovery system or method explained at dive site induction. Man riding winches shall incorporate two independent brake operating mechanisms, at least one of which should be applied automatically. The wire rope and all attachments shall be certified as having a breaking load of at least weight (8) times the SWL.
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Where a stage is used it shall: Be large enough to accommodate a minimum of two persons with all their equipment, in uncramped conditions. Be prevented from tipping or spinning. Have internal hand grips. Have a tool box, that can double as a seat for each intended occupant. Not contain equipment in such a manner as to obstruct the occupants foothold or handhold. Have a chain or hinged bar across the opening to prevent a diver from falling out. Be fitted with onboard air reserve and fittings to support the anticipated number of divers at the maximum working depth for a period of 10 minutes. This will normally be by provision of 1 G size cylinder.
Reference DOF Subsea DOM Section 7.4.7. 1.3.8 Cutting Equipment Cutting equipment must be tested prior to deployment. Refer to the DOF Subsea DOM Section 8.7.10 for safety checks prior to use. Under no circumstances shall cutting equipment be made hot without prior approval from the site PIC (OIM / Vessel Master) and welder/electrician (where applicable). 1.3.9 Communications Establish channels to be used with vessel Master / rig or platform and cranes. For diving tasks, a dedicated channel is preferable over a client working channel. Fully brief crane drivers, winch/tugger operators, etc., of diving requirements. Refer to section on Dive Briefings which follows this section. 1.3.10 Diving Equipment General
Check all other equipment required for the project. Refer to section 0 for details of Diver Dress. Pay particular attention to the following: Dive torches, spare batteries and globes. Tools are sufficient for the tasks at hand and operable. Weight belts are to contain enough weight and be of sufficient size and are not to be of the quick release type. Diver knives are in good working order and sharpened.
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Harnesses must have crutch straps, buckles, a D ring for lifting and are to be nonquick release type. Fins are of the correct size with spare pairs and fin straps being held. Spares: Check the system inventory and manifests to ensure sufficient spares are stored as tasks and work scopes may change during the course of the project necessitating more of some items than originally envisaged.
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1.4
1.4.2 Vessel Master / PIC Briefings Most PICs (Vessel Masters / OIMs) supporting diving operations are fully aware of what is required of them, their vessel / facility and crew whilst diving operations are taking place, but a briefing to them must include the following. Vessel engines must be switched off and isolated whilst divers are in the water (except when the vessel is in DP mode). They must not be started until the Diving Supervisor gives the all clear to do so. Impressed current systems must be switched off prior to diving, and again not switched on until the diver Supervisor gives the all clear to do so. In certain circumstances, it may be safe for another vessel to come alongside whilst diving is being conducted, but this may only be done if the Diving Supervisor and PIC give permission to do so. Check the location of sea water intakes and be aware of their status whilst diving. This may necessitate communications with the faciltiy engineer as well as the PIC.
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When moored to a structure, rather than tied up to it, two mooring lines must be used at each corner of the vessel closest to the structure. When using air lifts or pneumatic tools from a vessel, warn the ship's Master and/or engineer of the possibility of air being taken up into the ship's sea water intakes.
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1.5
EMERGENCY DRILLS
The conduct of all emergency drills should be discussed prior to the drill being conducted, although the dive Supervisor should always consider drills to test the responsiveness of the dive team. During drills, some common steps should be followed: The standby diver shall always follow the divers umbilical. The Supervisor shall give air to both divers pneumo hoses. The standby diver shall always free flow the mask of an unconscious diver.
1.5.1 Daily Checks The following daily checks are to be performed on diving equipment as listed. These constitute the minimum checks required prior to use. NOTE: These Daily Checks are additional to and do not replace the Pre-Dive Checks see section 1.6. Type Hats and Masks Band Daily Checks Confirm maintenance log book is up to date. Non return valve is to be checked. Communications at hat, hose and radio. Check oral nasal in place and clean. Check butterfly valves secure. Check hood band secure. Check neck dam is correctly fitted. Confirm there is no tension on marsh marine. Flow test free flow. Test bail out through hat. Observe general condition of hat.
NOTE: Personnel utilising a KM Superlite helmet shall ensure that particular attention is paid to the correct functioning of the clamping and locking mechanisms between the helmet and yoke. Modifications to the lock plunger shall only have been made in accordance with DOF Subsea approved methods
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Compressors
Confirm maintenance log book is up to date. Compressor oil level is correct. Engine oil level is correct. Check belt tension. Check belt condition. Drain volume tank. Drain water trap. Drain filters. Log hours run at end of day - running total. Check running total, hours since last oil change. Check electrical compressor is switched off if not in use. Check fuel level and top up at end of shift. Check pressure and top up if necessary prior to every dive Check chamber is at depth and prepared for use. Refer to 1.6.4 (DDC Prompt lists).
Communication checks to be made on all radios and are to include, diver radio, bull horn and radio contact to bridge, platform Supervisor, drill floor, etc. Check LP and HP air supply to panel and hats by function testing both
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1.6
PRE-DIVE CHECKS
The responsible person shall ensure the following is completed Responsible Position Dive Supervisor Checks
Dive Control Panel Prompt lists (see 1.6.1). Divers Equipment Prompt lists (see 1.6.2). LP Compressor Prompt lists (see 1.6.3). DDC Prompt lists (see 1.6.4). LARS Prompt lists (see 1.6.5). Ensure diver, standby diver and surface crew have completed their pre-dive checks (Reference 1.6.2 and 0).
NOTE: These checks shall be noted and logged in the Daily Log Book.
Necessary documents (Diving Project Plan, decompression scheduled, company manuals, dive sheets) stop watches etc. are available. Dive team is briefed and stations assigned with tasks understood. Support personnel ready and understand tasks. Standby boat advised of impending dive and is in position, if applicable. Environmental conditions suitable for air diving. All relevant permits signed and in date. A full understanding of the job to be done. Understanding of the decompression procedures. Checking of the equipment he will be using (see 1.6.2 and 0). Checks that the tools for the task and the emergency tools are in the diving cage. Full understanding of the emergency procedures. A full understanding of the job to be done. Understanding of the decompression procedures.
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Diver
Standby Diver
Diving Operations Manual Annexe A Air Diving Operations and Emergency Procedures
Checking of the equipment he will be using. Full understanding of the emergency procedures as outlined in the Emergency Procedures section of this manual.
Support Crew
The support crew shall prepare, and function check equipment used in association with the air diving operation. During an air diving operation they will confirm the following to the Diving Supervisor: Communications Supervisor. checked and opened to the Diving
Checks have been carried out on the DDC and it is ready for use. The low pressure compressor is checked and running. Power to the LARS and LARS functioning correctly. Any extra equipment required is on hand, checked and ready for use. Divers are dressed in and checked, ready to launch the stage. Personnel are tending the divers and standby divers umbilicals.
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2. 3. 4. 5. 6.
Check for correct operation Analyse and check contents Analyse and check contents Ensure all valves are open to air regulator Ensure all are in correct positions and main air to diver after bailout checked Check for correct operation (both ways) Check Recording
7.
Communications to: Divers 1 & 2, any external bull horns in use, bridge and to ROV Control Room Video System (Camera)
9 10
Standby boat Whips, divers hoses and communications lines Permit To Dive or Dive Clearance
Ensure crew are briefed and in position for the dive Ensure all are protected and clear of the deck working areas
11.
Check that a Permit To Dive has been issued and signed as required. Take note of any special precautions or restrictions
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2.
3. 4. 5.
Check for correct operation Check that air is available on demand and also free flow Inspect for corrosion and damage. Ensure correct amount of weight Inspect for any tears or damage Inspect for damage and correct fit Inspect for corrosion and damage. Ensure blade is sharp and that the knife is positioned within easy reach of the divers hands Function check Inspect for corrosion and damage. Check for correct operation Ensure all are fully open Ensure air / gas is on line to the divers helmet / mask and that the reserve supply is available Check contents pressure. Ensure correct operation to helmet / mask Ensure the necessary tools are available and in good condition Ensure instructions are clear and understood by all parties Check on latest weather forecast and for any tidal currents that may interfere with diving operations
6. 7. 8.
Torch Umbilical D ring and karabiner Air / gas quad valves Air / Gas Supply
13.
Bail-out cylinder
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5. 6. 7. 8.
Volume tank and water taps Safety relief valve Oil and air pressures Compressor to control panel valves Filter Air intakes
9. 10.
Ensure filter is clean and within recommended change date Ensure not obstructed and not in vicinity of engine exhaust or other atmospheric contaminates I within 3 months of last test
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Air Analysis
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Ensure sufficient BIBS are available in each compartment and operating correctly. Check overboard dump is working and vent mask on completion Ensure availability as required Ensure correct operation
5 6.
Blankets, towels and dry clothes Communications, lights, scrubber and heaters Oxygen bottles / quads Depth gauges
7. 8
Check contents and regulator for operation Check for correct operation and are within 6 monthly examination date Ensure all are available
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7. 8.
Swivels Shackles
9. 10.
Sheaves Stages
11. 12.
*** Note where split pins are used as retainers on Clevis pins or similar connections, they are to be used in conjunction with castellated nuts or Drilled and pinned nuts.
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1.6.6 Dress The minimum DOF Subsea standard dress for all diving projects will be as follows. Booties or weighted dive boots. Fins must be worn or taken by the diver on all dives with the exception of when weighted boots are worn.
Supervisors may use their discretion if a documented risk assessment is completed. Weighted dive boots A dive knife are only to be worn with permission from the Dive Supervisor who must take into account local conditions such as current and swell, nature of the task and distance from the diving platform. to be worn of the fixed blade variety, housed in a sheath and secured by a lanyard, personal knives may be worn in addition to this. with full length sleeves and legs and/or full length wet suits. The thickness of a wet suit should be determined by local conditions but both hyper and hypothermia must be kept in mind when selecting wet suits for use. of the crutch type with a lifting D-ring and hose securing D-ring. Only DOF Subsea approved harness are to be used. must be of the non quick-release type.
Dive coveralls
Diver harness
must be worn at all times. Personal diving gloves may be worn, providing they are approved by the site Diving Supervisor. regardless of depth and nature of the task, must be worn on all diving tasks. The bailout must be of a suitable size and contain sufficient pressure and volume to cater for the depth of water in which the diving tasks will be performed. Comfort of the diver will not override the need to supply sufficient air to the diver in an emergency situation. Must meet the requirement of the DOF Subsea DOM Section 7.4.4
A bailout
taken to the job must either be secured to the diver's harness with a lanyard or, if hand-carried, or placed in the tool basket. All DOF Subsea tools, cameras, CP meters, etc., as far as practicable, will not be used underwater without a lanyard. Tools should have a lanyard attached to enable securing on the work site.
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1.7
Pulls and bells shall never be made violently. Single-Lifeline Code (As per AS/NZS2299.1: 2007). Routine Lifeline Signals, however, are listed below.
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1.7.4 Hand Signals Shown here are the hand signals most commonly required for diving.
Note: that variations in other underwater signals exist between training organisations. The diver should be made aware of such variations as appropriate.
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1.8
DEMOBILISATION
Before the project is completed, the Diving Supervisor must receive, formal plans and directions for demobilisation, where the equipment is to be stored, how it is to be transported and the likely duration of storage before deployment again. The nature of DOF Subsea operations is that Dive Systems or individual items will be transported many times during use. They may be moved by truck, lifted by cranes, dropped onto decks and subject to wild movement on vessels at sea. There is potential for damage to DOF Subsea diving equipment during this period. It is therefore important that equipment be adequately and appropriately packed having in mind the length of the journey and the type of hazards likely to be encountered. The following is a list of precautions to be taken: Secure loose items inside containers. Pad fragile items. Dont put heavy items on top of other items. Secure lids on liquid containers. Cover against the elements - rain, heat, dust, and humidity. Protect against items rubbing against other items. Chamber doors secured, pressure in locks, exhausts secured and closed.
Commonsense is to be used when assessing the likely risks of damage during transit and the steps to be taken to minimise the risk.
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1.8.1 Demobilisation checklist Before demobilisation, complete the following: 1 Liaise with the local Supervisor responsible for transport to ascertain times and type of transport available. Complete an inventory, ensuring that all consumables used are on daily reports and all deficiencies are requested on a stores requisition form. Check air compressors for gas analysis dates and ensure the system gauges will be in calibration for the next diving period. The levels of the O2 and air quads are to be recorded on a Gas Status Sheet on completion of each job. Any damage to quads should be advised to DOF Subsea. This includes damage to or loss of the chain on the top of the quad. Please ensure that quad numbers are used and that dates, job numbers and system numbers are endorsed on the Status sheet. The quad numbers to be reported are in the following format: a) WA 019 or b) WAA 319 etc. The numbers are generally welded onto the frame of the quad. 7 8 Depressurise all whips, tape the ends and clean externally if required. Back off all regulators and wash in clean, fresh water, dry and store in a secure place. When O2 analysers are to be stored, remove the O2 fuel cell and seal it inside a plastic bag. This stops the fuel cell reaction and greatly extends the life of the cell. Where possible all radio batteries are to be fully charged prior to the end of the project. In any case at least one battery should be fully charged. Ensure adequate craneage. Check lifting points in certification. Postpone loading if weather not conducive to safe operations. Ensure system sea-fastened. Conduct this check with the vessel engineer. Ensure trucking sufficient for load. A Project Debrief shall be carried out with the Diving Supervisor at the completion of every job. The Debrief Sheet shall be completed. by the Project / Operations Manager.
10
11 12 13 14 15 16
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2.0 2.1
Under no circumstances shall US Navy and DCIEM Air Decompression Tables be used concurrently on the same diving task or within 24 hours of a previous diving task using one or the other table. Serious debilitating decompression illness can result from such practice as the tables were developed independently of each other using quite different procedures and principles. For example: Within a 24 hour period do not use the US Navy table for the first dive and then switch to the DCIEM tables for the second dive (or vice-a-versa). Do not complete a dive on day one using DCIEM Tables and the next day (day two, 20 hours later) undertake another dive using US Navy Tables.
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2.1.2 Air Decompression Definitions The following terms are frequently used when conducting diving operations and discussing the decompression tables. Term Descent Time Description Descent time is the total elapsed time from when the divers leave the surface to the time they reach the bottom. Descent time is rounded up to the next whole minute. Bottom time is the total elapsed time from when the divers leave the surface to the time they that they begin their final ascent from the bottom. Bottom time is measured in minutes and is rounded up to the next whole minute. A decompression table is a structured set of decompression schedules, or limits, usually organised in order of increasing bottom times and depths. A decompression schedule is a specific decompression procedure for a given combination of depth and bottom time as listed in a decompression table. It is normally indicated as feet/minutes. A decompression stop is a specified depth where a diver must remain for a specified length of time (stop time). NOTE: Divers chest should be located as closely as possible to the stop depth. The following terms are used to indicate the depth of a dive: Deepest Depth: is the deepest pnuemo reading obtained when conducting surface supplied diving or the deepest depth gauge reading when conducting scuba operations. Maximum Depth is the deepest depth attained by the diver plus the pneumofathometer correction factor (Table below). When conducting scuba operations, maximum depth is the deepest depth gauge reading. Stage Depth is the pneumofathometer reading taken when the divers are on the stage just prior to leaving the bottom. Stage depth is used to compute distance and travel time to the first stop, or to the surface if no stops are required.
Bottom Time.
Decompression Table
Decompression Schedule.
Decompression Stop
Depth.
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Equivalent Single Dive Bottom Time. Unlimited/No Decompression (No D) Limit Limiting Line
The equivalent single bottom time is the time used to select a schedule for a single repetitive dive. This time is expressed in minutes. The maximum time that can be spent at a given depth so that safe ascent can be made directly to the surface at a prescribed travel rate with no decompression stops is the unlimited/no-decompression or No D limit. The depth segments in; Standard Air Decompression Tables; (Table 2.3.1) Surface Decompression Table Using Oxygen; (Table 2.4.6) Surface Decompression Table Using Air; (Table 2.5.1)
are divided into two sections by a limiting line. This limiting line corresponds to the line dividing the normal air range and exceptional exposure range. The shaded areas below each limiting line (a double bolded line in each depth increment) in the tables highlight dive profiles which are in the exceptional exposure range. The DOF Subsea limiting line may be at variance to those published in Chapter 9 of the USN Diving Manual. DOF Subsea has increased the safety margin1, in some instances, by enlarging the exceptional exposure range in the depth increment.
It is standard industry practice to limit total combined decompression times, in water, to a maximum of approximately 30 minutes . The limiting line reflects this policy.
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Repetitive Dive.
A repetitive dive is any dive conducted more than 10 minutes and within 12 hours of a previous dive. NOTE: DOF Subsea prohibits repetitive diving using any USN Table. Accumulative diving (as described in 2.1.3), however, is permitted
The repetitive group designation is a letter used to indicate the amount of residual nitrogen remaining in a diver's body following a previous dive. Residual nitrogen is the nitrogen gas that is still dissolved in a diver's tissues after surfacing. Residual nitrogen time is the time that must be added to the bottom time of a repetitive dive to compensate for the nitrogen still in solution in a divers tissues from a previous dive. Residual nitrogen time is expressed in minutes. A single dive refers to any dive conducted more than 12 hours after a previous dive. A single repetitive dive is a dive for which the bottom time used to select the decompression schedule is the sum of the residual nitrogen time and the actual bottom time of the dive. The surface interval is the time that a diver has spent on the surface following a dive. It begins as soon as the diver surfaces and ends as soon as he starts his next descent.
Single Dive.
Surface Interval
2.1.3 Accumulative Dives While DOF Subsea prohibits repetitive dives using any USN Table, accumulative dives are permitted. When one diver is conducting multiple dives in a 12 hour period, the bottom depth used is always the deepest depth of the series of dives and the bottom times are added together to gain the Total Bottom Time. There is no allowance for Surface Interval or Residual Nitrogen Times. Example Dive 1, 63 feet for 12 minutes, Dive 2, 42 feet for 15 minutes. Dive 2 Decompression Schedule is assessed on a depth 63 feet and the Total Bottom Time of 27 minutes.
