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Abstract

Abstract: We compiled lists/descriptions of errors found in the standard diving medicine literature. Methods: We scanned our diving medicine archives and looked there for already existing error-reports; typos etc. were ignored. Results: Severe errors are appearing more frequently in monographs. Omnibus Volumes, written by teams of experts, are obviously more resilient to errors. Discussion / Recommendations: Single authors / editors should consult with expert teams prior to publication. If you want to contribute s.th. to our list, we would be very happy if you send an e-mail to our head of lab: director@smc-de.com
1
The diving medical detectives:
when diving medicine books
are completely wrong
01.12.2021, Part III
Miri Rosenblat, TAU
Nurit Vered, Technion Haifa
Yael Eisenstein,
SubMarineConsulting
DOI: t.b.d.!
2
The diving medical detectives:
when diving medicine books
are completely wrong, Part III
Abstract / Methods / Results:
the same, as per Part I & Part II of this series:
Part I DOI: 10.13140/RG.2.2.15199.79528
Part II DOI: 10.13140/RG.2.2.35722.39366
Severe errors are appearing more frequently in monographs. Omnibus
Volumes, written by teams of experts, are obviously more resilient to errors.
Discussion / Recommendations:
Single authors / editors should consult with expert teams prior to
publication.
If you want to contribute s.th. to our list, we would be very happy if you send
an e-mail to our head of lab: director@smc-de.com
(That is: to be continued with Part IV )
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[43] Göbel / Scheyer, Max Hahn: Dekompression,
Delius Klasing Edition Naglschmid,
Stuttgart 1996, ISBN 3-89594-050- X, 86 p.
The CNS-OT dose calculations in the
Decompression tables for Air, EAN 32 & EAN 36
on pages 68 86 are wrong for
high pO2 / long bottom-times!!! Sample for EAN36
for sealevel taken from page 83:
4
[43] Max Hahn, Dekompression,
Delius Klasing Edition Naglschmid,
Stuttgart 1996, ISBN 3-89594-050- X, 86 p.
Various samples of CNS-OT doses, assessed with different
sources, pls. cf. “Legend”, next slide:
Gas Depth
[m] /
Time
[min]
%CNS
from
[43]:
DIVE
3_11 Sub-
surface
5.0.5.0
DP 3 OSTC
v2.70.5 G2
Air 63 / 13 10 11.5 12 12 14 17 11
EAN32 12 /100 14 17.5 18 17 18 n.a. n.a.
EAN32 39 / 34 34 41 45 42 44 46 40
EAN36 33 / 29 26 34.5 33 30 32 33 30
EAN36 33 / 39 35 47 45 41 42 43 41
We will not discuss the NOAA OT tables further, since the „K-valueas a new
OT index is already ante portas, pls. cf. in the refs. [e]!
5
[43] Max Hahn, Dekompression
Discussion:
Obviously there is leeway in calculating the
% of CNS-OT. Main factors in variance are:
The implemented precision of the extrapolation from the original, step-wise
linear NOAA CNS-OT table
Implemented constants for water temperature & -density, since the input
parameter for tables & computers is the geometrical length of the water
column to calculate the hydrostatic pressure
Proper handling of the conversion factors Bar  atm
Allowance for the shallow decompression phase (like in DP3)
As neither from the tables in [43], nor SS5, DP3 or the G2, these parameters
are documented, take the arithmetic average of columns 4 8 and compare
with column 3.
The implementation details in question are documented for DIVE Version 3 in
the handbook:
https://www.divetable.info/DIVE_V3/V3e/DOXV3_0.pdf
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[43] Max Hahn, Dekompression
Legend:
The CNS oxygen toxicity dose (CNS-OT) is in percent
[%] of the NOAA Ox-Tox Tables
DIVE Version 3_11, available @
https://www.divetable.info/beta/D3_11.exe , Ref. [c]
Subsurface 5.0.5.0 :
Deco Planner 3.1.4:
OSTC Planner v2.70.5:
UWATEC / Scubapro Galileo G2:
HW-Ver.: 0.0, SW-Ver.: 1.6
7
[187] Cole, Bob (2008) The SAA Bühlmann DeeP-Stop
System Handbook, AquaPress Ltd.,
ISBN: 978-0-9532904-2-0
and, as well:
[183] Cole, Bob (2014) Out of the Decompression Matrix, AquaPress
Ltd., ISBN 978-1-905492-28-2
p. 3-8:
„ … about 8000 metres above sealevel.“
No, would be severly hypoxic. It is about 2000 to 3000 m;
(taken in the passengers cabin during a standard
intercontinental flight). So it should read 8000 feet, probably.
8
[187], [183]:
p. 63 & p. 84: „ …PADI moved to eight … “ or same as on
p. 69, or
p. 72, Fig. 3.17.
