of Reverse /profiles O«<*«<f 29 MMI 30/1999 Smithsonian institution DAN AAUS DEMA DIVE TRAINING SMITHSONIAN Lang, M.A. and C.E. Lehner (eds.). 2000. Proceedings of the Reverse Dive Profiles Workshop. October 29-30, 1999. Smithsonian Institution, Washington, D.C. 295 p. Copyright © 2000 by Smithsonian Institution 900 Jefferson Drive S.W. Washington DC 20560-0415 All Rights Reserved No part of this book may be reproduced in any form by photostat, microfilm, or any other means without written permission from the publisher. The publication of this document was sponsored by the Office of the Provost, Smithsonian Institution, Washington, D.C. The U.S. Government is authorized to produce and distribute reprints for governmental purposes notwithstanding the copyright annotation that appears above. Opinions presented at the Workshop and in the Proceedings are those of the contributors, and do not necessarily reflect those of the Smithsonian Institution Scientific Diving Program, Divers Alert Network (DAN), American Academy of Underwater Sciences (AAUS), Diving Equipment and Marketing Association (DEMA) or DIVE TRAINING Magazine. of Reverse ^ive /profiles October 29 «od 30/1999 DAN AAUS DEMA DIVE TRAINING SMITHSONIAN Contents About the Smithsonian Institution iii About DAN iv About AAUS v About DEMA vi About DIVE TRAINING Magazine vii Acknowledgments viii I. Introductory Session. PRESENTATION OF THE ISSUES. Michael A. Lang 1 THE EVOLUTION OF REPETITIVE DIVING: FROM HALDANE (1908) TO HARDY (1999). John £. Lewis 3 REVERSE DIVE PROFILES: RISK VERSUS BENEFIT. GlenH.Egstrom 22 Introductory Session Discussion. Michael A. Lang, Moderator IS II. Physics/Physiology Session. IMPLICATIONS OF THE VARYING PERMEABILITY MODEL FOR REVERSE DIVE PROFILES. David E. Yount, Eric B. Maiken and Erik C. Baker 29 COMPUTATIONAL REVERSE DIVE PROFILES - CONTRASTS AND COMPARISONS. Bruce R. Wienke and Timothy R. O'Leary 61 REVERSE DIVING AND PRECURSORS OF DCS BUBBLES: QUESTIONS IN NEED OF ANSWERS. Hugh D. Van Liew 83 ANALYSIS OF REVERSE DIVE PROFILES USING THE DCIEM BUBBLE EVOLUTION MODEL. PARTI: MODEL DEVELOPMENT. Peter Tikuisis and Ron Y.Nishi 87 ANALYSIS OF REVERSE DIVE PROFILES USING THE DCIEM BUBBLE EVOLUTION MODEL. PART II: RISK ASSESSMENT. Ron Y. Nishi and Peter Tikuisis 91 Physics/Physiology Session Discussion. Charles E. Lehner, Moderator 99 III. Physiology/Modeling Session. ACCORDING TO A PHYSIOLOGICAL MODEL. Valerie Flook 105 EVALUATION OF REVERSE DIVE PROFILES. Alf O. Brubakk and O. Eftedal 111 REVERSE DIVE PROFILES IN THE NMRI AIR AND N2O2 DIVING DATABASE. Paul K. Weathersby and Wayne A. Gerth 123 THEORETICAL, EXPERIMENTAL AND OPERATIONAL ASPECTS OF REVERSE DIVE PROFILES. Michael L. Gemhardt 129 Physiology/Modeling Session Discussion. Charles £. Lehner, Moderator 242 IV. Dive Computer Session. ESTIMATED DCS RISKS OF REVERSE DIVE PROFILES. Wayne A. Gerth and Edward D. Thalmann 145 Dive Computer Session and Panel Discussion. Michael A. Lang, Moderator 272 V. Medical Session. REVERSE DIVES: RECORDED DIVE PROFILES, MEDICAL OUTCOMES, AND ESTIMATED DECOMPRESSION STRESS. Richard D.Vann, Petar Denoble and Wayne A. Certh 181 REVERSE PROFILES VERSUS FORWARD PROFILES: A REVIEW OF DIVERS TREATED AT THE USC CATALINA HYPERBARIC CHAMBER. KarlE.Huggins 189 TWO CASES OF SEVERE DCS AFTER COMPLETION OF REVERSE DIVE PROFILES. Till S. Mutzbauer 193 SOME OLDE FASHIONED COMPUTATIONS AND SOME CONTEMPORARY THOUGHTS. R.W. Bill Hamilton 197 Medical Session Discussion. Charles E. Lehner, Moderator 200 VI. Operational Experience Session. QUANTITATIVE RISK MANAGEMENT OF DCS. Paul K. Weathersby 203 DOING IT "OUT OF ORDER". Jon Hardy 207 REVERSE PROFILES IN ORCA EDGE TESTS. KarlE.Huggins 215 EUROPEAN EXPERIENCE WITH REVERSE DIVE PROFILES. Peter HJ. Mueller 219 Operational Experience Session Discussion Part I. Michael A, Lang, Moderator 222 THE DEVELOPMENT AND USE OF REPET-UP AND HANG-OFF DIVING PROCEDURES IN THE OFFSHORE OILFIELD COMMERCIAL DIVING INDUSTRY. Terry Overland 227 REVERSE DIVE PROFILES - A THREE PART PADI PERSPECTIVE. Drew Richardson and Karl Shreeves 235 NAUI APPROACH TO REVERSE DIVE PROFILES. Bruce R. Wienke, Jed D. Livingston, and Timothy R. O Teary 247 SSI POSITION STATEMENT ON REVERSE DIVE PROFILES. Jon Hardy 259 YMCA POSITION ON REVERSE DIVE PROFILES. DukeHJScott 261 REVERSE DIVE PROFILES ACTIVITY IN THE SCIENTIFIC DIVING COMMUNITY. Edward J. Money, Steven H. Sellers, and Walter C. Jaap 263 Operational Experience Session Discussion Part II. Michael A. Lang, Moderator 266 VII. General Discussion. A PERSPECTIVE ON REVERSE DIVE PROFILES. Richard E. Moon 269 INDIVIDUAL PERSPECTIVE. Tom S. Neuman 270 General Session Discussion. Michael A. Lang, Moderator 272 VIII. Findings and Conclusion. 290 IX Workshop Participants. 