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2.2
TABLE SELECTION
The following US Navy decompression tables are available for DOF Subsea diving operations: Unlimited/No-Decompression Limits and Repetitive Group Designation Table for No-Decompression Air Dives. Standard Air Decompression Table. Surface Decompression Table Using Oxygen. Surface Decompression Table Using Air. Therapeutic Tables (see section 2.6.4 and 2.6.5).
2.2.1 Selection of Decompression Schedule DOF Subsea uses a modified USN Decompression Table using Oxygen. These tables present a series of decompression schedules which must be rigidly followed during ascent from an air dive. Each decompression table has specific conditions which justify its selection. These conditions are depth and duration of the dive, availability of an oxygen breathing system within the chamber, and environmental conditions such as sea state, water temperature etc. The four air tables containing the pertinent criteria for the selection and application of each are listed below. US Navy Standard Air Decompression Table - Conditions dictate that in-water decompression permissible. Normal schedules. No repetitive dives; normal decompression schedules only. No Decompression Limits and Repetitive Group Designation Table for NoDecompression Air Dives - Decompression not required.
NOTE: Again DOF Subsea prohibits repetitive diving using any USN Table. Accumulative dives, however, are permissible. Residual Nitrogen Time Table for Repetitive Air Dives, this table is not to be used for operations - Repetitive group designations after surface intervals greater than 10 minutes and less than 12 hours. Residual nitrogen times for repetitive air dives. DOF Subsea Modified USN Surface Decompression Table Using Oxygen Available decompression chamber with oxygen breathing system. Conditions dictate in-water decompression undesirable. Accumulative diving permitted. Surface Decompression Table Using Air - Available decompression chamber without an oxygen breathing system; or diver forced to surface prior to completing decompression. Conditions dictate in-water decompression undesirable. Accumulative dives permitted. Diver suffers oxygen toxicity.
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The decompression schedules of all the tables are usually given in 10 foot depth increments and 10 minute bottom time increments. Depth and bottom time combinations from dives, however, rarely match the decompression schedules listed exactly. To ensure that the selected decompression schedule is always conservative: Always select the schedule depth equal to or next greater than the maximum depth of the dive and Always select the schedule bottom time equal to or next longer than the bottom time of the dive and then move to the next time increment.
CAUTION: Never attempt to interpolate between decompression schedules. With reference to paragraph, above, if the diver was exceptionally cold during the dive or if the work load is relatively strenuous, the next longer decompression schedule than the one they would normally follow should be selected. Therefore it is mandatory for all DOF Subsea supervisors to decompress divers in accordance with the next time increment one above the divers actual bottom time. For cold and strenuous work supervisors will be required to decompress divers in accordance with the time increment two above the divers actual bottom time. Bottom times are not to exceed the times shown in the table at 8.5.6 in the DOF Subsea DOM.
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2.2.2 Ascent Procedures Term Rules During Ascent. Requirement After selecting the applicable decompression schedule, it is imperative that it be followed as closely as possible. Unless a hyperbaric doctor recommends a deviation, decompression must be completed according to the schedule selected. Always ascend at a rate of 30 feet per minute. Minor variations in the rate of travel between 20 and 40 FSW/minute are acceptable. Any variation in the rate of ascent must be corrected in accordance with the procedures. However, a delay of up to one minute in reaching the first decompression stop can be ignored. Decompression stop times, as specified in the decompression schedule, begin as soon as the divers reach the stop depth. Upon completion of the specified stop time, the divers ascend to the next stop or to the surface at the proper ascent rate. Ascent time is not included as part of stop time. The following rules for correcting variations in rate of ascent apply to Standard Air Decompression dives as well as Surface Decompression dives.
Ascent rate
Delay greater than 1 minute, deeper than 50 FSW. Add the total delay time (rounded up to the next whole minute) to the bottom time, recompute a new decompression schedule and decompress accordingly. Delay greater than 1 minute, shallower than 50 FSW. If the rate of ascent is less than 30 fpm, add the delay time to the divers first decompression stop. If the delay is between stops, disregard the delay. The delay time is rounded up to the next whole minute.
On a Standard Air Dive, if the rate of ascent is greater than 30 feet per minute, STOP THE ASCENT, allow the watches to catch up, and then continue ascent. If the stop is arrived at early, start the stop time after the watches catch up.
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2.2.3 Diving At High Altitudes Because of the reduced atmospheric pressure, dives conducted at altitude require more decompression than identical dives conducted at sea level. Standard air decompression tables, therefore, cannot be used as written. Some organisations calculate specific decompression tables for use at each altitude. An alternative approach is to correct the altitude dive to obtain an equivalent sea level dive, then determine the decompression requirement using standard tables. This procedure is commonly known as the "Cross Correction technique and always yields a sea level dive that is deeper than the actual dive at altitude. A deeper sea level equivalent dive provides the extra decompression needed to offset effects of diving at altitude. 2.2.3.1 Need for Correction
No correction is required for dives conducted at altitudes between sea level and 300 ft (100 metres). The additional risk associated with these dives is minimal. In addition, where a dive is undertaken at an altitude of 1000 feet (300 metres), and the actual depth of dives is less than 145 FSW (42 metres) no correction is required. At altitudes between 300 feet (100 metres) and 1000 feet (300 metres), correction is required for dives deeper than 145 FSW (42 metres) [actual depth]. At altitudes above 1000 ft., correction is required for all dives. 2.2.3.2 Procedure
Where a correction is required for dives at altitude, in accordance with paragraph 2.2.3.1 above, separate job specific DOF Subsea procedures will be provided. These procedures shall be developed with reference to Chapter 9 of the USN Diving Manual and detailed in the DPP.
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2.2.4 Unlimited / No-Decompression Limits and Repetitive Group Designation Table for No-Decompression Air Dives The Unlimited / No-Decompression Table (2.2.4.3) serves three purposes; First, the table identifies that on a dive with the depth 20 FSW and shallower, unlimited bottom time may be achieved. Second, it summarises all the depth and bottom time combinations for which no decompression is required. Third, it provides the repetitive group designation for each unlimited/nodecompression dive. However, this is not used as DOF Subsea prohibits repetitive diving using USN Tables.
Each depth listed in the Unlimited / No-Decompression Table has a corresponding nodecompression limit listed in minutes. This limit is the maximum bottom time that the diver may spend at that depth without requiring decompression. Use the columns to the right of the no-decompression limits column to obtain the repetitive group designation. This designation must be assigned to the diver subsequent to every dive. To find the repetitive group designation: Enter the table at the depth equal to, or next greater than, the maximum depth of the dive. Follow that row to the right to the bottom time equal to, or just greater than, the actual bottom time of the dive. Follow that column upward to the repetitive group designation.
Depths shallower than 20 fsw do not have a specific no-decompression limit. The limits are, however, restricted in that they only provide repetitive group designations for bottom times up to 6 hours. These bottom times are considered the limitations of the NoDecompression Table and no field requirement for diving should extend beyond them. Any dive deeper than 20 fsw which has a bottom time greater than the no-decompression limit given in this table is a decompression dive and must be conducted in accordance with the Standard Air Decompression Table. 2.2.4.1 Example:
In planning a dive, the Dive Supervisor desires the divers to conduct a brief inspection of the work site, located at a depth of 157 fsw. Determine the maximum no-decompression limit and repetitive designation.
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2.2.4.2
Solution:
The maximum bottom time which may be used without requiring decompression and repetitive group designation after the dive are found in the No-Decompression Table or the US Navy Standard Air Decompression Table. The no-decompression limit corresponding to the 160 fsw depth in the No-Decompression Table is five minutes. Therefore, to avoid having to make decompression stops, the Diver must descend to 158 fsw, make the inspection, and begin ascent within five minutes. Following the 160 fsw row to the 5 minute column, the repetitive group designation at the top of the column is D. NOTE: Although repetitive diving is prohibited on USN Tables, the repetitive group is important as DOF Subsea bans dives in excess of an O group.
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2.2.4.3
Table Unlimited / No Decompression Limits and Repetitive Group 2 Designation Table for Unlimited / No-Decompression Air Dives
Group Designation
Depth No-Deco Limits (min) Unlimited Unlimited Unlimited 595 405 310 200 100 60 50 40 30 25 20 15 10 10 5 5 5 5 5 A 60 35 25 20 15 5 5 B C D E F * 350 452 * * 361 250 160 130 90 540 595 310 344 405 190 220 270 310 150 170 200 100 G H I J K L M N O
(feet/meters) 10 15 20 25 30 35 40 50 60 70 80 90 100 110 120 130 140 150 160 170 180 190 3.0 4.6 6.1 7.6 9.1 10.7 12.2 15.2 18.2 21.3 24.4 27.4 30.5 33.5 36.6 39.6 42.7 45.7 48.8 51.8 54.8 59.9
180 240 325 390 917 125 160 195 245 315 95 60 50 40 30 30 25 20 20 15 15 120 145 170 205 80 70 50 40 35 30 25 22 20 100 120 140 80 60 50 40 35 30 25 100 110 70 55 45 40 80 60 50
5 5 5 5
Highest repetitive group that can be achieved at this depth regardless of bottom time.
Taken from the US Navy Manual, Chapter 9, Table 9.6; 7 March 2000 (PDF Version 1.3)
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2.3
2.3.1 Table US Navy Standard Air Decompression Table US Navy Standard Air Decompression Table
Decompression Stops (feet/meters) Bottom Depth - feet /meters Time (min) Time first stop (min:sec) 50 15.2 40 12.1 30 9.1 20 6.0 10 3.0 Total Deco. time (min:sec) Repetitive Group
200 210 230 1:00 1:00 1:00 1:00 1:00 1:00 1:00 1:00
0 2 7 11 15 19 23 41 69
* N N O O Z ** ** **
40 12.1
Taken from the US Navy Manual, Chapter 9 , Table 9.8; 7 March 2000 (PDF Version 1.3)
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100 110 120 1:20 1:20 1:20 1:20 1:20 1:20 1:20 1:20
0 3 5 10 21 29 35 40 47
* L M M N O O Z Z
50 15.2
60 70 80 100 120 1:40 1:40 1:40 1:40 1:40 1:40 1:40 1:20 1:20 1:20 1:20 1:20 1 2 20 44 78
2:00 4:00 9:00 16:00 28:00 41:00 50:00 58:00 72:00 83:00 141:00 194:00 267:00
* K L M N O Z Z Z ** ** ** **
60 18.1
* **
See No Decompression Table for repetitive groups Repetitive dives may not follow exceptional exposure dives
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50 60 70 80 90 2:00 2:00 2:00 2:00 2:00 1:40 1:40 1:40 1:40 1:40 1:40 1:40 2 4 6 8 9 13 19
0 8 14 18 23 33 41 47 52 56 61 72 79
2:20 10:20 16:20 20:20 25:20 35:20 45:20 53:20 60:20 66:20 72:20 87:20 100:20
* K L M N N O O O Z Z Z Z
70 21.3
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40 50 60 70 80 90 100 2:20 2:20 2:20 2:00 2:00 2:00 2:00 2:00 2:00 2:00 2:00 2:00 1:40 1:40 1:40 1:20 17 6 29 59 108 2 7 11 13 17 19 26 32 35 52 90 107 142
2:40 12:40 19:40 25:40 35:40 48:40 59:40 68:40 75:40 84:40 97:40 111:40 122:40 180:40 281:40 355:40 456:40
* K L M N N O O Z Z Z Z ** ** ** ** **
80 24.3
110 120 130 140 150 180 240 360 480 720
* **
See No Decompression Table for repetitive groups Repetitive dives may not follow exceptional exposure dives
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30 40 50 60 2:40 2:40 2:40 2:20 2:20 2:20 2:20 2:20 2:20 2:00 5 7 13 18 21 24 32 36
0 7 18 25 30 40 48 54 61 68 74
3:00 10:00 21:00 28:00 40:00 56:00 69:00 78:00 88:00 103:00 118:00
* J L M N N O Z Z Z Z
90 28.7
* **
See No Decompression Table for repetitive groups Repetitive dives may not follow exceptional exposure dives
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25 30 40 50 60 3:00 3:00 2:40 2:40 2:40 2:40 2:20 2:20 2:20 2:20 2:00 2:00 1:40 1:40 1:40 2 21 55 1 14 42 61 106 3 7 10 12 29 42 73 91 122 2 9 17 23 23 23 34 41 53 84 111 142 142
3:20 6:20 18:20 29:20 40:20 59:20 74:20 86:20 99:20 119:20 134:20 204:20 285:20 418:20 505:20 615:20
* I K L N O O Z Z Z Z ** ** ** ** **
100 30.4
* **
See No Decompression Table for repetitive groups Repetitive dives may not follow exceptional exposure dives
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0 3 7 21 26 36 48 57 64 72
3:40 6:40 10:40 26:40 37:40 57:40 75:40 90:40 109:40 127:40
* H J L M N O Z Z Z
110 33.1
40 50 60 70 80 90 100
* **
See No Decompression Table for repetitive groups Repetitive dives may not follow exceptional exposure dives
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Repetitive group
* H I J L N O O Z Z Z ** ** ** ** ** **
120 36.5
10 15 20 4:00 4:00 4:00 3:40 3:40 3:20 3:20 3:20 3:00 3:00 3 8 3 9 16 19 19 3 10 21 23 24 35 45
0 1 4 10 18 25 37 52 61 72 80
4:20 5:20 8:20 14:20 25:20 39:20 65:20 88.20 105:20 133:20 156:20
* F H J M N O Z Z Z Z
130 39.6
25 30 40 50 60 70 80 90
* **
See No Decompression Table for repetitive groups Repetitive dives may not follow exceptional exposure dives
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Repetitive group
* G I J K N O Z Z Z ** ** ** ** ** ** **
(min:sec) 27.4 24.3 21.3 18.2 15.2 12.1 9.1 6.0 3.0
0 2 6 14 21 26 44 56 68 79 88
140 42.6
56 120 94 168
78 124 187
59 100 114 122 142 187 97 100 114 122 142 187
5 10 15 4:40 4:40 4:20 4:20 4:20 4:00 4:00 3:40 3:40 3:20 1 3 11 17 5 12 19 19 19 2 4 8 19 23 26 39 50
0 1 3 7 17 24 33 51 62 75 84
5:00 6:00 8:00 14:00 26:00 37:00 62:00 91:00 115:00 149:00 176:00
C E G H K L N O Z Z Z
150 45.7
20 25 30 40 50 60 70 80
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Repetitive group
D F H J K M N Z Z **
(min:sec) 27.4 24.3 21.3 18.2 15.2 12.1 9.1 6.0 3.0
0 1 4 11 20 25 39 55 69 80
160 48.7
20 25 30 40 50 60 70
Time Bottom first stop Depth feet/ metres time (min) 5 10 15 20 25 30 5:20 5:00 5:00 4:40 4:40 4:20 4:20 4:00 4:00 3:40 3:00 2:40 2:40 2:20 2:00 14 22 40 4 18 34 42 2 10 24 40 56 10 22 30 52 91 12 12 28 42 60 2 8 12 18 34 50 1 5 15 17 14 32 50 2 4 10 18 22 19 34 42 2 4 7 13 23 23 37 51 (min:sec 110 100 90 ) 80 70 60 50 40 30 20 10 Total deco. Time (min:sec) 5:40 7:40 12:40 24:40 37:40 48:40 84:40 112:40 155:40 186:40 249:40 359:40 538:40 684:40 876:40 1010:40 Repetitive group D F H J L M O Z Z ** ** ** ** ** ** **
33.5 30.4 27.4 24.3 21.3 18.2 15.2 12.1 9.1 6.0 3.0 0 2 5 15 23 26 45 61 74 86
170 51.8
52 120 82 156
78 120 187
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33.5 30.4 27.4 24.3 21.3 18.2 15.2 12.1 9.1 6.0 3.0 0 3 6 17 24 27 50 65 81
180 54.8
15 20 25 30 40 50 60
5 10
0 3 7 20 25 32 55 72 84
D G I K M N O ** **
190 57.9
* **
15 20 25 30 40 50 60
See No Decompression Table for repetitive groups Repetitive dives may not follow exceptional exposure dives
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2.4
This safe way out procedure is not intended to be used in place of normal SurD O2 procedures. If the prescribed surface interval is exceeded and the divers are asymptomatic, treat them using the USN Table 5 See 2.6.4. If the divers are symptomatic, they are treated as if they have DCI (Treatment USN Table 6 See 2.6.5) even if they are only displaying minor symptoms. Symptoms occurring during the chamber stops are treated as recurrences.
The symbol hh:mm denotes hours and minutes. The symbol mm::ss denotes minutes and seconds. Therefore :03::30 means 3 minutes and 30 seconds.
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The divers are to remain on oxygen at 50 FSW and whilst transferring to the main lock. The diver is to be held at 50 FSW for a period of 10 minutes during which time the entry/outer lock is to be brought back to the surface. At the completion of the 10 minute stay at 50 FSW ascend to 40 FSW in 1 minute (10 fpm). When the chamber reaches 40 FSW the divers are to be given a 5 minute air break prior to starting the 40 FSW oxygen time. At the completion of the 5 minute air break, the divers are again placed on the Built-in Breathing System (BIBS) mask breathing pure oxygen. The designated 40-foot stop time commences once the divers are breathing oxygen. The divers breathe oxygen throughout the 40-foot stop, interrupting oxygen breathing after each 20 minutes with a 5-minute period of breathing chamber air (referred to as an air break). Count the air breaks as dead time and not part of the oxygen stop time. If the air break interval falls on time to travel, leave the diver on O2 and commence travelling to the surface. Maintain the diver on the O2 mask prior to leaving the 40 FSW stop for the surface. Upon completion of the total oxygen breathing time at 40 FSW, surface the diver in 10 minutes at a constant rate of 4 fpm. The diver breathes oxygen during the entire ascent. This oxygen is in addition to the total time spent at 40' dictated by the table. 2.4.2 Oxygen System Failure (40-FSW Chamber Stop). Follow this procedure when there is an oxygen system failure at the 50 or 40 FSW chamber stop: If the oxygen breathing system fails, the diver should be decompressed according to the surface decompression using air procedures (see 2.5). Disregard all time spent breathing oxygen. It is important that all DOF Subsea Supervisors be aware of the appropriate Surface Decompression Table Using Air at all times.
