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DMO Subspeciality Codes
*only DMO's w/ these codes may modify Tx tables w/ concurrence of CO/OIC.
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availability of AED
w/in :10 keep on surface
press to 60; w/in :20 surface @ 30fpm
*do not compress pulseless diver
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Type II categories
- Neurological
- Inner Ear (staggers)
- Cardio Pulmonary (chokes)
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Type I
- full neuro on surface
- complete relief w/in :10
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Type II
significant relief w/in :20
if unchanged or worsen; DOR not to exceed 165/ TT6A
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Symptomatic Omitted D
50fsw or shallower - TT6
deeper - compress to significant improvement not to exceed 165/ TT6A
deeper 165 - DOR not to exceed 225/TT8
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Patient observation
Pain only - 2 hours
serious Sx - 6 hours
*do not release w/o DMO consult
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Air Tx Tables
1A - pain relieved less than 66fsw
2A - relief greater than 66fsw
3 - relief w/in :30 @ 165
4 - greater than :30 @ 165
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TT5
- - Type I DCS (full neuro/complete relief w/in :10)
- - Asymptomatic Omitted D
- - resolved Sx after in-water Tx
- - follow-up for residual
- - CO poisoning
- - gas gangrene
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TT6
- - AGE
- - Type II DCS
- - Type I DCS (no neuro on surface/no relief w/in :10 but significant improvement w/in :20)
- - Cutis Marmorata
- - CO, cyanide, smoke
- - Asymptomatic Omitted D
- - Symptomatic uncontrolled ascent
- - recurrance shallower than 60fsw
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Px sleeping
anyitme except on O2 deeper than 30fsw
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Vital signs
Pulse 60-100
Respirations 12-16
BP 120/80
Temp: 98.6 (+/-2)
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Chamber manning requirements
3 minimum
2 emergent
4 optimal
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CO2 chamber levels
1.5 SEV (11.4 mmHg)
- 0.78 - 30fsw
- 0.53 - 60fsw
- 0.25 - 165fsw
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Permissable Chamber Temperatures
- over 104F - intolerable/no Tx
- 95-104F - 2 hrs / TT5,9
- 85-94F - 6 hrs / TT5,6,6A,1A,9 under 85F - all
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IV drip rate
w/o guidance from medical:
75-100 cc/hr normal saline/lactated ringers solution
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adequate urine output
.5cc/kg/hr
clear/colorless urine
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Inside Tender Responsibilities
- - release door latches (dogs)
- - communicate w/ topside
- - first aid as required
- - Tx gas
- - hearing protection
- - Px position
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Non-diver IT requirements
IT PQS complete
pre-req:
- dive physical
- Navy physical standards
- pressure test
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Specialized medical care
A qualified IT is req to be inside chamber to handle system related requirements.
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IT tending frequency
18hrs - 1A,2A,3,5,6,6A
48hrs - 4,7,8
5,6,6A w/in 18 require O2 / 30fsw ^
SI inforced for 1A,2A,3,4,7,8
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Tx gases used w/ TT's
- 0-60 100% O2 (ppO2 1.0 - 2.82)
- 61-165 50/50 N2O2 (ppO2 1.42-3.0)
- 166-225 64/36 HeO2 (ppO2 2.17-2.81)
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Procedures for CNS O2 Tox.
- 5,6,6A
- 1st:
- - off O2
- - :15 after Sx completly subsided
- - resume POI
- 2nd(or 1st convulsion):
- - off O2
- - Sx completely subsided (fully relaxed and breathing normally); up 10fsw (1ft/min)
- - resume POI
- 3rd
- -DMO for modification
- 4,7,8
- - off O2
- - DMO for modification
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Loss of O2 to Chamber
- - repair w/in :15
- - resume POI
- - before 2hrs
- - max extensions
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Medical kits
- primary - immediately available
- (diagnostic equipment)
secondary - equipment/meds
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Types of Thermometers used in the Chamber
- alcohol
- bi metalic
- led
- electronic
*not mercury
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Permisable polyester/cotton blend?
65/35
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When is a pressure test required for a chamber?
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What are the ventilation rates for air/O2 (@ work / @ rest)?
AIR: 2@rest / 4@work
O2: 12.5@rest/25@work
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What are the symptoms of Hypoxia?
- Loss of concentration
- Inability to perform delicate tasks
- Drowsiness
- Weakness
- Agitation
- Euphoria
- Loss of Consciousness
- ^ pulse rate
- ^ BP
- General cyanosis (lips, nail beds, skin)
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What are the symptoms of Hypercapnia?
- ^ breathing rate
- Euphoria
- ^ sweating
- Drowsiness
- Headache
- Loss of consciousness
- Convulsions
- ^ breathing rate
- ^ pulse rate
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Name 5 POIS's
- interstitial emphysema
- AGE
- mediastinal emphysema
- pneumothorax (simple/tension)
- subcutaneous emphysema
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Lvls for Hypoxic Sx's
- .21 ppO2 normal
- .16 ppO2 onset of hypoxic symptoms
- .11 ppO2 helplessness
- .10 ppO2 unconsciousness
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Chamber lvls for O2 & CO2
19-21% O2
1.5 SEV CO2
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