291 ii About the Smithsonian Institution http://www.si.edu/dive The Smithsonian Institution was established in 1846 with funds bequeathed to the United States by James Smithson. The Institution is an independent trust instrumentality of the United States holding some 140 million artifacts and specimens in its trust for "the increase and diffusion of knowledge". The Institution is also a center for research dedicated to public education, national service, and scholarship in the arts, sciences, and history. The Smithsonian is composed of sixteen museums and galleries and the National Zoo and numerous research facilities in the United States and abroad. Nine Smithsonian museums are located on the National Mall between the Washington Monument and the Capitol. A three-level underground building houses two museums and the S. Dillon Ripley Center, which includes the International Gallery, offices, and classrooms. Five other museums and the National Zoological Park are elsewhere in Washington, D.C., and the Cooper-Hewitt, National Design Museum and the National Museum of the American Indian are in New York City. The Smithsonian Tropical Research Institute is located in the Republic of Panama, The Smithsonian Environmental Research Center in Edgewater, Maryland, the Smithsonian Marine Station in Fort Pierce, Florida, and the Caribbean Coral Reef Ecosystems Laboratory at Carrie Bow Cay, Belize. The Smithsonian Scientific Diving Program is in the Office of the Provost and conducts approximately 4,000 scientific dives annually. Headed by the Smithsonian Scientific Diving Officer, a staff of 6 Unit Diving Officers authorizes approximately 200 scientific divers to conduct underwater research under the auspices of the Institution. 1U About Divers Alert Network http://www.diversalertnetwork.org Divers Alert Network (DAN), a nonprofit organization, exists to provide expert information and advice for the benefit of the diving public. DAN's historical and primary function is to provide emergency medical advice and assistance for underwater diving injuries, to work to prevent injuries, and to promote diving safety. Second, DAN promotes and supports underwater diving research and education, particularly as it relates to the improvement of diving safety, medical treatment and first aid. Third, DAN strives to provide the most accurate, up-to-date, and unbiased information on issues of common concern to the diving public, primarily, but not exclusively, for diving safety. For scuba divers worldwide, DAN means safety, health, and peace of mind. Founded in 1980 to provide an emergency hotline to serve injured divers and the medical personnel who care for them, DAN is a 501(c)(3) non-profit dive safety organization affiliated with Duke University Medical Center in Durham, North Carolina, and supported by the largest membership association of divers in the world. DAN is best known for its 24-hour diving injury hotline, ALERT DIVER, the Dive Safety and Medical Information, and its medical research programs. However, DAN America and its international affiliates also serve the recreational scuba community with diving first aid training programs, dive emergency oxygen equipment, affordable dive accident insurance, and books and videos on scuba safety and health. Most importantly, DAN is a reference for divers, members of the medical community, and emergency medical services personnel who often refer to DAN for consultation about the management of a relatively unusual kind of emergency. In addition to supporting diving's lifeline, DAN members receive a number of valuable dive and travel benefits. DAN members are also eligible for the exclusive DAN Tag®, diving's original dive and travel emergency I.D. system. IV About the American Academy of Underwater Sciences http://www.erols.com/aaus The mission of the American Academy of Underwater Sciences (AAUS) is to promote the safety and welfare of its members who engage in underwater science. To accomplish this mission, the Academy has established five objectives. These objectives underlie all Academy activities: • To develop, review and revise standards for safe scientific diving certification and the safe operation of scientific diving programs; • To collect, review and distribute statistics relating to scientific diving activities and scientific diving incidents; • To conduct symposia and workshops to educate the membership and others in safe scientific diving programs and practices; • To represent the scientific diving interests of the membership before other organizations and government agencies; and, • To fund research, education and development of safe scientific diving programs and practices. Organized in 1977, the AAUS was incorporated in the State of California in 1983. The Board of Directors, responsible for governing the corporation,