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2.4.3 CNS Oxygen Toxicity (40-FSW Chamber Stop). Follow this procedure when a diver displays symptoms of CNS O2 toxicity at either the 50 or 40 FSW chamber stop: 1 2 3 Remove the BIBS masks from the divers. Attendant to enter the chamber to render assistance. Wait for all symptoms to completely subside, then wait an additional 15 minutes. Place the divers back on oxygen and resume the decompression at the point of interruption. The period the divers are not breathing oxygen is considered dead time and is not counted toward the total stop time. This procedure can be repeated as many times as the Dive Supervisor considers prudent until all the required time spent breathing oxygen at 40 FSW is met. If the Dive Supervisor decides that the diver cannot tolerate oxygen: 5 The diver should be removed from O2, and decompressed according to the surface decompression using air procedures (see 2.5). Disregard all time spent breathing oxygen.
It is important that all DOF Subsea Supervisors be aware of the appropriate surface decompression using air procedures (see 2.5).
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2.4.4 Convulsions at the 40-FSW Chamber Stop. NOTE: If the first symptom of O2 toxicity at the 50 or 40 FSW stop is a convulsion, oxygen must not be restarted. Follow this procedure when a diver convulses at the 40-FSW chamber stop: 1 2 3 Remove the BIBS mask. Attendant to enter the chamber to render assistance. Keep the chamber depth constant at 40 FSW. Wait for the convulsion to stop, ensuring the diver is breathing. The diver breathes air until regaining consciousness and all symptoms resolve. The diver should now be decompressed according to the Surface Decompression Table Using Air. Disregard all time spent breathing oxygen.
It is important that all DOF Subsea Supervisors be aware of the appropriate surface decompression using air procedures (see 2.5) at all times. 2.4.5 Repetitive Dives. Divers are not to undertake a repetitive dive following a dive involving surface decompression.
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1st Stop 24.3 21.3 18.2 15.2 12.1 9.1 2:20 1:20 1:20 1:20 1:20
15.2 12.1
70 21.3 80 24.3
150 180
30 60
90 27.3
1. 5 min air break for every 20 min on O2. 2. Remain on O2 if time to travel during 20 min O2 period. 3. Max surface interval is 5 min from 30ft (may be less, but not more). 4. Ascent time in water 30 fpm.
Taken from the US Navy Manual, Chapter 9, Table 9-9; 7 March 2000 (PDF Version 1.3)
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1st Stop 24.3 21.3 18.2 15.2 12.1 9.1 3:20 2:20 2:20 2:20 2:20 2:20 2:20 2:20 2:00
15.2 12.1
100 30.4
20 40
110 33.5
50 60 70 80 90 100 110
15 30
120 36.5
40 50 60 70 80 90
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1st Stop 24.3 21.3 18.2 15.2 12.1 9.1 4:20 3:20 3:20 3:00 3:00 3:00 3:00 3:00
15.2 12.1
130 39.6
40 50 60 70 80 90
1. 5 min air break for every 20 min on O2. 2. Remain on O2 if time to travel during 20 min O2 period. 3. Max surface interval is 5 min from 30ft (may be less, but not more). 4. Ascent time in water 30 fpm.
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1st Stop 24.3 21.3 18.2 15.2 12.1 9.1 4:40 3:40 3:40 3:40 3:20 3:20 3:20 3:20 3:20 3:20 3:00
15.2 12.1
140 42.6
35 40 45 50 55 60 65 70
5 25
150 45.7
30 35 40 45 50 55
160 48.7
20 25 30 35 40 45
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US Navy Surface Decompression Using Oxygen Table Time (min) breathing air at water stops (feet/metres) Bottom Depth feet/metres Time (min) 5 Time to 80 70 60 50 40 30 Surface Interval 50 40 Ascent Time in chamber on oxygen Total deco. time (min:sec) 5:40 3 3 5 4 4 4 6 8 7 9 13 5 5 5 5 5 10 10 10 10 10 13 19 23 29 36 10 10 10 10 10 51:40 57:40 75:40 81:40 105:40
1st Stop 24.3 21.3 18.2 15.2 12.1 9.1 5:40 4:40 4:40 4:20 4:00 3:40
15.2 12.1
170 51.5
20 25 30 35 40
1. 5 min air break for every 20 min on O2. 2. Remain on O2 if time to travel during 20 min O2 period. 3. Max surface interval is 5 min from 30ft (may be less, but not more). 4. Ascent time in water 30 fpm.
US Navy Surface Decompression Using Oxygen Table Time (min) breathing air at water stops (feet/metres) Bottom Depth feet/metres Time (min) 15 Time to 80 70 60 50 40 30 Surface Interval 5 5 5 50 40 Ascent 10 10 10 Time in chamber on oxygen Total deco. time (min:sec) 71:00 106:00 138:00
1st Stop 24.3 21.3 18.2 15.2 12.1 9.1 4:40 4:00 3:20 2 2 4 3 6 4 5 12 6 10 18
15.2 12.1 10 10 10 20 40 50
180 190
30 45
15 30 45
2 5 10
4 8 18
6 12 26
5 5 5
10 10 10
20 50 60
10 10 10
1. 5 min air break for every 20 min on O2. 2. Remain on O2 if time to travel during 20 min O2 period. 3. Max surface interval is 5 min from 30ft (may be less, but not more). 4. Ascent time in water 30 fpm.
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2.5
When using the SurD Air table, all ascents are made at 30 fpm. This includes the ascent rate from the last water stop. The time spent on the surface should not exceed 3 minutes and the rate of descent to the first recompression chamber stop should not exceed 60 fpm. The total elapsed time for these three procedures must not exceed 5 minutes. If the prescribed surface interval is exceeded and the divers are asymptomatic, treat them using the USN Table 5 See 2.6.4. If the divers are symptomatic, they are treated as if they have DCI (Treatment USN Table 6 See 2.6.5) even if they are only displaying minor symptoms. Symptoms occurring during the chamber stops are treated as recurrences.
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US Navy Air Surface Decompression Table Chamber stops Time (min) at water stops (feet/meters) Time to first stop Bottom Depth feet / metres time (min) 230 250 270 300 or surface (min:sec) 1:00 1:00 1:00 1:00 30 9.1 20 6.0 10 3.0 3 3 3 3 Surface Interval 5 5 5 5 20 6.0 10 3.0 7 11 15 19 Total deco. time (min:sec) 15:20 19:20 23:20 27:20 (air) (min) (feet/meters)
40 12.1
120
3 3 3 3 3 3 3
5 5 5 5 5 5 5
5 10 21 29 35 40 47
50 15.2
80
3 3 3 3 3 3
5 5 5 5 5 5 5 3
7 14 26 39 48 56 69
60 18.2
60
2:00 2:00
3 3
5 5
8 14
17:20 23:20
70
6
70
Taken from the US Navy Manual, Chapter 9 , Table 9.10; 7 March 2000 (PDF Version 1.3)
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US Navy Air Surface Decompression Table Chamber stops Time (min) at water stops (feet/meters) Time to first stop Bottom Depth feet / metres time (min) 80 90 100 110 120 130 140 150 160 170 or surface (min:sec) 2:00 2:00 2:00 1:40 1:40 1:40 1:40 1:40 1:40 1:40 3 3 3 3 3 3 3 30 9.1 20 6.0 10 3.0 3 3 3 Surface Interval 5 5 5 5 5 5 5 5 5 5 3 4 6 8 9 13 19 20 6.0 10 3.0 18 23 33 41 47 52 56 61 72 79 Total deco. time (min:sec) 27:20 32:20 42:20 53:50 60:50 67:50 73:50 79:50 94:50 107:50 (air) (min) (feet/meters)
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US Navy Air Surface Decompression Table Chamber stops Time (min) at water stops (feet/meters) Time to first stop Bottom Depth feet / metres time (min) 50 60 70 80 or surface (min:sec) 2:23 2:20 2:20 2:00 2:00 2:00 2:00 2:00 2:00 2:00 2:00 2:40 3 3 3 3 3 3 26 32 3 30 9.1 20 6.0 10 3.0 3 3 3 Surface Interval 5 5 5 5 5 5 5 5 5 5 5 5 3 7 11 13 17 19 26 32 20 6.0 10 3.0 10 17 23 31 39 46 53 56 63 69 77 7 Total deco. time (min:sec) 19:40 26:40 32:40 44:10 56:10 67:10 76:10 83:10 92:10 128:10 148:10 17:00 (air) (min) (feet/meters)
80 24.3
50 60
3 3
5 5 5 5 5 5 5 5 5 7 13 18 21 24 32 36
18 25 30 40 48 54 61 68 74
90 27.4
40
3:00
15
25:20
100
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US Navy Air Surface Decompression Table Chamber stops Time (min) at water stops (feet/meters) Time to first stop Bottom Depth feet / metres time (min) 50 60 70 80 40 100 110 120 or surface (min:sec) 2:40 2:40 2:40 2::40 2:20 2:20 2:20 2:20 3 7 10 12 30 9.1 20 6.0 3 3 3 23 23 23 34 41 10 3.0 Surface Interval 5 5 5 5 5 5 5 5 20 6.0 3 9 17 23 23 23 34 41 10 3.0 24 28 39 48 57 66 72 78 Total deco. time (min:sec) 37:50 47:50 66:50 101:50 113:50 126:50 157:50 179:50 (air) (min) (feet/meters)
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US Navy Air Surface Decompression Table Chamber stops Time (min) at water stops (feet/meters) Time to first stop Bottom Depth feet / metres time (min) 30 40 or surface (min:sec) 3:20 3:00 3:00 3:00 2:40 2:40 2:40 2:40 1 7 12 15 3 3 18 23 23 30 37 30 9.1 20 6.0 10 3.0 3 Surface Interval 5 5 5 5 5 5 5 5 3 8 18 23 23 30 37 20 6.0 10 3.0 7 21 26 36 48 57 64 72 Total deco. time (min:sec) 17:40 35:10 45:10 80:10 103:10 118:10 144:10 169:10 (air) (min) (feet/meters)
110 33.5
50 60 70 80 90 100
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US Navy Air Surface Decompression Table Chamber stops Time (min) at water stops (feet/meters) Time to first stop Bottom Depth feet/metres time (min) 25 30 or surface (min:sec) 3:40 3:40 3:20 3:20 3:00 3:00 3:00 3:00 3:00 2 9 15 19 23 3 15 22 23 27 37 45 50 15. 2 40 12. 1 30 9.1 20 6.0 10 3.0 3 3 Surface Interval 5 5 5 5 5 5 5 5 5 5 15 22 23 27 37 45 20 6.0 10 Total deco. time (air) (min) (feet/meters)
3.0 (min:sec) 6 14 25 31 45 55 63 74 80 17:00 25:00 41:30 69:30 99:30 118:30 140:30 175:30 201:30
120 35.5
40 50 60 70 80 90 100
25 30
5 5 5 5 5 5 5 5 3 10 21 23 24 35 45
10 18 25 37 52 61 72 80
130 39.6
40 50 60 70 80 90
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US Navy Air Surface Decompression Table Chamber stops Time (min) at water stops (feet/meters) Time to first stop Bottom Depth feet/metres time (min) 20 25 or surface (min:sec) 4:20 4:00 4:00 3:40 3:40 3:40 3:20 3:20 4 10 2 6 16 19 23 3 5 16 24 23 32 41 50 15. 2 40 12. 1 30 9.1 20 6.0 10 3.0 3 Surface Interval 5 5 5 5 5 5 5 5 3 5 16 24 23 32 41 20 6.0 10 Total deco. time (air) (min) (feet/meters)
3.0 (min:sec) 6 14 21 26 44 56 68 79 17:40 29:10 40:10 69:10 107:10 127:10 164:10 203:10
140 42.6
30 40 50 60 70 80
20 25
3 4 8 19 23 26 39 50
5 5 5 5 5 5 5 5
3 4 8 19 23 26 39 50
7 17 24 33 51 62 75 84
150 45.7
30 40 50 60 70 80
20
3 7 11 23 23 33 44
5 5 5 5 5 5 5
3 7 11 23 23 33 44
11 20 25 39 55 69 80
160 48.7
25 30 40 50 60 70
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US Navy Air Surface Decompression Table Chamber stops Time (min) at water stops (feet/meters) Time to first stop Bottom Depth feet/metres time (min) 15 20 or surface (min:sec) 5:00 5:00 4:40 4:40 4:20 4:20 4:00 4:00 2 8 1 5 15 17 2 4 10 18 22 19 50 15. 2 40 12. 1 30 9.1 20 6.0 3 4 7 13 23 23 37 51 10 3.0 Surface Interval 5 5 5 5 5 5 5 5 20 6.0 3 4 7 13 23 23 37 51 10 Total deco. time (air) (min) (feet/meters)
3.0 (min:sec) 5 15 23 26 45 61 74 86 21:10 33:10 49:10 66:10 112:10 140:10 197:10 242:10
170 51.8
25 30 40 50 60 70
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US Navy Air Surface Decompression Table Chamber stops Time (min) at water stops (feet/meters) Time to first stop Bottom Depth feet/metres time (min) 15 or surface (min:sec) 5:20 5:00 5:00 5:00 4:40 4:20 4:20 2 5 3 9 16 1 3 6 14 19 19 50 15. 2 40 12. 1 30 9.1 20 6.0 3 5 10 17 23 30 44 10 3.0 Surface Interval 5 5 5 5 5 5 5 20 6.0 3 5 10 17 23 30 44 10 Total deco. time (air) (min) (feet/meters)
180 54.8
20 25 30 40 50 60
15
4 6 11 19 23 33 50
5 5 5 5 5 5 5
4 6 11 19 23 33 50
7 20 25 32 55 72 84
190 57.9
20 25 30 40 50 60
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2.6
OMITTED DECOMPRESSION
Certain emergencies, such as uncontrolled ascents, an exhausted air supply, or bodily injury, may interrupt or prevent required decompression. If the diver shows symptoms of decompression sickness or arterial gas embolism, immediate treatment using the appropriate oxygen or air recompression treatment table is essential. Even if the diver shows no symptoms, omitted decompression must be addressed in some manner to avert later difficulty. The Table at 2.6.2 summarizes management of asymptomatic Omitted Decompression. 2.6.1 Planned and Unplanned Omitted Decompression Omitted decompression may or may not be planned. Planned omitted decompression results when a condition develops at depth that will require the diver to surface before completing all of the decompression stops and when there is time to consider all available options, ready the recompression chamber, and alert all personnel as to the planned evolution. Equipment malfunctions, diver injury, or sudden severe storms are examples of these situations. In unplanned omitted decompression, the diver suddenly appears at the surface without warning or misses decompression for some unforeseen reason. In either instance, the Surface Decompression Tables may be used to remove the diver from the water, if the surfacing time occurs such that water stops are either not required or have already been completed. When the conditions that permit using the Surface Decompression Tables are not fulfilled, the divers decompression will be compromised. Special care shall be taken to detect signs of decompression sickness. The diver must be returned to pressure as soon as possible.
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20 FSW or shallower
No
Return to depth of stop. Increase stop time 1 minute. Resume decompression. Return to depth of stop. Multiply 20- and 10foot stop times by 1.5. OR: Treatment Table 5 if for surface interval less than 5 minutes. OR: Treatment Table 6 if for surface interval less than 5 minutes.
No
N/A
N/A
YES
Perform Chamber stops in water. (See note 1.) Descend to depth of first stop. Follow the schedule to 30 FSW. Multiply 30, 20 , 10 FSW stops by 1.5.
No
No
Decompression stops Required (Greater than 30 minutes) NOTES: 1. 2. Sur-D Air only.
No
Any
If a diver missed a stop deeper than 60 feet and oxygen is available, first compress to the depth of the first missed stop. Double this stop, then decompress to 60 feet using the appropriate decompression schedule doubling all stop times. Decompress from 60 feet on Treatment Table 5 or 6 as appropriate.
3. Using a recompression chamber is strongly preferred over in-water recompression for returning a diver to pressure. 4. Table 5 reference paragraph 2.6.4 5. Table 6 reference paragraph 2.6.5
Taken from the US Navy Manual, Chapter 21 , Table 21-3; 7 March 2000 (PDF Version 1.3)
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2.6.3 Omitted Decompression Procedures If the diver develops symptoms of decompression sickness during the surface interval, treat in accordance with the procedures in paragraph 2.6.5 (chamber available). If the diver has no symptoms of decompression sickness or arterial gas embolism, make up the omitted decompression as described in this section. Ascent From 20 Feet or Shallower (Shallow Surfacing) with Decompression Stops Required The diver surfaced from 20 feet or shallower, feels well, and can be returned to stop depth within 1 minute, the diver may complete normal decompression stops. The decompression stop from which ascent occurred is lengthened by 1 minute. If the diver cannot be returned to the depth of the stop within 1 minute and the diver remains asymptomatic, return the diver to the stop from which the diver ascended. Multiply each decompression stop time missed by 1.5. Alternatively, if the surface interval is less than 5 minutes, the diver may be placed in a recompression chamber and treated on a Treatment Table 5. If the surface interval is greater than 5 minutes, the diver may be placed in a recompression chamber and treated on Treatment Table 6 (2.6.5). The diver should be observed for 1 hour after surfacing and/or completing treatment. Ascent from 20 Feet or Shallower with No Decompression Stops Required No recompression is required if the diver surfaces from 20 feet or shallower but was within no-decompression limits. The diver should be observed on the surface for 1 hour. Ascent from Deeper than 20 Feet (Uncontrolled Ascent). Any unexpected surfacing of the diver from depths in excess of 20 feet is considered a uncontrolled ascent. If the diver is within no-decompression limits and asymptomatic, he should be observed for at least one hour on the surface. Recompression is not necessary unless symptoms develop.