No: should be14“. Workman i.e. USN, used already 8, resp. 9
for exceptional exposures since long, pls. cf. in: NEDU Report 6-65 [a].
Between 1980 and 1992 Hamilton, Powell, Bassett, Vann et al. produced a lot of
preliminary sets of M-Values for a new PADI table with reduced NDLs;
the RDP uses 14 compartments in its final, published configuration.
Pls. cf. the published scientific source of the RDP [b] there on p. 21,
Table III with the appropriate 14 M0-Values for the RDP (pls. cf. next slide).
The Fig. 3.17 values and elsewhere are obsolete, they are from the
„Blue Book“ (Powell, 1988) (and, by the way, only for the sake of
completeness: the 40 min value for the USN column should read 56
instead of 58, 80 min: 54“, 120: 52“; pls. cf. again that particular
NEDU Report [a] on p. 31 & p. 5.)
9
[b] The DSAT Recreational Dive Planner:
Development and validation of
no-stop decompression procedures
for recreational diving
Hamilton, Rogers, Powell, Vann
28 Februar 1994:
10
[187], [183]:
p. 70, „ .. H = Hospital
No: ZH is the ISO abbreviation for Zürich, pls. see as well the
license plates of swiss cars from this particular area
p. 70, Fig. 3.15: does not match the coeffcients published from Bühlmann,
neither in:
Dekompression - Dekompressionskrankheit, A. A. Bühlmann, Springer,
1983, ISBN 3-540-12514-0, p. 27; nor:
Bühlmann, Albert Alois (1984) Decompression - Decompression Sickness,
Springer, ISBN: 3-540-13308-9, 0-387-13308-9,
e-book 978-3-662-02409-6, p. 27; nor:
Tauchmedizin (Barotrauma, Gasembolie, Dekompression,
Dekompressionskrankheit) A. A. Bühlmann, Springer, 1993,
ISBN 3-540-55581-1, p. 108, nor:
"Tauchmedizin", Albert A. Bühlmann, Ernst B. Völlm (Mitarbeiter),
P. Nussberger; 5. edition from 2002, Springer, ISBN 3-540-42979-4), p. 158
There is as well no match with the ZH-L 16 B coefficients.
11
[187], [183]:
Thus in Fig. 3.16: the calculation is correct, but not the
used parameters from the original ZH-L12! (Instead, the real
ZH-L12 parameters read: 26,5 min; a = 0,75; b = 0,845). And this is why on:
p. 72, Fig. 3.18:
the converted values differ by a couple of % to the real, the published values!
p. 85, Fig. 4.9; x-axisHalf-time“.
No: it is the (real) time.
p. 88, Fig. 4.15, the in-line description for „c“:
No, it’s not 2 min at 3 meters, the original data from Andi Pilmanis reads:
4 min at 10 feet
p. 131, „ … 3.3 Bar
No: it is 3.2 Bar (4.0 - 2.4 = 1.6, 50 % yields 0.8 Bar; i.e.: 4.0 0.8 = 3.2 Bar)
p. 132, „ … Völlem of Zurich“.
No: Ernies correct family name is Völlm and the city is Zürich.
12
[187], [183]:
p. 145, „ … Deco-Brain I … employed … ZHL 12 algorithm…“
No: theDeco-Brain I“ did not use this algorithm!
(and, b.t.w. the correct designation would have been ZH-L12 …)
It used a stored table and interpolated the tabulated values with an
undocumented / untested procedure which utilises a 80 min.
compartment. Pls. cf. the international patent specification of the
Deco-Brain I: WO 83 / 00670
And this is very much inline with what Bühlmann himself wrote in his
2002 book (p. 195).
The first computer from the Deco-Brain series which really used
a full-blown perfusion-algorithm with 16 compartments was the successor of the
Deco-Brain I: it was the Deco-Brain II.
The coefficients, however, have been adapted for computer-usage
by Dr. Max Hahn (pls. cf. the Deco-Brain II User Manual, chapter „X“, p. 22)
13
[187], [183]:
p. 150, Fig 8.10:
the inlet refers to the wrong Fig (8.8) instead
to the correct one, Fig 8.9.
p. 150, Fig 8.10:
„ … they occur together as a summation“
No, they do NOT! As per Bruce Wienke in „RGBM in-depth“ they have to be
multiplied!
p. 168, Fig 10.2: EANx is 2 *, instead of pO2
SAA Dive Planner / RNT Section:
Bühlmanns original value on p. 235
in his 2002 book reads 154
14
And, as well, just by the way and again only for the
sake of completeness: in the EAN / Nitrox manual of the
SAA-suite, the:
[186] SAA Student Diver Tool Box - Course Notes,
AquaPress Ltd., ISBN 0953290492
p. 3-2 „Where 1 = the surface pressure 1 bar
No: 1 = 1.0 or 100 %, i.e. unity, that is: dimensionless.