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Asymtomatic Uncontrolled Ascent. Asymptomatic divers who experience an uncontrolled ascent and who have missed decompression stops are treated by recompression based on the amount of decompression missed as follows: Oxygen Available. Immediately compress the diver to 60 feet in the recompression chamber. If less than 30 minutes of decompression (total ascent time from the tables) were missed, decompress from 60 feet on Treatment Table 5. see 2.6.4 If more than 30 minutes of decompression were missed, decompress from 60 feet on Treatment Table 6. see2.6.5 Development of Symptoms. As long as the diver shows no ill effects, decompress in accordance with the treatment table. Consider any decompression sickness that develops during or after this procedure to be a recurrence (any recurrence is to be reported to the DOF Subsea consulting physician to determine the next treatment required). Try to keep all surface intervals as short as possible (5 minutes or less). If an asymptomatic diver who has an uncontrolled ascent from a decompression dive has more than a 5-minute surface interval, recompress to 60 feet on Treatment Table 6 even if the missed decompression time was less than 30 minutes. In-Water Procedure: When no recompression facility is available, use the following in-water procedure to make up omitted decompression in asymptomatic divers for ascents from depths below 20 feet. Recompress the diver in the water as soon as possible (preferably less than a 5-minute surface interval). Keep the diver at rest, provide a standby diver, and maintain good communication and depth control. Use the decompression schedule appropriate for the divers depth and bottom time. Follow the procedure below with 1 minute between stops: Return the diver to the depth of the first stop. Follow the schedule for stops 40-FSW and deeper. Multiply the 30-, 20-, and 10-FSW stops by 1.5.
Symptomatic Uncontrolled Ascent If a diver has had an uncontrolled ascent and has any symptoms, he should be compressed immediately in a recompression chamber in accordance with Table 6.
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General Points Descent rate - 20 ft/min. Ascent rate - Not to exceed 1 ft/min. Do not compensate for slower ascent rates. Compensate for faster rates by halting the ascent. Time on oxygen begins on arrival at 60 feet. If oxygen breathing must be interrupted because of CNS. Oxygen Toxicity, allow 15 minutes after the reaction has entirely subsided and resume schedule at point of interruption. Treatment Table may be extended two oxygen-breathing periods at the 30-foot stop. No air break required between oxygen-breathing periods or prior to ascent. Tender breathes 100 percent O2 during ascent from the 30-foot stop to the surface. If the tender had a previous hyperbaric exposure in the previous 12 hours, an additional 20 minutes of oxygen breathing is required prior to ascent. USN Table 5
Taken from the US Navy Manual, Chapter 21 , 7 March 2000 (PDF Version 1.3).
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Tabulated Table 5 ACTION LEAVE SURFACE ON O2 0-60 feet 3.0 mins ON AIR Time from 0-60ft not included 3 DEPTH TIME GAS NOTES
ARRIVE BOTTOM
60 feet
ON AIR
60 feet
20 mins ON AIR
60 feet
5 mins
ON AIR
60 feet
20 mins ON AIR
30 feet
5 mins
ON AIR
30 feet
20 mins ON AIR
30 feet
5 mins
ON AIR
30-0 feet
30 mins
ON O2 Note
135 mins
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General Points Descent rate - 20 ft/min. Ascent rate - Not to exceed 1 ft/min. Do not compensate for slower ascent rates. Compensate for faster rates by halting the ascent. Time on oxygen begins on arrival at 60 feet. If oxygen breathing must be interrupted because of CNS Oxygen Toxicity, allow 15 minutes after the reaction has entirely subsided and resume schedule at point of interruption. Table 6 can be lengthened up to 2 additional 25-minute periods at 60 feet (20 minutes on oxygen and 5 minutes on air), or up to 2 additional 75-minute periods at 30 feet (15 minutes on air and 60 minutes on oxygen), or both. Tender breathes 100 percent O2 during the last 30 min. at 30 fsw and during ascent to the surface for an unmodified table or where there has been only a single extension at 30 or 60 feet. If there has been more than one extension, the O2 breathing at 30 feet is increased to 60 minutes. If the tender had a hyperbaric exposure within the past 12 hours an additional 60-minute O2 period is taken at 30 feet. USN Table 6
Taken from the US Navy Manual, Chapter 21 , 7 March 2000 (PDF Version 1.3).
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Tabulated Table 6 ACTION LEAVE SURFACE ON O2 ARRIVE BOTTOM ON O2 OFF O2 ON AIR ON O2 OFF O2 ON AIR ON O2 OFF O2 ON AIR ON O2 OFF O2 ON AIR ON O2 OFF O2 ON AIR ON O2 ON O2 TOTAL TIME ELAPSED 3 DEPTH TIME GAS NOTES
ON AIR
60-30 feet 30 mins ON AIR 30 feet 30 feet 30 feet 30 feet 30-0 feet 15 mins ON AIR 60 mins ON AIR 15 mins ON AIR 60 mins ON AIR 30 mins 285 mins ON O2 Note
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3.0 3.1
Under no circumstances shall US Navy and DCIEM Air Decompression Tables be used concurrently on the same diving task or within 24 hours of a previous diving task using one or the other table. Serious debilitating decompression illness can result from such practice as the tables were developed independently of each other using quite different procedures and principles. For example; Within a 24 hour period do not use the US Navy table for the first dive and then switch to the DCIEM tables for the second dive (or vice-a-versa). Do not complete a dive on day one using DCIEM Tables and the next day (day two, 20 hours later) undertake another dive using US Navy Tables.
3.1.2 Use Of Tables It is important to note that while the depths referred to in the text of this Appendix are given in metres (m) followed by the corresponding imperial depths in feet (ft) in parentheses, these imperial depths are approximations only and are not interchangeable as far as the decompression requirements in the tables are concerned. The depth segments in Tables 3.2.2 are divided into two sections by a limiting line. This limiting line corresponds to the line dividing the Normal air range and Exceptional exposure range in Figure F1 of AS/NZS2299.1: 2007. The shaded areas below each limiting line in the tables highlight dive profiles which are in the Exceptional exposure range. Repetitive groups in Tables 3.2.2 are shown for dives within the Normal air range only, and are not shown for dives within the Exceptional exposure range, since repetitive diving is not recommended in this range. Although these procedures cover diving only to a depth of 50 m (164 ft), decompression schedules for depths up to 72 m (240 ft) have been included to allow for altitude corrections. 3.1.3 Definitions
1
Taken from the Appendix F of AS/NZS2299.1: 2007 DCIEM Decompression Tables for Diving.
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The tables in this Annexe may only be used in accordance with the following definitions. NOTE: Supervisors need to be aware that some variations exists in definitions between US Navy and DCIEM Tables i.e. stop times. Term Ascent rate Description a specified rate of travel that the diver has to maintain up to and between decompression stops. For these tables, the ascent rate is from 18 3 m/min (from 60 10 ft/min). the total elapsed time from when a diver leaves the surface to the time (next whole minute) at which ascent is commenced, measured in minutes. a specific decompression procedure for a given combination of depth and bottom time as listed in a decompression table; it is normally described as maximum depth (metres (m) or feet (ft)) / bottom time (min). a specific length of time that a diver has to spend at a specified depth to allow for the elimination of sufficient inert gas from the body to allow safe ascent to the next decompression stop or the surface. the maximum depth attained, measured in metres (m) or feet (ft). the maximum rate of travel allowed in descending to the bottom. For these tables, the descent rate is 18 m (60 ft)/min maximum. for repetitive diving, the calculated bottom time for decompression purposes taking into consideration the residual nitrogen from the previous dive(s). for a dive at altitude, the depth of an equivalent dive at sea level. the maximum bottom time that allows a direct ascent to the surface without requiring decompression stops. the time at which normal decompression was interrupted as a result of an emergency procedure, i.e., loss of breathing air, O2 symptom. Once the situation allows the return to normal decompression procedures, the table is to be reentered where the interruption occurred. any dive that has a repetitive factor greater than 1.0. a figure, used for repetitive diving, determined by the repetitive group and the length of the surface interval after a dive.
Decompression schedule
Decompression stop
Depth
Descent rate
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a letter that relates directly to the amount of residual nitrogen in a divers body immediately on surfacing from a dive. nitrogen in excess of normal conditions, and which is still dissolved in a divers tissues after the surface has been reached. the tabulated decompression stop time, which includes the travelling time to that stop at 18 3 m/min (60 10 ft/min). the time that a diver has spent on the surface following a dive; beginning as soon as the diver surfaces and ending as soon as the diver starts the descent for the next dive. when using Table 3.3.3 (Surface decompression with oxygenSur D O2 ), this is the time from the diver leaving the 9 m (30 ft) water stop (or the bottom if no stop required) to arriving at the 12 m (40 ft) compression chamber stop. The maximum time allowed is 7 min.
Residual nitrogen
Stop time
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3.2
Example: Determine the decompression schedule required for a dive to 32 m (104 ft) and a bottom time of 22 min. Procedure: Enter Table 3.2.2. at the depth that is exactly equal to or next greater than 32 m (104 ft). Select 33 m (110 ft). Using the 33 m (110 ft) schedule, proceed to the Bottom time column and find the listed time that is exactly equal to or next greater than 22 min. Select 25 min. Proceed horizontally across the table at the 33 m (110 ft)/25 min level to find the decompression stops and the Repetitive group (RG) designator prescribed for this dive, as follows: 6 min stop at 6 m (20 ft) 10 min stop at 3 m (10 ft) Repetitive group on surfacing G
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27 (90) -
24 (80) -
21 (70) -
18 (60) -
15 (50) -
12 (40) -
9 (30) -
6 (20) -
3 (10) 3 5 7 10 15 20 5 10 15 19 26 35 44 53 62
Repet. group
A B C D E F G H I J K L M A C D F G H J K L M N O
30 60 90 120 150
6
(20)
180 240 300 360 420 480 600 720 30 60 90 120 150 180 210 240 270 300 330 360 400 420 450 480 20 30 60 90 120 150
9
(30)
A B D G H J M
12
(40)
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27 (90) -
24 (80) -
21 (70) -
18 (60) -
15 (50) -
12 (40) -
9 (30) -
6 (20) 2 2 3 3 4 4 5 7 13 17 21 24
Repet. group
A B C D E F G I K K L M
10 20 30 40 50 60 75 100 120
15
(50)
125 130 140 150 160 170 180 200 220 240 260 280 10 20 30 40 50 60 80 90 100 110
A B D E F G I J K L M
18
(60)
120 130 140 150 160 170 180 190 200 210 220 230 240
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27 (90) -
24 (80) -
21 (70) -
18 (60) -
15 (50) -
12 (40) -
9 (30) 2 3 4 4 5 5
6 (20) 3 4 5 6 7 7 8 9 15 20 25 29 34 38 4 5 6 7 7 8 9 9 10 11 11 12 18 23 28 33 39
Repet. group
A C D D E F G H J K M N
10 20 25 30 35 40 50 60 70 80 90 100 110 120 130 140 150 160 170 180 190 200 10 15 20 25 30 40 50 55 60 65
21
(70)
A C D E F G H I J J K L M
24
(80)
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27 (90) -
24 (80) -
21 (70) -
18 (60) -
15 (50) -
12 (40) 2 3 3 3 4
9 (30) 2 3 3 4 4 5 5 6 6 7 8 3 4 5 6 6 7 8 8 9 8 8 8 9 8
6 (20) 2 6 7 8 9 8 8 9 9 10 10 14 17 20 26 31 3 5 7 9 8 8 9 9 10 10 14 18 21 24 27 31 34 38
3 (10) 7 9 10 14 20 26 31 36 40 46 51 56 60 64 70 82 95 8 9 10 11 16 23 29 34 40 46 52 56 61 67 75 82 90 98 106
Repet. group
A B C D E F H I J K L
5 10 15 20 25 30 40 45 50
27
(90)
A B D E F G H I J K L
30
(100)
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27 (90) -
24 (80) -
21 (70) -
18 (60) -
15 (50) 2 3 3 4 4
12 (40) 2 3 4 4 5 5 6 6 7 7 8 3 4 5 6 6 7 8 6 6 7 6 7
9 (30) 3 5 6 7 8 7 7 7 8 8 9 9 9 9 12 15 4 6 8 6 7 7 7 8 8 8 9 10 13 16 19
6 (20) 3 6 9 8 8 9 9 10 10 15 19 23 26 30 34 38 42 45 48 6 9 8 8 8 10 10 13 18 22 27 31 35 40 42 46 50
Repet. group
A B C D F G H I J K M N
5 10 12 15 20 25 30 35 40 45
33
(110)
A C D F G I J K M N
36
(120)
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27 (90) -
24 (80) -
21 (70) -
18 (60) 3 3 4 4
15 (50) 2 3 4 4 5 5 6 6 3 4 5 6 6 7 5 6 5 6
12 (40) 3 4 6 7 6 6 6 7 6 7 7 8 4 5 7 5 6 6 6 7 7 7 7 8 8
9 (30) 5 7 6 7 7 7 8 8 8 9 11 14 17 20 4 7 6 7 7 8 8 8 9 10 14 18 21 25 28
6 (20) 4 8 7 8 9 9 10 15 20 25 30 34 39 42 47 52 6 7 8 8 9 10 16 21 27 32 37 40 45 51 57 65
3 (10) 5 8 10 11 22 30 39 47 53 61 70 82 94 106 118 129 138 7 9 10 17 28 37 46 53 62 73 86 99 114 126 137 146 152
Repet. group
A B C E G H J K M N
5 8 10 15 20 25 30 35
39
(130)
40 45 50 55 60 65 70 75 80 85 90 7 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90
B D F G I K L N O
42
(140)
90
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27 (90) -
24 (80) -
21 (70) 3 3 4 5 5
18 (60) 3 3 4 5 5 6 3 4 5 6 7 4 3 4 5 6 4 4 4 5
15 (50) 3 4 5 6 5 5 5 5 6 6 3 5 6 5 5 5 5 5 6 3 5 4 5 5 6 6 6 6 6
12 (40) 4 6 5 6 6 7 6 7 8 8 8 8 6 5 5 6 6 7 7 8 8 8 5 5 5 6 6 7 7 7 8 9 12
9 (30) 6 5 6 7 7 8 8 9 12 16 20 24 28 4 8 6 7 8 8 9 9 13 17 22 26 5 5 6 7 8 8 9 13 18 23 27 30
6 (20) 8 7 8 9 10 15 21 27 33 38 42 48 55 63 6 8 8 9 13 20 26 33 38 43 50 58 5 7 8 9 10 18 26 32 37 44 51 61 72
3 (10) 9 9 11 23 34 44 52 61 73 88 103 119 132 142 150 11 10 14 29 40 49 59 72 88 105 122 135 146 8 10 20 33 46 55 68 85 105 122 137 148 155
Repet. group
B D F H J K M O
7 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 6 10 15 20 25 30 35 40 45 50 55 60 65 70 6 10 15 20 25 30 35 40 45 50 55 60 65 70
45
(150)
B D G H K M N
48
(160)
B D G I K M O
51
(170)
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27 (90) 3
24 (80) 3 4 4 5 3 4 5 3
21 (70) 4 4 5 6 3 4 5 3 3 3 5 6 3 4 5 3 4 4 4
18 (60) 3 5 6 4 5 5 5 5 4 4 5 5 5 5 4 4 4 5 4 6 4 4 4 5 6
15 (50) 5 4 4 5 5 5 6 6 4 7 7 5 5 5 6 7 5 4 4 5 6 6 7 7 4 4 6 6 6 6
12 (40) 6 5 6 6 7 7 8 8 9 4 4 5 6 6 7 8 8 9 5 5 5 6 6 7 8 9 7 5 6 7 7 8 9 13
9 (30) 7 6 7 7 8 9 13 18 23 28 5 6 7 8 9 11 17 22 27 6 6 7 9 10 15 21 27 5 6 7 8 8 12 19 25 29
6 (20) 6 7 8 9 15 23 30 36 42 51 61 8 7 9 10 19 27 35 41 50 61 10 8 10 14 23 32 38 47 58 6 8 9 17 28 35 43 54 70
3 (10) 9 11 25 39 50 62 80 101 121 137 149 9 11 29 44 55 72 93 116 135 149 9 16 33 48 62 84 109 131 147 5 10 20 39 52 71 97 123 142 154
Repet. group
B E H J M O
5 10 15 20 25 30 35 40 45 50 55 60 5 10 15 20
54
(180)
57
(190)
25 30 35 40 45 50 55 5 10 15
60
(200)
20 25 30 35 40 45 50 5 10 15
63
(210)
20 25 30 35 40 45 50
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27 (90) 3 4 3 5 5 3
24 (80) 3 5 3 3 5 3 3 4 6 3 3
21 (70) 4 3 3 4 4 6 3 4 4 4 3 3 4 4
18 (60) 5 4 4 4 4 5 6 3 4 4 5 4 4 5 4 6
15 (50) 4 4 4 5 6 7 7 6 4 5 5 6 6 7 4 5 5 6 6
12 (40) 5 5 6 7 7 8 11 4 6 6 7 8 9 4 5 5 6 8 9 13
9 (30) 7 5 7 8 9 16 23 28 8 6 7 9 12 19 27 5 6 8 9 15 23 28
6 (20) 6 9 10 21 32 39 49 65 7 9 12 24 35 44 57 7 9 16 28 37 49 67
Repet. group
5 10 156
66
(220)
20 25 30 35 40 45 5 10
69
(230)
15 20 25 30 35 40 5 10
72
(240)
15 20 25 30 35 40
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3.3
NOTE: The maximum surface interval, Sur D O2 , of 7 min was chosen to enhance the operability of the procedure and to reduce the chances of omitted decompression during operations. Extensive experimentation using the full 7 min has proven this procedure safe. In operational use, the surface interval, Sur D O2, should be kept to a minimum. The surface Interval is the time from the diver leaving the 9mtr (30ft) water stop, or the bottom if no water stop required, to arriving at the 12 mtr (40ft) recompression chamber stop. 4 Remain on O2 at 12 m (40 ft) for the tabulated stop time with 5 min air breaks after every 30 min on O2
NOTE: The asterisks following the stop times for Chamber on O2 in Table 3.3.3 represent the number of air breaks. The tabulated 12 m (40 ft) stop times are for O2 only, while the Total decompression time column includes the air breaks. If no asterisk follows a tabulated 30 min Chamber on O2 stop time, no air break is taken prior to ascent on O2. If only one asterisk follows a tabulated 60 min Chamber on O2 stop time, no second air break is taken prior to ascent on O2 5 6 Ascend to the surface on O2 NOTE: A time of 1 min for this ascent has been added to the Total decompression time column as an example only.
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Example: Determine the decompression schedule for a dive to 36 m (120 ft) with a duration of 75 min. Procedure: 1 Enter Table 3.3.3 at the depth that is exactly Select 36 m (120 ft). equal to or next greater than 36 m (120 ft). Using the 36 m (120 ft) schedule, proceed to the Select 75 min. Bottom time column and find the listed time which is exactly equal to or next greater than 75 min Proceed horizontally across the table at the 36 Table 3.3.3 calls for m (120 ft)/75 min level to find the 9 min stop at 12 m decompression stops and stop times as follows 8 min stop at 9 m Time from 9 m in-water to 12 m compression chamber stop on surface is maximum 7 min 80 min stop at 12 m on O2 (70min +2 5 min air breaks) No repetitive group (exceptional exposure dive) NOTE: Repetitive diving can also be conducted using Sur D O2, as shown by repetitive groups in Tables 3.4.8 and 3.4.9for dives within the Normal air range, however these Repetitive groups may be different from those in Tables 3.2.2 and 3.3.3. Supervisors are not to plan repetitive dives.
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For loss of O2, switch diver to standard air decompression (Table 3.2.2) and commence decompression at the 12 m (40 ft) stop. NOTE: Previous O2 time is good time and is subtracted from 12 m (40 ft), 9 m (30 ft), 6 m (20 ft) and 3 m (10 ft) stops as appropriate. Example: Dive 42 m (140 ft), Bottom time 30 min: Table 3.3.3 call for 30 min Sur D O2. Situation: After 24 min on O2 in compression chamber, O2 is lost At 42 m, Table 3.2.3 calls for 12 m 4 min stop 9 m 5 min stop 6 m 8 min stop 3 m 28 min stop
The 24 min spent on O2 satisfied the 12 m, 9 m and 6 m stops, and 6 min of the 3 m stop; therefore, ascend to 3 m and complete decompression by remaining on air at 3 m for 22 min.
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3.3.2.2
For minor symptoms of O2 toxicity, the procedure is as follows: 1 2 Take diver off O2 After symptoms have gone, either 3 leave diver on air for an additional 15 min and then resume O2 from the time of interruption; or switch diver to the Standard Air Decompression Table 3.2.2 and complete decompression on air.
If O2 breathing is resumed and O2 symptoms recur, switch the diver to the Standard Air Decompression Table 3.2.2 and complete the decompression on air.
Example: Dive 36 m (120 ft), Bottom time 75 min: Table 3.3.4 call for 70 min Sur D O2 plus two 5 min air breaks. Situation: After 11 min on O2 in compression chamber, diver develops symptoms of O2 toxicity. Procedure: Take diver off O2. Wait until diver stabilizes, then wait further 15 min. Resume O2 breathing from point of interruption (see Note).
NOTE: If diver took 4 min to stabilize, then the 12 m (40 ft) compression chamber stop would be 11 + 4 (stabilize) + 15 (wait) + 19 (remainder of first O2 period) + 5 (air break) + 30 (second O2 period) + 5 (air break) + 10 (remaining O2 required) = 99 min. In this case, however, the 10 (remaining O2 required) may be added to the 19 (remainder of first O2 period) thus precluding the need for the final 5 min air break. The 12 m (40 ft) compression stop would then become 11 + 4 (stabilize) + 15 (wait) + 29 (first O2 period) + 5 (air break) + 30 (second O2 period) = 94 min. Further, since treatment may resume with 30 min O2 periods, it may be convenient, in some cases, to complete the treatment with the shortest O2 period. In this case, this would simply mean that the first O2 period would become 30 min, and the second O2 period 29 min.
3.3.2.3
For serious, incapacitating symptoms of CNS O2 toxicity, the procedure is as follows: 1 2 Take diver off O2 and stabilize. Switch to Standard Air decompression on air. Decompression Table 3.2.2 and complete
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Repet. group.
F H H I J K K
18
(60)
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DCIEM Surface Decompression Using Oxygen Table Depth m (ft) Stop time (min) at different depths, m (ft) Bottom 30 27 24 21 18 15 12 9 time (100) (90) (80) (70) (60) (50) (40) (30)
35 50 60 70 80 90 NOT 110 120 EXCEE 130 140 150 160 170 180 190 200 1 7 min D 50* 55* 59* 63** 71** 76** 81** 85** 63 68 72 81 89 94 99 104 40* 45* 53 58 MUST
Repet. group.
E H H I J K K
21
(70)
100
25 45 50 55 60
2 20 25 29 32 38 48 55 62 68 74 84 94 101 107
E H H H I J K
24
(80)
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DCIEM Surface Decompression Using Oxygen Table Depth m (ft) Stop time (min) at different depths, m (ft) Bottom 30 27 24 21 18 15 12 9 time (100) (90) (80) (70) (60) (50) (40) (30)
20 35 40 45 1 2 EXCEE 70 80 90 100 110 120 3 4 5 6 7 8 7 min D 37* 45* 52* 58* 65** 74** 53 62 70 77 90 100 NOT MUST
Repet. group.
D G G H H I J
27
(90)
50 55 60
15 30 35 40 45
2 3 4
2 16 25 32 38 42 49 56 66 75 83 101 111
D G G H I I J
30
(100)
50 55 60 70 80 90 100 110
100
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DCIEM Surface Decompression Using Oxygen Table Depth m (ft) Stop time (min) at different depths, m (ft) Bottom 30 27 24 21 18 15 12 9 time (100) (90) (80) (70) (60) (50) (40) (30)
12 25 30 35 40 45 50 2 3 4 4 5 5 6 6 7 7 8 2 3 5 6 7 8 NOT 60 65 7 7 EXCEE 70 75 80 85 90 95 100 105 110 7 8 8 9 9 9 9 12 15 7 min D 54* 59* 60** 69** 75** 80** 85** 89** 93*** 78 84 91 101 108 113 119 126 139 45* 50* 67 73 MUST
Repet. group.
C G G H I J K K
33
(110)
55
101
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DCIEM Surface Decompression Using Oxygen Table Depth m (ft) Stop time (min) at different depths, m (ft) Bottom 30 27 24 21 18 15 12 9 time (100) (90) (80) (70) (60) (50) (40) (30)
10 20 25 30 35 40 45 2 3 3 4 4 2 3 4 4 5 5 6 6 3 4 5 6 6 7 8 6 6 7 6 7 3 4 6 7 6 6 6 7 6 7 7 8 2 4 6 8 6 7 7 7 8 8 8 9 10 13 16 19 5 7 6 7 7 7 8 8 8 9 11 14 17 20 7 min EXCEE D NOT MUST 7 min EXCEE D NOT MUST
Repet. group.
C F G G H I J K
36
(120)
50 55 60 65 70 75 80 85 90 95 100 8 20 25 30 35 40
B G G H I J K
39
(130)
45 50 55 60 65 70 75 80 85 90
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DCIEM Surface Decompression Using Oxygen Table Depth m (ft) Stop time (min) at different depths, m (ft) Bottom 30 27 24 21 18 15 12 9 time (100) (90) (80) (70) (60) (50) (40) (30)
7 15 20 25 30 35 40 3 3 4 4 3 4 5 6 6 7 5 6 5 6 4 5 7 5 6 6 6 7 7 7 7 8 8 4 7 6 7 7 8 8 EXCEE 55 60 65 70 75 80 85 90 8 9 10 14 18 21 25 28 7 min D 60** 70** 78** 84** 90** 100*** 107*** 113*** 97 109 119 130 141 160 172 182 NOT MUST
Repet. group.
B F G H I J K M
42
(140)
45 50
7 15 20 25 30 35
3 3 4 5 5 6
3 4 5 6 5 5 5 5 6 6
4 6 5 6 6 7 6 7 8 8 8 8
8 17 27 30* 40* 48* 55* 60** 72** 80** 87** 95*** 105*** 111***
B G G H I K M
45
(150)
40 45 50 55 60 65 70 75 80
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DCIEM Surface Decompression Using Oxygen Table Depth m (ft) Stop time (min) at different depths, m (ft) Bottom 30 27 24 21 18 15 12 9 time (100) (90) (80) (70) (60) (50) (40) (30)
6 15 20 25 3 4 5 6 7 4 3 5 6 5 5 5 5 5 6 6 5 5 6 6 7 7 8 8 8 4 8 6 7 8 8 EXCEE 45 50 55 60 65 70 9 9 13 17 22 26 7 min D 60* 72** 81** 88** 99*** 108*** 96 115 129 142 164 178 NOT MUST
Repet. group.
B G G I J L
48
(130)
30 35 40
6 10 15 20 25
3 4 5 5
3 4 5 6 4 4 4 5
3 5 4 5 5 6 6 6 6 6
5 5 5 6 6 7 7 7 8 9 12
6 11 25 30* 42* 51* 60* 70** 80** 89** 101*** 110*** 117***
B D G H J K M
51
(170)
30 35 40 45 50 55 60 65 70
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DCIEM Surface Decompression Using Oxygen Table Depth m (ft) Stop time (min) at different depths, m (ft) Bottom 30 27 24 21 18 15 12 9 time (100) (90) (80) (70) (60) (50) (40) (30)
5 10 15 20 4 4 5 6 3 5 6 4 5 5 5 5 4 4 5 5 5 6 6 6 5 6 6 7 7 8 8 9 7 6 7 7 8 9 13 18 23 28 7 min EXCEE D NOT MUST
Repet. group.
B E G H J M
54
(180)
25 30 35 40 45 50 55 60
5 10 15
3 4
3 4 5 3 3
5 4 4 5 5 5
4 7 4 5 5 5 6 7
4 4 5 6 6 7 8 8 9
57
(190)
20 25 30 35 40 45 50 55
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DCIEM Surface Decompression Using Oxygen Table Depth m (ft) Stop time (min) at different depths, m (ft) Bottom 30 27 24 21 18 15 12 9 time (100) (90) (80) (70) (60) (50) (40) (30)
5 10 15 4 5 3 5 6 3 4 5 4 4 4 5 4 5 4 4 5 6 6 7 5 5 5 6 6 7 8 9 6 6 7 9 10 15 21 27 7 min EXCEE D NOT MUST
Repet. group.
60
(200)
20 25 30 35 40 45 50
10 15
3 4 5 3
5 3 4 4 4
6 4 4 4 5 6
7 4 4 6 6 6 6
7 5 6 7 7 8 9 13
63
(210)
20 25 30 35 40 45 50
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DCIEM Surface Decompression Using Oxygen Table Depth m (ft) Stop time (min) at different depths, m (ft) Bottom 30 27 24 21 18 15 12 9 time (100) (90) (80) (70) (60) (50) (40) (30)
10 15 3 4 3 5 3 3 4 3 3 4 4 5 4 4 4 4 5 4 4 4 5 6 7 7 5 5 6 7 7 8 11 7 5 7 8 9 16 23 28 MUST NOT EXCEE
Repet. group.
66
(220)
20 25 30 35 40 45
D 7 min
10
3 5
-5 3 3
6 3 4 4
6 3 4 4 5
6 4 5 5 6 6
4 6 6 7 8 9
69
(230)
15 20 25 30 35 40
10
5 3
4 6 3 3
4 3 3 4 4
4 4 5 4 6
7 4 5 5 6 6
4 5 5 6 8 9 13
72
(240)
15 20 25 30 35 40
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3.4
REPETITIVE DIVING
The Repetitive Diving tables are contained in Tables 3.4.8 (repetitive factors (RF) for surface intervals (SI) for repetitive diving) and 3.4.9 (no-decompression limits for repetitive diving). These Tables have been validated using the Standard Air Decompression and Surface Decompression with Oxygen (Sur D O2) decompression methods to the limit of the normal air range. DOF Subsea prohibits repetitive diving using DCIEM Tables unless approved by the DOF Subsea Manager Diving Operations. 3.4.1 Repetitive Factors (RF) For Surface Intervals (SI) For Repetitive Diving In Table 3.4.8 repetitive factors (RF) are given for each repetitive group (RG) letter from A to O, at selected surface intervals (SI) from 15 min up to 18 h. As the SI increases, the RF decreases until it becomes 1.0. A dive is considered a repetitive dive if it is conducted while the RF from the previous dive is greater than 1.0. For example, any dive within 18 h after surfacing from a dive with an RG of H or higher would be considered a repetitive dive. The RF is used to calculate the effective bottom time (EBT) for the repetitive dive. This EBT, determined by multiplying the actual bottom time of the repetitive dive by the RF, is the total of the actual bottom time and the time that has to be considered to have been already spent at that depth, because of the residual nitrogen remaining in the divers body from the previous dive. The EBT is then used to determine the decompression requirements for the repetitive dive. 3.4.2 No-decompression Limits For Repetitive Diving In Table 3.4.9, the no-decompression (No-D) limits for repetitive dives are shown for different depths as a function of the RF. These No-D limits are actual bottom times and not EBTs; the EBTs of these repetitive No-D limits are less than the No-D limits given in Tables 3.2.2 or 3.3.3 which are for first dives only. With Table 3.4.9, calculations are unnecessary if only No-D repetitive dives are planned. For any repetitive dive, this table should be consulted to determine whether the planned dive can be done as a nodecompression dive or whether decompression will be required. NOTE: Multiple dives can be performed using the RG of the EBT and the depth of the repetitive dive, however it may be necessary to adjust this RG under certain conditions (see Paragraph 3.4.6).
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3.4.2.1
Procedure
The procedure for using the Repetitive Diving Tables 3.4.8 and 3.4.9 is as follows: 1 Find the RG of the first dive (from Table 3.2.2 or 3.3.3 ), and enter Table 3.4.8. Proceed down the RG column to locate the matching RG letter from the first dive, and then proceed horizontally along the same line to the appropriate surface interval (SI) column. Where the RG and the SI intersect, note the RF. Enter Table 3.4.9 at the RF column and proceed down to the applicable depth of the planned repetitive dive. Where the RF and the depth intersect, note the No-D limit for this repetitive dive.
NOTE: The No-D limit obtained is the actual bottom time and not the EBT 3.4.3 Repetitive Dives Not Requiring Decompression If the actual bottom time of the second dive is less than or equal to the No-D limit in Table 3.4.9, the second dive is a No-D dive (if a third dive is not intended within the next 18 h, no further calculations are necessary). If a third dive is planned, and the actual bottom time of the second dive is less than the No-D limit, multiply the actual bottom time by the RF to obtain the EBT for the second dive. Find the new RG from the EBT and depth of the second dive from the appropriate decompression table (this RG may need to be adjusted before a third dive can be conducted see Paragraph 3.4.6). To find the minimum SI for a No-D dive, enter Table 3.4.9 at the depth of the repetitive dive and proceed horizontally to the intended bottom time of the repetitive dive. Proceed upward in the column to find the RF. Enter Table 3.4.8 at the RG of the first dive and proceed horizontally to the appropriate RF. Proceed upward in the column to determine the minimum SI following the first dive.
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3.4.3.1
Example
Example 1: First dive 18 m (60 ft), bottom time 30 min, surface interval 1 h. Second dive 15 m (50 ft), actual bottom time 30 min. Intended third dive 12 m (40 ft) after surface interval 1 h 15min. Procedure 1: RG of first dive = D (from Table 3.2.2). Enter Table 3.4.8. RF = 1.4. Enter Table 3.4.9. No-D limit = 45 min. Actual bottom time of second dive (30 min) is less than No-D limit, therefore no decompression required at this stage. For planned third dive, EBT for second dive is 30 1.4 = 42 min. RG for second dive = E (using 15 m (50 ft)/42 min in Table 3.2.3). From Paragraph 3.4.6, adjust the RG for the second dive. Since SI before third dive is less than 6 h, and the RG for the second dive (E) is greater than the RG from the first dive (d), no adjustment is necessary therefore RG remains at E. Enter Table 3.4.8 for RG = E and SI = 1 h 15min. RF for third dive = 1.5. Enter Table 3.4.9 . No-D limit for third dive is 100 min.
Example 2: First dive 24 m (80 ft), bottom time 25 min. Second dive 15 m (50 ft), bottom time 50 min. Possible third dive. Procedure 2: RG of first dive = E (from Table 3.2.3). Enter Table 3.4.9 for second dive. For 15 m (50 ft)/50 min, RF = 1.3. Enter Table 3.4.8. For a first dive of RG = E, a SI of 2 h is required.
If another dive is planned, EBT for second dive is 50 1.3 = 65 min, and the RG = G (from Table 3.2.2).
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3.4.4 Repetitive Dives Requiring Decompression If the actual bottom time of the repetitive dive is greater than the No-D limit in Table 3.4.9, then the repetitive dive requires decompression. Multiply the actual bottom time of the repetitive dive by the RF to obtain the EBT and then use Table 3.2.2, or 3.3.3 to determine the decompression schedule for the depth and EBT of the repetitive dive. For repetitive bottom times exceeding the No-D limits in Table 3.4.9, but with EBTs less than the No-D limit in Tables 3.2.2 or 3.3.3, a 5 min decompression stop at 3 m (10 ft) is mandatory. NOTE: The No-D limits in Tables 3.2.2 and 3.3.3 are for first dives only. Example 1: First dive 33 m (110 ft), bottom time 15 min, surface interval 40 min. Second dive 33 m (110 ft), bottom time 10 min. Procedure 1: RG of first dive = D (from Table 3.2.2). Enter Table 3.4.8. RF = 1.5. Enter Table 3.4.9. For RF = 1.5, No-D limit for second dive is 7 min. EBT for second dive is 10 (min) 1.5 = 15 min. From Table 3.2.2, decompression schedule is 33 m (110 ft)/15 min.
Example 2: First dive 18 m (60 ft), bottom time 50 min, surface interval 1 h 45min. Second dive 18 m (60 ft), bottom time 30 min. Procedure 2: RG of first dive = F (from Table 3.2.2). Enter Table 3.4.8. RF = 1.5. Enter Table 3.4.9 For RF = 1.5, No-D limit for second dive is 27 min. EBT for second dive is 30 (min) 1.5 = 45 min. From Table 3.2.2, 18 m (60 ft)/45 min is in the No-D range, therefore mandatory decompression is 5 min at 3 m (10 ft).
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3.4.5 Surface Intervals Less Than 15 Min Where the SI after the first dive is less than 15 min, if the first and second dives are at the same depth, add the bottom times of the first and second dives together to obtain the EBT for the second dive. If a third dive is planned, use this total time to determine the RG from Table 3.2.2. If the first and second dives are at different depths, it is necessary to firstly determine the bottom time at the second dive depth which would be equivalent to the first dive. Find the RG from the first dive, proceed to the second dive depth and find the bottom time with the same RG. Add this bottom time to the intended bottom time of the second dive to obtain the EBT for the second dive. Example 1: First dive 18 m (60 ft), bottom time 30 min, surface interval 10 min. Second dive 18 m (60 ft), bottom time 25 min. Procedure 1: RG of first dive = D (from Table 3.2.2). EBT of second dive is 30 min + 25 min = 55 min. From Table 3.2.2 decompression schedule for 18 m (60 ft)/55 min is 5 min at 3 m (10 ft), and RG = G.
Example 2: First dive 36 m (120 ft), bottom time 10 min, surface interval 12 min. Second dive 21 m (70 ft), bottom time 20 min. Procedure 2: RG of first dive = C (from Table 3.2.2). From Table 3.2.2, a dive with RG = C at 21 m (70ft) has a bottom time of 20 min. EBT for the second dive is 20 + 20 = 40 min. From Table 3.2.2, decompression schedule for 21 m (70 ft)/40 min is 5 min at 3 m (10 ft).
NOTE: The repetitive factors (RF) in Table 3.4.9 have been cut off, arbitrarily, at 2.0. It is felt that after a strenuous first dive, the surface interval (SI) should be of sufficient length to reduce the residual nitrogen level of a diver to that degree. Should it be necessary to perform a repetitive dive before the RF reduces to 2.0, the above procedure for surface intervals less than 15 min can be used.
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3.4.6 Adjustments For Multiple Repetitive Dives Repetitive dive tables, by their nature of having fixed limits, cannot take into account every possible diving situation. Repetitive group adjustments may be required in some cases if more than one repetitive dive is planned. These adjustments are necessary to avoid problems on repetitive dives after the first repetitive dive. For example, if a series of similar No-D repetitive dives are conducted (i.e. similar depth / bottom time / surface interval), it is possible to get locked into a loop resulting in the same RG and RF after each dive. Because decompression will eventually be required, it is necessary to adjust the RG to break out of this loop. Similarly, if a short duration dive follows a longer bottom time dive, the RG calculated for the second dive will be too small and will not take into account the influence of the longer first dive. Thus the second dive RG has to be adjusted upward. If another dive is planned after a repetitive dive, calculate the RG that corresponds to the depth and EBT of the just completed repetitive dive from the appropriate decompression table (Table 3.2.2, or 3.3.3). If the surface interval before the next repetitive dive is less than 6 h, and the RG of the just completed repetitive dive is greater than the RG from the previous dive, no adjustment is necessary. However, if the RG is lower than or equal to the RG of the previous dive, adjust the RG of the just completed dive upward to equal the RG of the previous dive plus one letter. If the surface interval to the next repetitive dive is more than 6 h, no adjustment is necessary. Example: First dive 21 m (70 ft), bottom time 25 min, surface interval 15 min. Second dive 21 m (70 ft), bottom time 8 min. Third dive planned after surface interval 1.5 h. Procedure: RG of first dive = D (from Table 3.2.2). Enter Table 3.4.11. RF = 1.8. EBT for second (just completed) dive is 8 (min) 1.8 = 14.4 min. From Table 3.2.2, RG of second dive is C (21 m (70 ft)/20 min) and is lower than RG of first (previous) dive. Adjust RG of second dive from C to E (RG =D +one letter). Enter Table 3.4.9. RF of second dive = 1.4 (from RG = E and SI 1.30 to 1.59).
NOTE: If the surface interval after the first dive was less than 15 min in the above example, then in accordance with Paragraph 3.4.5, the EBT of the second dive would be 25 + 8 = 33 min. Consequently, the RG would be E for the second dive.
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3.4.7 Flying after diving After a no-decompression dive, allow enough surface interval time to elapse for the RF to diminish to 1.0 before flying. After a decompression dive, a minimum of 24 h surface interval is required before flying.
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3.4.8 Table - Repetitive Factors (RF) For Surface Intervals (SI) For Repetitive Diving Repetitive factors (RF) for surface intervals in hr.min Repetitive 0.15 0.30 1.00 1.30 2.00 3.00 4.00 6.00 group (RG)
A B C D E F G H I J K L M N O
9.00 to
12.00 15.00 to to
to
to
to
to
to
to
to
to
0.29 0.59 1.29 1.59 2.59 3.59 5.59 8.59 11.59 14.59 18.00
1.4 1.5 1.6 1.8 1.9 2.0 1.2 1.3 1.4 1.5 1.6 1.7 1.9 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.9 2.0 1.1 1.2 1.2 1.3 1.4 1.5 1.6 1.7 1.8 1.9 2.0 1.1 1.2 1.2 1.3 1.3 1.4 1.5 1.6 1.7 1.8 1.9 2.0 1.1 1.1 1.2 1.2 1.3 1.3 1.4 1.5 1.5 1.6 1.7 1.7 1.8 1.9 2.0 1.1 1.1 1.1 1.2 1.2 1.3 1.3 1.4 1.4 1.5 1.5 1.6 1.6 1.7 1.7 1.1 1.1 1.1 1.1 1.2 1.2 1.2 1.3 1.3 1.3 1.3 1.4 1.4 1.4 1.4 1.0 1.1 1.1 1.1 1.1 1.1 1.1 1.1 1.1 1.2 1.2 1.2 1.2 1.2 1.2 1.0 1.0 1.0 1.0 1.1 1.1 1.1 1.1 1.1 1.1 1.1 1.1 1.1 1.1 1.1 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.1 1.1 1.1 1.1 1.1 1.1 1.1 1.1
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250 125 55 35 25 18 14 11 9 7 6 5 5
1.3
230 115 50 31 21 16 12 10 8 7 6 5 4
1.4
214 107 45 29 19 15 11 9 8 6 5 5 4
1.5
200 100 41 27 18 14 11 9 7 6 5 4 4
1.6
187 93 38 26 17 13 10 8 7 6 5 4 3
1.7
176 88 36 24 16 12 9 8 6 5 4 4 3
1.8
166 83 34 23 15 12 9 7 6 5 4 3 3
1.9
157 78 32 22 14 11 8 7 6 5 4 3 3
2.0
150 75 31 21 13 11 8 7 6 5 4 3 3
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3.5
OMITTED DECOMPRESSION
The Omitted Decompression table is contained in Table 2.6.4. Where a diver has omitted decompression but remains asymptomatic, the procedure is dependent on the availability of a compression chamber. NOTE: The flow chart at 3.5.5 shows an omitted decompression flow chart to assist in determining the appropriate course of action when using the decompression tables and procedures in this Standard.
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3.5.1 Compression Chamber Immediately Available (Less Than 7 Min) Where a compression chamber is available to a diver within 7 min of the diver leaving the water, the procedure is as follows: 1 If the 9 m (30 ft) or deeper stops were not completed, either 2 treat in accordance with Table 2.6.4 decompression time is less than 30 min; or if the total omitted
treat in accordance with Table 2.6.5 if the total decompression time is equal to or greater than 30 min.
omitted
If the 9 m (30 ft) stop was completed with no previous decompression omitted, recompress the diver in the chamber on O2 to 12 m (40 ft) and decompress in accordance with Table 3.3.3 When using Table 3.3.3 for any dive profile not including a 9 m (30 ft) inwater stop, if the surface interval - Sur D O2 exceeds 7 min, treat in accordance with Table 2.6.4
NOTE: If the surface interval Sur D O2 is completed within the 7 min, the diver cannot incur omitted decompression
Example: Dive 39 m (130 ft), bottom time 40 min. Table 3.2.2 calls for; 12 m4 min stop 9 m7 min stop 6 m9 min stop 3 m39 min stop Situation: Diver surfaces after completing the 12 m (40 ft) stop, the 9 m (30 ft) stop and 3 min of the 6 m (20 ft) stop. Diver is asymptomatic and a compression chamber is available. Procedure: Since the diver has completed the 9 m (30 ft) stop, dive on O2 in compression chamber to 12 m (40 ft). Enter Table 3.3.3. For 39 m (130 ft)/40 min dive, 36 min on O2 is called for. Add 5 min air break after 30 min on O2 for a total decompression time of 41 min in the compression chamber.
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3.5.2 Compression Chamber Not Immediately Available Where a compression chamber is not immediately available to a diver having omitted decompression, the preferred action is to get the diver to a compression chamber for treatment. The diver should receive 100% O2 by double-seal oral nasal mask en route to the compression chamber. However, the supervisor has the following options if the situation warrants it: Return the diver to the next deeper stop where the omission occurred. Continue decompression with the original schedule (see Example 1). If no deeper stop was called for, spend the time of the first stop at the next deeper stop and complete the total schedule (see Example 2).
Example 1: Dive 39 m (130 ft), bottom time 40 min. Table 3.2.3 calls for 12 m4 min stop 9 m7 min stop 6 m9 min stop 3 m39 min stop Situation 1: Diver surfaces after completing the 12 m (40 ft) stop, the 9 m (30 ft) stop and 3 min of the 6 m (20 ft) stop. Diver is asymptomatic and a compression chamber is not available. Procedure 1: Recompress immediately to either 9 m for 7 min (Table 3.2.2). Resume schedule beginning with the 6 m (20 ft) stop.
Example 2: Dive 39 m (130 ft), bottom time 40 min. Table 3.2.3 calls for 12 m4 min stop 9 m7 min stop 6 m9 min stop 3 m39 min stop Situation 2: On ascent to 12 m (40 ft) stop, diver loses control and surfaces (blow-up). Diver is asymptomatic and a compression chamber is not available. Procedure 2: Return diver to 15 m for 4 min (Table 3.2.2) or 50 ft. Complete total decompression schedule
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3.5.3 Violation of 7 minute surface interval Sur D O2 Where the 7 minute surface intervalSur D O2 has been exceeded but the diver remains asymptomatic, either treat in accordance with Table 2.6.4 if the surface intervalSur D O2 exceeds 7 min but is less than 30 min; or treat in accordance with Table 2.6.5, if the surface intervalSur D O2 equals or exceeds 30 min.
3.5.4 Decompression Stress During Surface IntervalSur D O2 During the surface interval (SI) of a Sur D O2 dive, the required decompression has been intentionally violated in order to take the diver out of the water and complete the decompression in a recompression chamber. At the completion of the SI, the diver is repressurized in the chamber to a depth of 12 m (40 ft), deeper than called for by the decompression schedule. The diver is given additional decompression during the chamber phase of the Sur D O2 profile for the increased stress of the SI. During the SI, the diver is exposed to a higher level of decompression stress than would be encountered if in-water decompression only had been executed. Therefore, the diver may experience signs or symptoms of decompression stress. Manned validation has indicated that when symptoms do occur during the SI, they are almost always very mild and late into the SI. In addition, the symptoms usually completely resolve during the compression to 12 m (40 ft) in the chamber. Experimental dives have demonstrated that the divers who experienced SI symptoms had the same incidence of decompression illness after the completion of the dive as those divers who did not experience signs or symptoms during the SI. Therefore, during Sur D O2 diving, when all signs and symptoms of SI stress have completely resolved by the time the diver is confirmed on oxygen at 12 m (40 ft), the decompression profile is to be completed as planned. When the signs and symptoms of SI stress have not completely resolved by the time the diver is confirmed on oxygen at 12 m (40 ft), it should be treated as decompression illness. The diver should be immediately compressed to 18 m (60 ft), treatment in accordance with table 2.6.5 (see also section 4.8, and section 4 Annexe C) initiated, and a medical practitioner appropriately trained in underwater medicine contacted.
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Depth Corrections For Diving At Altitude Depth corrections for diving at altitude are given in Tables 3.6.2. The depth corrections in these tables have not been experimentally validated and have been derived by recalculating the Standard Air Decompression tables (the Table at 3.2.2) at different altitudes. They should not be used with any other published tables. The corrections for altitude shown in Tables 3.6.2 only apply for divers who have been acclimatized at that altitude, i.e. for those who have spent at least 12 to 24 h at the altitude of the dive site. Corrections to the depth would be greater for those who have not acclimatized. If diving at altitude is conducted within 24 h of arriving at the altitude of the dive site, apply an additional 3 m (10 ft) to the actual maximum depth of the dive used in Tables 3.6.2 After 24 h, this additional correction is not required (see Example 2). 3.6.1 Procedure The procedure for using Tables 3.6.2 is as follows: 1 Establish the altitude of the dive site and determine the actual maximum water depth of the dive. Find the correction for the actual depth according to the altitude from Table 3.6.2 and add this correction to the actual depth to obtain the effective depth (ED). Determine the decompression schedule from the appropriate decompression table by applying the effective depth and the actual planned bottom time. Replace the stop depths from the normal decompression table with the actual stop depths shown at the bottom of Table 3.6.2 (the stop times are not changed). Decompress on this altitude schedule in accordance with normal procedures using the regular travel rates, unless the altitude is above 1524 m (5000 ft), in which case reduce the ascent rate to 15 m (50 ft)/min.
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Example 1: Altitude of dive site 2195 m (7200 ft). Dive 30 m (100 ft), Bottom time 23 min. Decompression by Standard Air Decompression (Table 3.2.2). Procedure 1: Enter Table 3.6.2Depth correction for 2195 m (7200 ft) is +9 m (+30 ft). Effective depth (ED) of dive is 30 +9 =39 m(100 + 30 = 130 ft). For 39 m/25 min Table 3.2.2 calls for o 6 m7 min stop o 3 m11 min stop o Repetitive group H From Table 3.6.2, actual decompression schedule, corrected for stop depths, as follows: o 7.5 m5 min stop o 5.0 m7 min stop o 2.5 m11 min stop
Example 2: Altitude of dive site 2195 m (7200 ft). Dive 30 m (100 ft), bottom time 23 m. Unacclimatised diver. Decompression by Standard Air Decompression (Table 3.2.2). Procedure 2: Apply depth correction. Actual maximum depth of dive is 30 +3 =33 m (100 + 10 = 110 ft). Enter Table 3.6.2. Depth correction for 2195 m (7200 ft) is +12 m (+40 ft). Effective depth (ED) of dive is 33 + 12 = 45 m (110 + 40 = 150 ft). For 45 m/25 min, Table 3.2.2 calls for 12 m4 min stop 9 m5 min stop 6 m8 min stop 3 m23 min stop Repetitive group J From Table 3.6.2, actual decompression schedule, corrected for stop depths, as follows: Table 3.6.2 calls for 9.5 m4 min stop 7.0 m5 min stop 5.0 m8 min stop 2.5 m23 min stop
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3.6.2 Table - Depth CorrectionsDiving At Altitude (Metres) Depth correction at altitude, m Actual depth m
9 12 15 18 21 24 27 30 33 36 39 42 45 48 51 54 57 60 63 66 69
100 to 299
+0 +0 +0 +0 +0 +0 +0 +0 +0 +0 +0 +0 +3 +3 +3 +3 +3 +3 +3 +3 +3
300 to 599
+3 +3 +3 +3 +3 +3 +3 +3 +3 +3 +3 +3 +3 +6 +6 +6 +6 +6 +6 +6
600 to 899
+3 +3 +3 +3 +3 +3 +3 +3 +6 +6 +6 +6 +6 +6 +6 +6 +6 +6 +6
900 to 1199
+3 +3 +3 +3 +3 +6 +6 +6 +6 +6 +6 +6 +6 +9 +9 +9 +9 +9 +9
1200 to 1499
+3 +3 +3 +6 +6 +6 +6 +6 +6 +6 +9 +9 +9 +9 +9 +9 +12 +12
1500 to 1799
+3 +3 +6 +6 +6 +6 +6 +9 +9 +9 +9 +9 +9 +12 +12 +12 +12 +12
1800 to 2099
+3 +6 +6 +6 +6 +9 +9 +9 +9 +9 +12 +12 +12 +12 +15 +15 +15
2100 to 2399
+6 +6 +6 +6 +9 +9 +9 +9 +12 +12 +12 +12 +15 +15 +15 +15
2400 to 3000
+6 +6 +6 +9 +9 +12 +12 +12 +15 +15 +15 +18 +18 +18 +21
300 to 599
3.0 6.0 9.0 12.0 14.5 17.5 20.5 23.5 26.0
600 to 899
3.0 6.0 8.5 11.5 14.0 17.0 20.0 22.5 25.5
900 to 1199
3.0 5.5 8.5 11.0 13.5 16.5 19.0 21.5 24.5
1200 to 1499
3.0 5.5 8.0 10.5 13.0 16.0 18.5 21.0 23.5
1500 to 1799
2.5 5.0 7.5 10.0 12.5 15.0 17.5 20.0 22.5
1800 to 2099
2.5 5.0 7.5 10.0 12.0 14.5 17.0 19.5 22.0
2100 to 2399
2.5 5.0 7.0 9.5 12.0 14.0 16.5 19.0 21.0
2400 to 3000
2.5 4.5 7.0 9.0 11.5 13.5 16.0 18.0 20.0
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4.0
EMERGENCIES - DIVING
An emergency, by definition, is an unforeseen combination of circumstances the resulting state of which calls for immediate action. Because of the characteristics of the underwater environment, a situation which might only be annoying on the surface may assume life or death proportions for a working diver. By training and experience, a diver must be able to handle the wide range of actual and potential emergency situations which he may encounter. He must be able to separate the important from the trivial, while at the same time recognising the dangers which a seemingly minor symptom or event may foreshadow. He must be able to identify and properly react to the warning signs of various physiological disorders, whether affecting himself or other divers. He must have a working knowledge of the most effective methods for handling physical emergencies (such as entrapment or malfunctioning equipment) as well as a basic knowledge of the correct steps to be taken in treating medical emergencies. And, most importantly, he must be able to work toward solving the emergency while he himself is under the emotional and physical stress which is almost certain to be one component of any emergency situation. Knowledge and training are vital. Men and women who are well trained, well rested, alert and confident only rarely cannot cope with an emergency. An operation that is thoroughly planned, with a carefully paced workload and the prior organisation of all necessary personnel, equipment and supplies, tends to be a safer operation. Equipment in good repair, properly maintained and not jury-rigged or adapted to a non-designed task, is usually safe equipment. While the environment of the dive cannot be directly controlled, it can be understood, and any hazardous elements provided for with special training, equipment or scheduling.
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In the administering of first aid, there are four primary tasks. In order of priority they are: Assure clear airway. Restore breathing. Assure heart function. Stop massive bleeding.
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RESUSCITATION
Resuscitation is a general term, which covers all the measures taken to restore vital signs, particularly the breathing and heartbeat. These measures include pulmonary resuscitation to restore breathing and cardiac resuscitation to establish normal heart function. 4.2.1 Expired Air Resuscitation (EAR) Of the several types of manual pulmonary resuscitation which have been developed (i.e.: back pressure arm lift, back pressure hip lift, chest pressure arm lift), the EAR method is the most effective and is definitely the choice for initial resuscitation. The others may be useful if the victim is vomiting or facial injury makes the EAR method impractical. The use of an airway not only offers the aesthetic advantage, but also helps to maintain a clear air passage. Resuscitation must be continued without interruption. The treatment of other injuries can be administered during resuscitation. A bag or mechanically-powered resuscitator can be substituted for EAR when it becomes available. Oxygen may also be administered to assist respiration. Do not delay starting resuscitation to find an Ambu bag or Emmerson device. NOTE: Remember the O2 in the bloodstream is elevated above the normal level when diving. You may have as much as twenty minutes before brain damage occurs. Do not hesitate to give resuscitation to a diver who has stopped breathing for more than four minutes. 4.2.2 Cardiac Resuscitation Cardiac arrest may result from electrical shock or asphyxia, or it may be caused by a combination of factors such as hypoxia, shock or embolism. There are may other causes, but the immediate problem is not the cause but to initiate cardiac massage. Closed-chest cardiac massage is a method for artificially continuing the flow of blood to the central nervous system and other vital organs. If the heart has been interrupted for more than four minutes, irreversible brain damage will generally result. If, however, the heart has been interrupted for a period of more than 4 minutes due to drowning in extremely cold water, brain damage has been known to be retarded by some considerable time. However, cardiac massage should be continued until the victim is pronounced dead by a doctor or medic, or until you are unable to continue.
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When a diver is cold the bodys core temperature does not drop significantly, whereas skin temperature is obviously below normal. Signs and symptoms of cold are goose bumps, shivering, pale to blue skin colour, and there may be an increased rate of breathing to fulfil oxygen requirements to produce energy and maintain body heat. As blood is withdrawn from the extremities in an effort to maintain core temperature, numbness of toes and fingers occur. Signs and symptoms of cold are the early warning signs that our core temperature can no longer be maintained and will begin to fall, i.e. hypothermia will occur. 4.4.1.2 Mild Hypothermia (Body core temperature dangerously affected)
As further heat is lost to the environment, the body shuts down larger blood vessels, particularly those in the limbs. As a result of this lack of blood supply, in-coordination and cramping occur and the diver will have difficulty performing fine tasks. Shivering becomes spasmodic and uncontrollable. As the brain cools down the patient becomes confused and loses interest. 4.4.1.3 Severe Hypothermia (Critical, death is imminent)
As core temperature gets progressively lower, the patient will go into a state of collapse, shivering will stop and muscle rigidity occurs. The patient may also have slurred speech or even lose the ability to speak. The patient can go into a state of semi to total unconsciousness. Breathing difficulties and heart irregularities will also occur as the heart itself cools. 4.4.1.4 Treatment
When the body core temperature has begun to fall the vast majority of stored food and energy reserves have been consumed. Unless specifically treated, the patient will die without corrective measures being introduced quickly. Cold Dry clothes, warm drink, rest and sweet fluids. Mild Hypothermia Gentle re-warming using body heat of others, electric blanket, glucose and warm drinks. Severe Hypothermia Treat very gently, remove from water with care, needs hospitalisation.
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4.4.2 Heat Stroke This is sometimes called sun stroke and is a very serious condition which results in the failure of the heat regulating mechanism of the body. 4.4.2.1 Signs and Symptoms
Heat stroke is caused when persons exposed to excessive heat perspire and the loss of water leads to a decrease in plasma volume. This condition will lead to a decreased cardiac output resulting in a decreased blood flow to the skin. As the blood supply to the skin becomes inadequate, a major pathway for heat loss is decreased. Body temperature will rise causing heat stroke. This condition can lead to cardiac failure and death. The most striking characteristic of heat stroke is lack of sweat. The skin is dry and flushed. Early signs include headache, blurred vision and vomiting. 4.4.2.2 Treatment
Move the victim to a cool place. Remove as much clothing as possible; place the victim on his / her back with head and shoulders slightly raised. When the victim regains consciousness, administer small amounts of cool (but not cold) water. Absolutely no stimulants or hot drinks. NOTE: If no response, a more drastic cooling method must be employed to initially cool the victim. Ice water may be applied externally. Once the temperature starts to drop, remove to a cool place. 4.4.3 Treatment for Heat Exhaustion (Hyperthermia) This is the bodily reaction to excessive heat. In doing so, the body sweats profusely and loses large amounts of salt and water. 4.4.3.1 Signs and Symptoms
Victims may complain of headache, dizziness, nausea and weakness; temperature is subnormal and pulse is likely to be weak and rapid. 4.4.3.2 Treatment
Move the victim to a cool, well-circulated are, but do not allow him / her to chill; loosen all tight clothing; lie the victim on his / her back with feet and legs slightly elevated; sponge with cold water and give fluids to drink (i.e. water).
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Some marine animals, such as groper, killer whales, seals and sharks have been known on rare occasions to injure divers. The wounds from bites are generally extensive with ragged edges. Tissue injury and haemorrhaging are usually severe. Blood loss, shock and secondary infection are the main features causing concern. In severe cases, quick and efficient first aid is of vital importance. It is important to note, however, that the most likely cause of this type of injury will be boat propellers, broken glass or divers falling and hurting themselves. Management 1 2 3 4 5 DRABC. Observe and assess the signs and symptoms. Broad pressure bandage (pressure immobilisation). Splint. A second broad pressure bandage.
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4.5.1.2
Venomous Bites
There are principally two animals that are known to bite causing injection of venom into the wound. They are blue-ringed octopus and the sea snake. Blue-ringed Octopus: A blue ringed octopus grows to a maximum of 20 cm from tip to tip of its tentacles. When undisturbed, this animal has a yellowish-brown colour with dull ringed markings on the tentacles and stripes on the body. When disturbed, these dull markings become iridescent blue. The initial bite is almost painless. After about 15 minutes the bite becomes swollen, resembling a mosquito bite. A few minutes after the bite a rapid, painless paralysis results. The symptoms progress as follows: 1 Numbness around the mouth and neck, which may cause difficulties in swallowing. Nausea and vomiting. Breathing difficulties arise fairly quickly. The eye muscles gradually become paralysed. General weakness and difficulty with coordination leads to complete paralysis which persists for 4 to 12 hours.
2 3 4 5
Sea Snakes: There are a number of different species of this marine reptile, some being more dangerous than others. The toxins interfere with nerve and muscle function. The initial puncture is noticed but is not painful. Symptoms may take 10 minutes to several hours to manifest themselves. Restlessness, nausea and vomiting may occur, followed by a general stiffening and aching. Weakness develops into paralysis and spreads. This may be preceded by muscular twitching and spasms. Respiratory and cardiac distress and failure may also occur. Management 1 2 3 4 5 DRABC. Observe and assess the signs and symptoms. Broad pressure bandage (pressure immobilisation). Splint. A second broad pressure bandage.
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Cone Shells: Although more prevalent in tropical waters, cone shells are found in temperate waters. While not strictly a bite these animals have a minute, rasp-like feeding appendage (radula) which can thrust out of the narrow end of the shell. The radula has a series of 120 teeth which penetrate the skin and inject the venom. These specialised teeth are generally used for immobilising prey, but may also be used for protection. The shell should never be picked up by divers. The toxins injected affect the nerve muscle function. The initial puncture may be painless or associated with excruciating pain. Numbness and tingling may extend from the bite to involve the whole body, particularly the mouth and lips. This process takes around 10 minutes. Mild to severe muscular paralysis may result within 10-30 minutes, including respiratory paralysis. Cardiac arrest may also occur. The patient's general condition deteriorates for 1-6 hours, after which improvement is likely. Management 1 2 3 4 5 DRABC. Observe and assess the signs and symptoms. Broad pressure bandage (pressure immobilisation). Splint. A second broad pressure bandage.
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4.5.2 Puncture Wounds These generally result from spines or darts. They may be complicated by toxins or irritants. 4.5.2.1 Puncture Wounds Without Venom
This type of wound is probably the most common injury resulting from contact with the marine animal. These wounds often occur while cleaning fish, and while handling specimens. Sea urchins are the most common marine animal encountered by divers that cause a puncture wound. The spines of these animals are long, sharp and brittle. The spines tend to break off within the tissues. Pain occurs immediately after penetration. Swelling or inflammation usually occurs. The area of inflammation may increase and begin to ache. This ache can extend to involve the whole limb. The lymph glands become tender and swollen. General weakness and shock may result. With sea urchin spines, removal should not be attempted unless it can be accomplished without breaking the spine. 4.5.2.2 Puncture Wounds With Venom
Many animals are particularly well endowed with spines. Fish such as the butterfly cod (lionfish), stonefish, and catfish are common examples found within tropical waters. Stingrays also have spines. In these fish, the spines are covered by a sheath which is pierced and displaced when contact is made with the victim. Venom then passes along the spine into the wound. Severe pain is experienced at the affected site. This gradually increases in intensity. The intense pain lasts for several hours and may persist as a dull ache for a few days. The wound is susceptible to secondary infection. Pain may extend to the lymph glands of the groin and armpit. Distress as a result of the pain may lead to mild delirium. Nausea, vomiting, sweating, fever and shock may also result. Respiratory failure may occur. Weakness and exhaustion may last for several days. It is unlikely to be fatal except in the case of the stonefish. These fish have short stout spines covering the head and gill covers which may inflict a simple puncture wound. Management 1 2 3 4 5 DRABC Observe and assess the signs and symptoms. Broad pressure bandage (pressure immobilisation). Splint A second broad pressure bandage
4.5.3 Stings
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Animals that have tentacles coated with stinging cells (nematocysts) belong to a group of creatures called the cnidaria (hollow gutted animals) or coelenterates and include corals, anemones, hydroids, fire urchins and sea jellies. Examples of the better known species are blue-bottle, mauve stinger, jimble, and the most dangerous of all, the box jelly. Portuguese Man-of-War is a compound hydroid rather than a sea jelly but gives similar symptoms. Generally, a few seconds after contact, a stinging sensation is felt and this increases in intensity for a few minutes. A red coloured reaction surrounds the area of contact and may rise up in the form of a pimple. Lesions, weals and blisters often result, the shape of which may be characteristic of the animal responsible. The pain may extend to the lymph glands of the groin and armpit. General symptoms include abdominal pains, cramps, muscular aches, respiratory distress, sweating, anxiety and restlessness. Nausea and vomiting may also occur. Symptoms generally diminish within 4-12 hours. Convalescence may take up to a week. In the case of the box jelly, if death occurs, it usually occurs within the first 10 minutes. 4.5.3.1 Management
Box Jelly Fish - Priority lies with immediate and appropriate resuscitation. Vinegar inhibits the discharge of all known box jelly fish nematocysts. So it should be used to douse all known box jelly fish stings. The stings can then be scraped off with a knife. Apply vinegar first and then a pressure immobilisation bandage. Soak the bandage in vinegar if practicable. Administer anti-venom if available. Vinegar plays no role in pain relief therefore pain relief methods must be used together with treatment for shock. Other Jelly Fish Stings - Vinegar may actually discharge other jelly fish stings. Therefore, for these painful but not life threatening stings, nematocyst inhibition is not as high a priority. The stings can be scraped off with a knife or picked off using the thicker pads of the fingers. Ice packs or cold packs can then be applied for pain relief, much like treating a burn. Ice should not be applied directly as the ice melting may cause the nematocysts to discharge.
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4.5.4 Electric Shocks Electric rays or numbfish are slow and ineffective swimmers. The electric discharge varies from 8 to 220 volts. The ray can deliver a successive series of shocks. The electric shock may be disabling, a major threat coming from drowning. Recovery is uneventful and treatment is not usually required. 4.5.5 Marine Animal Injuries in Remote Areas In the situation where medical aid is unavailable for some hours, extra care must be taken to avoid the potential injuries from marine organisms. Dive supervisors have the responsibility to ensure the presence of a comprehensive first aid kit which should be put together in consultation with a doctor who is aware of the added problems associated with diving and the marine world. These should be addressed in the DPP.
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4.6
The most serious conditions which can apply to any of these categories have already been covered: Cessation of breathing Cardiac arrest Massive haemorrhage
A potentially serious symptom which may be common to these categories is loss of consciousness which may be both a warning of a severe problem and a complicating factor in any diagnosis. Loss of consciousness can be the result of near-drowning, inadequate oxygen, an oxygen convulsion or an excess of carbon dioxide in the blood. But in diving, loss of consciousness must be considered to be a symptom of the most dangerous problems gas embolism and decompression sickness. Recompression should be given in almost every case of unconsciousness simply because it is seldom possible to be certain that it is not essential. If satisfied that recompression is not called for in a given case, then treatment can progress along other lines, as outlined in the following sections.
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4.6.1 Respiratory Emergencies All human life is directly dependent upon the quantity and quality of its breathing mixture. Any deviations from established standards can result in a number of respiratory problems. Because of the particular nature of the underwater environment, any such problem which on the surface might easily be handled as transient annoyance must be handled as an emergency. Not all respiratory problems must necessarily result in the termination of the dive if they are identified and corrected soon enough. With most, however, the need to ensure the safety of the diver will outweigh an operational requirement to complete a planned dive, and the diver should be brought to the surface for treatment and thorough examination by medical personnel. Beware of the diver who reports from the bottom I think Im OK now and wants to continue his assignment. Every diver and every other member of the diving team must know the warning signs and symptoms of each of these problems: Oxygen Deficiency (hypoxia) Carbon Dioxide Poisoning Carbon Monoxide Poisoning Asphyxia Strangulation Chemical Irritants Nitrogen narcosis Oxygen Poisoning (toxicity)
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4.6.2 Oxygen Deficiency Although the specific cause varies, the following disorders all result in the same condition a shortage of oxygen reaching the cells for normal metabolism. In summary, these disorders are: 4.6.2.1 Hypoxia, caused by loss or inadequacy of the air supply. Carbon Dioxide Poisoning, resulting from inadequate ventilation of apparatus, over-exertion, controlled or skip breathing, excessive dead space in equipment. Carbon Monoxide Poisoning, caused by induction of exhaust fumes into the air supply compressor. Asphyxia, simultaneous oxygen deficiency and carbon dioxide excess usually caused by loss or inadequacy of the air supply. Strangulation, obstruction of the airway by a foreign object, laryngeal spasm or abnormal swelling. Chemical irritants, presence of irritating chemicals contaminating the air supply resulting in pulmonary oedema. Symptoms
The following signs and symptoms may be noted in situations involving oxygen deficiency. 4.6.2.2 Laboured breathing Lack of muscular control Mental confusion In-coordination Bad taste Treatment Headache Nausea Chest Discomfort Unconsciousness Weakness
The following procedure should be followed if oxygen deficiency is suspected: 1 2 Abort the dive. Switch to an alternate air supply. Send down the standby diver to assist (Standby diver to be on a separate air supply if possible). Thoroughly ventilate the apparatus. Administer 100% oxygen when diver is on the surface.
3 4
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The narcotic effect of high partial pressures of nitrogen can produce euphoria, disorientation, lapses of rationality or judgement, and other behaviour similar to that of alcoholic intoxication. Nitrogen narcosis is normally encountered below 100 feet and may result from exceeding established depth limits. 4.6.3.1 Treatment Reduction of the nitrogen partial pressure is the standard procedure for treatment. Specifically: Diver should ascend to a shallower depth. If mental acuity is not restored, abort the dive.
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4.6.4 Oxygen Toxicity Oxygen toxicity affects the lungs (pulmonary toxicity) or the central nervous system (CNS oxygen toxicity). 4.6.4.1 Pulmonary Toxicity
Pulmonary toxicity may occur during long oxygen exposures such as prolonged recompression treatment tables. Symptoms; Substernal burning and severe pain on inspiration. Treatment; The onset of central chest pain or other indications of this complication may require cessation of oxygen therapy pending medical assessment. Reference section G3.1 AS/NZS2299.1 :2007.
Air breaks between cycles may be tailored by a medical doctor to suit individual patients response to treatment. 4.6.4.2 CNS Oxygen Toxicity
CNS oxygen toxicity is the most common and most serious form of oxygen toxicity. CNS oxygen toxicity is usually not encountered unless the partial pressure of oxygen exceeds 1.4 ATA. Signs and symptoms of CNS oxygen toxicity include the following: Vision; any abnormality, such as tunnel vision (a contraction of the normal field of vision, i.e. tunnel vision). Ears; abnormal sounds, especially ringing or roaring. Nausea; may be intermittent. Twitching; usually first appears in the lips or other facial muscles. This is the most frequent and clearest symptom. Irritability; Any change in behaviour, including anxiety or confusion. Dizziness. Tingling; of the extremities.
These symptoms may occur singly or together. They occur in no particular order and there is no one symptom which could be considered more serious than another, or which is a better warning of an impending convulsion. The first sign of CNS oxygen toxicity may be a convulsion which occurs with little or no warning. Treatment: Procedures for treating CNS oxygen toxicity involve immediate reduction in oxygen partial pressure and protection of the diver from physical injury if he begins to convulse.
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Specifically: Stop mask breathing and breathe chamber atmosphere. If symptoms persist, switch to an air decompression schedule. If the diver is having convulsions, protect him from physical harm and protect his tongue with a padded depressor or similar.
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4.6.5 Drowning A swimmer can fall victim to drowning because of over-exertion, panic, inability to cope with rough water, exhaustion, or the effects of cold water or heat loss. These same factors can affect a diver, but if he is properly equipped, trained and monitored by a buddy or a surface tender, drowning should be a remote possibility. Unfortunately, divers do drown even when equipped, trained and tended. Divers wearing lightweight or scuba gear can drown if they lose or ditch their mask or mouthpiece. This could be the direct result of the failure of the air supply, or of panic in a hazardous situation. The scuba diver, because he is so directly exposed to the environment, can be directly affected by the same conditions which may cause a swimmer to drown. The prevention of drowning is best insured by the establishment of, and thorough training in, safe diving practices coupled with the careful selection of diving personnel. A physically fit, confident diver, equipped with proper gear, should not easily fall victim to drowning. At the same time, however, over confidence, in both self and equipment can give a feeling of security that might lead a diver to take dangerous risks. The treatment of near drowning falls into two phases: Restore breathing and heartbeat Call for assistance from qualified medical personnel
Regardless of the mildness or severity of a near drowning case, all victims should be hospitalised as quickly as possible. The occurrence of pulmonary oedema (accumulation of fluids in the lungs) pneumonia, and other complications may be delayed for many hours after the incident and proper medical observation is essential. Subsequent to resuscitation while awaiting transportation to medical facilities, the patient should be kept warm and rested.
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4.7
BAROTRAUMAS
Emergencies discussed in this section are those which arise out of the nature of the diving environment specifically. 4.7.1 Squeeze Basically, squeeze barotrauma is caused by a lack of pressure equalisation between parts of the body or between the body and diving equipment. It normally occurs during descent. Squeeze may be categorised by location and / or cause as follows: Middle-ear squeeze, caused by blocked Eustachian tube. External-ear squeeze, caused by a hood or other piece of equipment covering the external ear passage. Lung (thoracic) squeeze, which may happen when the air in the lungs is compressed to less than residual volume. This could happen in an extremely deep breath hold (free) dive. Body squeeze, (with deep-sea diving dress), caused by a failure of the air supply to balance water pressure; can be precipitated by a fall into water of greater depth, or by the malfunction or maladjustment of supply and exhaust valves, or by the absence or failure of the safety air non-return valve. Face-mask squeeze, caused by a failure to equalise air in the mask by nasal exhalation, or with full-face mask, by malfunction or the air supply or the valving. Suit squeeze, normally occurs in dry-type suits in which a pocket of air becomes trapped under a fold or fitting and pinches the skin in the fold area. Treatment
4.7.1.1
Squeeze may be relieved by the following procedures: 1 2 3 4 5 Stop descent. If efforts to equalize pressure fail, ascend to shallower depth. If further efforts to equalise pressure fail, abort the dive. If an ear drum rupture is suspected, send down the Standby diver to assist. Report any physical injury to the medical officer for appropriate treatment.
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4.7.2 Gas Expansion and Reverse Squeeze Occasionally, a diver may experience various types of internal gas expansion. For example, in rare instances, a middle ear or sinus that has equalised on descent may block on ascent, trapping a pocket of gas. Slowing the rate of ascent will usually permit the gas to escape without additional complications. A more common condition results from the generation of gas in the intestines during a dive, or from the swallowing of air which becomes trapped in the stomach. These pockets of gas will usually work their way out of the system through the natural vents. If not, and if pain begins to pass the stage of mild discomfort, ascent should be halted and the diver should descend slightly until the pain is relieved. He should attempt to belch or release the gas anally with a caution, however, over-zealous attempts to belch may result in swallowing more air. Most intestinal gas expansion can be avoided by a few simple precautions do not dive with an upset stomach or bowel, avoid eating foods which are likely to produce intestinal gas and avoid swallowing air during a dive. 4.7.3 Round Or Oval Window Rupture The round and oval windows are membranes which separate fluid in the inner ear from the middle ear. Symptoms of round or oval window rupture of the ear may become evident on the bottom or after the diver reaches the surface. Usually the diver will have had difficulty clearing his ears during descent but symptoms may arise for no apparent reason. The diver may have ringing or buzzing (tinnitus) in the affected ear, hearing loss, vertigo, disorientation or unsteadiness. Any or all symptoms of round or oval window rupture may follow dives with depth dive profiles which could give rise to inner ear decompression sickness or arterial gas embolism for which recompression is the only appropriate treatment. Differentiating between these causes may be impossible. If round or oval window rupture is the true cause of symptoms recompression will not usually give relief (and can make the problem worse) and no CNS symptoms other than those which refer to the inner ear will be present. 4.7.3.1 Treatment
A diver suspecting this injury must surface immediately. Once on the surface, it is important to prevent further fluid loss [from the inner ear] by keeping still and upright, and avoiding exertion. Do not allow the patient to do the Valsalva manoeuvre. NOTE: Permanent damage may be avoided by administering 100% oxygen and seeking immediate specialist medical attention via a diving doctor.
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4.8
Decompression illness is the term currently being recommended to describe all forms of decompression related problems regardless of the mechanism that has led to the condition. The term includes the conditions known as decompression sickness (see paragraph 4.8.1.2) and arterial gas embolism (see paragraph 4.8.1.3). This new terminology has arisen as a result of the difficulty encountered in trying to elucidate the mechanism of illness in many cases, the fact that mixed pictures often occur and current treatment recommendations do not differentiate between decompression illness arising from different mechanisms. The description decompression illness should be qualified by the part of the body affected, the severity and its timing, e.g. severe progressive spinal cord decompression illness arising within a few minutes of surfacing. The signs and symptoms listed below are subdivided into the categories of decompression illness previously usually referred to as this older terminology remains in current use. 4.8.1.2 Decompression sickness
Symptoms and signs of decompression sickness usually appear within a few hours of diving, but onset may be delayed for 36 hours or more. Any body system or part may be affected to a degree from apparently minimal to severe and life threatening. Untreated, the divers condition may deteriorate with time, and additional new symptoms may develop. Feeling generally unwell or unexpectedly lethargic are common early symptoms that may precede more specific symptoms. Upon examination, many divers suffering decompression sickness will have signs of spinal cord, nerve or cerebral disease which may not have been reported initially. Careful neurological examination (See section 7.1.5 in Annexe F and / or the DOF Subsea Decompression Illness Treatment Package) is therefore important in all cases. This examination may be conducted in the chamber, after treatment has commenced, if appropriate. Some of the possible symptoms and signs of decompression sickness include skin rash, pain (anywhere), tingling sensations, numbness, weakness or paralysis, difficulty passing urine, visual disturbance, mental slowness, confusion, convulsions or unconsciousness, giddiness, loss of balance or co-ordination, headache, nausea, vomiting and breathing difficulty.
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4.8.1.3
This usually presents within twenty minutes of a dive and commonly follows a rapid ascent. It can occur following ascents of as little as one metre, and significant bottom time is not required. Any loss of consciousness or rapid onset of neurological or cardiac problems following a dive should be treated as AGE. The sudden onset of any symptoms of cardiac problems should be similarly treated. Although symptoms of pulmonary barotrauma are not necessary for the diagnosis of AGE, all patients suffering pulmonary barotrauma should be carefully examined to exclude any neurological problem that would indicate the complication of AGE. Pulmonary barotrauma may be suggested by breathlessness, difficulty breathing, pain in the chest, cyanosis (blueness) or coughing of blood-stained sputum. NOTE: Arterial gas embolism (AGE) is also sometimes called air embolism or cerebral arterial gas embolism (CAGE).
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The rapid institution of 100% oxygen breathing pending recompression will often alleviate symptoms and improve the final outcome of treatment, although improvement on oxygen does not remove the necessity for recompression. It is important to ensure that the gas breathed by the lungs contains as near as possible to 100% oxygen as can be delivered by the resuscitator specified in paragraph 7.4.8 of the DOF Subsea DOM. A tight fitting oral nasal face mask, or mouthpiece and nose clip supplied by a demand air supply device or oxygen reservoir bag is necessary to prevent dilution of the oxygen by atmospheric air. Standard disposable medical oxygen masks or nasal catheters are unsuitable. Oxygen therapy at atmospheric pressure can be conducted for many hours before pulmonary oxygen toxicity becomes a problem. The onset of central chest pain or other indications of this complication may require cessation of oxygen therapy pending medical assessment. 4.8.2.2 Position
Whenever serious decompression illness is suspected, the patient should be made comfortable, lying horizontally. If the patient is not fully conscious, the patients airway should be protected, e.g. by lying the patient on the side (lateral or coma position). The steep (30) head down position that has sometimes been recommended is extremely uncomfortable and risks congestion and swelling of the brain and regurgitation of stomach contents. It should not be used for decompression illness routinely. Some anecdotal case histories suggest that an initial period of head down position may, however, be beneficial in some serious cases of decompression illness due to arterial gas embolisation. In cases where major neurological or cardiac symptoms arise within 15 min of surfacing, a trial of head down position may be beneficial provided that is compatible with maintenance of the patients airway, and administration of 100% oxygen. The head should be lower than the heart which should be lower than the abdomen and pelvis. The legs should not be elevated any more than the rest of the body. This position, if tried, should not be maintained if there is no response and, even if there is useful response, the patient should be returned gradually to a level position within 15 min. There have been reports of severe and even fatal relapses occurring when AGE patients have sat or stood up. No patient possibly suffering from AGE should therefore be allowed to sit or stand up before recompression unless they have been stable and walking around already.
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4.8.2.3
This should be instituted along usual guidelines if required. 4.8.2.4 Other therapy
Administration of fluids is useful. Intravenous fluids are preferred, however, oral fluids may be offered to the conscious patient without abdominal problems. Plain water is preferred, and fluids containing alcohol and caffeine should be avoided. Urinary catheterization will be necessary for patients who cannot pass urine, including patients with severe spinal or cerebral decompression illness, and those who are unconscious. Pneumothorax should be treated by intercostal drainage before decompression can occur during therapeutic recompression therapy. 4.8.3 Recompression Therapy Recompression is the definitive treatment for decompression illness. Modern therapy requires the use of oxygen in a suitable two-compartment chamber (see DOF Subsea DOM section 7.3). The initial treatment for all cases of decompression illness resulting from air diving operations shall be in accordance with a widely recognized and industry-approved therapeutic recompression treatment table. Such a Table is the USN Table 6 reference 2.6.5). The advice of a medical practitioner appropriately trained in underwater medicine and therapeutic recompression should always be sought, and should be considered mandatory in the following situations: Any case where symptoms do not rapidly and completely resolve. Any case which continues to deteriorate or relapses during treatment in accordance with a therapeutic table. Where pressurization equivalent to greater than 18 m (60 ft) depth of seawater is considered. Where symptoms recur following initial treatment.
Therapeutic recompression should only be performed by a dive supervisor, a medical practitioner appropriately trained in underwater medicine or, if neither of the above is available, a person (approved by the DOF Subsea Operations Manager) competent in compression chamber operations. The person supervising therapeutic recompression should seek advice from a medical practitioner experienced in this field.
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4.8.4 Recompression Treatment When the diver has received inadequate decompression or falls victim to gas embolism, the first treatment procedure is to return the diver to a pressurised environment where the expanded gases will be recompressed to a manageable volume. This will relieve any local pressure caused by the bubbles, will restore normal blood flow and will frequently relieve the patient of many, if not all, of the subjective symptoms. After recompression treatment is underway, additional treatment may be administered. Certain facets of recompression treatment have been previously mentioned, but they are so important that they cannot be overstressed: Treat promptly and adequately. Do not delay treatment for the arrival of medical personnel. The effectiveness of treatment decreases with the length of time between the onset of symptoms and the treatment. Do not ignore seemingly minor symptoms. They can quickly become major. Follow the treatment table accurately and completely. If a symptom, or group of symptoms, seems to be relieved, do not assume that the treatment is finished. Follow the tables to completion, and keep the diver in the immediate vicinity of the chamber (or the diving station) for at least 6 hours following recompression and within one half hour travel time to the chamber for 24 hours. Flying after diving (refer to DOF Subsea DOM section 8.4.1).
4.8.5 No Recompression Chamber In the event that the diving facility is not equipped with a recompression chamber, the Diving Supervisor must; Place the person on 100% O2 if possible. Transport the patient to the nearest recompression chamber for treatment.
Administration of fluids is useful. Intravenous fluids are preferred however oral fluids may be offered to the conscious patient without abdominal problems. Plain water is preferred, and fluids containing alcohol and caffeine should be avoided. Urinary catheterization will be necessary for patients who cannot pass urine, including patients with severe spinal or cerebral decompression illness, and those who are unconscious.
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4.8.6 Decompression & Recompression Treatment DOF Subsea shall only use United States Navy Table 6 for any decompression related incidents. A separate Decompression Illness Treatment Package in accordance with the DOF Subsea DOM Annexe E and this Annexe (A), which shall be kept on all dive sites, shall be utilised for the treatment of decompression illness.
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5.0 5.1
5.1.2 Smoke / Fumes / Gas Procedure 1 The person discovering the presence of smoke, fumes or gas shall immediately raise the alarm. The Supervisor shall assess the situation to determine if diving may continue.
If diving cannot continue, the Supervisor shall carry out the following: 3 4 5 6 7 8 Don the Supervisors breathing mask. Switch the divers to HP air. Switch the standby diver to HP air. Recover the diver as per DOF Subsea Decompression Procedures. Move to a safe place. If breathing sets are not available for the remainder of the crew they shall move to a safe place.
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Raise Alarm
Assess Situation
Can Continue?
NO
YES
Continue
Diver to HP Air
Recover Diver
Go To A Safe Place
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5.1.3 Chamber Fire - General The risk of fire is increased in air under pressure, and further increased when oxygen is being used. The drill for using the DDC provides for periodical ventilation of the chamber during operation to prevent build up of oxygen. The DDC shall be kept thoroughly clean and free from all flammable material when in use. This includes matches, cigarettes, lighters, flammable liquids, nylon fabric, oil, grease etc. 5.1.3.1 Action in the event of a fire 1 2 Secure oxygen. Attempt to put out the fire with the hyperbaric fire extinguisher, blankets, etc.
If unsuccessful: 3 4 5 Decompress chamber rapidly. Remove the occupants and extinguish the fire. Recompress the occupants at the earliest possible moment back to depth existing when the fire broke out.
NOTE: Should it suddenly become necessary to reduce the DDC pressure because of fire, the Diving Supervisor must bear in mind the physiological risks involved and weigh them against the risk of leaving the occupant in the chamber. It is not possible to lay down any hard and fast rules as there are an infinite number of circumstances that may affect a decision. Generally speaking, rapid decompression is likely to cause serious decompression sickness or air embolism. It is absolutely essential that the occupants of the chamber are put under pressure again as soon as possible.
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Secure Oxygen
YES
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5.2
2 3 4 5
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Assess Situation
NO
YES Fix
Can Continue?
YES
Continue
NO Abort Dive
NO
Assistance Required?
Assist Retrieval
Return To Surface
Investigate Cause
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5.3
Lost Communications Procedure Person Supervisor Actions Immediately communication is lost with the diver Request line signals, Are you OK? If available flash hat light to attract divers attention. The diver should give thumbs up in front of camera! Alert the standby diver and check his communications. Determine if the diver is still breathing by checking the divers LP supply gauge. If the diver is not breathing, instruct the standby diver to jump to rescue the diver. Ensure the standby diver follows the divers hose to the diver and not a down line or stage. If the diver is breathing, the following shall apply Check connections on the radio. If communications are re-established, continue diving. If communications are still lost, change radio and reestablish communications. If communications are re-established, continue diving. If communications cannot be re-established, instruct the standby diver and dive crew to use line signals and jump the standby diver.
Supervisor
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LARS Failure
YES
NO
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5.5
Entangled Diver
Continue
YES
NO
Continue
YES
Continue Dive?
NO
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5.6
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Abort Dive
NO
Assistance Required?
YES
Check Response
Recover to Surface
Retrieve To Deck
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5.7
If no, all operations shall cease and the dive team shall provide assistance as requested by the P.I.C. (person in charge). 5.7.1.1 Field Hazards Flow Chart
Field Emergency Other Vessel Emergencies Search & Rescue
Continue
YES
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