You subtract F02, also dimensionless.
Pls. cf. the EAN Manuals of:
PADI, SSI, ANDI, IANTD, NRC, RAB, TDI, NOAA or NAUI.
You could as well consult with the
Rev.7 of the USN Diving Manual, Chapter 10:
„Nitrogen-Oxygen Diving Operations
Instead of (1 - FO2) you could use as well directly FN2 (also
dimensionless)
15
p. 7-2 „… must be allowed to stand for at least 24 h …“
No: the approx. mixing time for an average scuba tank is
in the order of magnitude of less than 104 sec. This is a solution
of a partial differential equation for transport phenomena.
Depending on the transport coefficients, the temperature and the boundary
conditions for the geometry of an average scuba tank for 8, 10, 12 or 15 L
WC.
There are a couple of Gas Mixing / EAN / Blending Manuals which come to
exactly the same conclusion; pls. cf.:
Section 14: Popular Misconceptions, p. 137 in:
[95] Raftis, Nicos, The Technical Guide to Gas Blending, Best
Publishing 2000 ISBN 0-941332-84-5,
or:
[208] Aspacher, Bernd; Rettenmaier, Franz (2001) Gas Blender
Manual, ISBN: -
16
As a finalizing comment, not necessarily connected to the
flat errors in diving medicine, but to overall correctness:
a couple of remarks on
p. 69 „ … not confined by any previous baggage.“
p. 73: „ …were ahead of him …“
would be candidates for a careful revision: there is abundant first-hand
information from competent experts, with in-depth and on-hands
knowledge, for eg.:
SPUMS Journal Volume 29 No.2 June 1999
So, with this in mind and as well with the slides # 7 15, and, of course
with the information on deep stops from [d], for the further distribution of
this SAA suite of documents our recommendation (slide #2) should be
considered.
17
References:
We from the lab (Miri, Nurit & Yael) rely heavily on the
knowledge & experience of our boss:
https://www.researchgate.net/profile/Albi-Salm-2
As well we have our big library at hand:
http://www.divetable.eu/BOOKS/index.htm
יבלא: הדותךל הבר!
ירימ ,לעיו תירונ
[a] Workman, R.D. (26 May 1965) Research Report 6-65,
Calculation of Decompression Schedules for Nitrogen-Oxygen and
Helium-Oxygen Mixtures, USN NEDU, AD #620-879
[b] The DSAT Recreational Dive Planner: Development and validation of no-
stop decompression procedures for recreational diving, Hamilton, Rogers,
Powell, Vann, 28 Februar 1994
[c] Rosenblat, Miri; Vered, Nurit (11 / 2021) PoC for DIVE Version 3_11,
http://dx.doi.org/10.13140/RG.2.2.17024.56326
18
References, cont‘d.:
[d] Salm, Albi (2020) A „deep stop“ table for recreational
dives on air: Debunked!
DOI: 10.13140/RG.2.2.24738.04800
[e] Miri Rosenblat, Nurit Vered, Albi Salm (01 / 2021)
An agile implementation of the “K-value”:
a severity index for CNS- and pulmonary oxygen-toxicity
DOI: http://dx.doi.org/10.13140/RG.2.2.17583.87205
[43] Göbel / Scheyer, Max Hahn (1996) Dekompression, Delius Klasing
Edition Naglschmid, Stuttgart, ISBN 3-89594-050- X, 86 p.
[187] Cole, Bob (2008) The SAA Bühlmann DeeP-Stop System Handbook,
AquaPress Ltd., ISBN: 978-0-9532904-2-0
[183] Cole, Bob (2014) Out of the Decompression Matrix, AquaPress Ltd.,
ISBN 978-1-905492-28-2
Presentation
Full-text available
Abstract: We compiled lists/descriptions of errors found in the standard diving medicine literature. Methods: We scanned our diving medicine archives and looked there for already existing error-reports; typos etc. were ignored.
Presentation
Full-text available
The K-value power functions for the central nervous system and pulmonary oxygen toxicity (CNS-OT, P-OT) are described in: [1], [2], [3], [4] & [5], pls. cf. chapter „References“. As Ran et al. would have it ([3], abstract), there is a need for an implementation. Which is what we did ([6], [7], [8], [9]). „Agile“ means here, in the context of IT-projects: a failure rate of 20 % is subliminally accepted … Which is why we put the software on the BETA TEST site of „DIVE“
Presentation
Full-text available
A „deep stop“ table for recreational dives on air: Debunked! A "deep stop" table is challenged with 2 box-profiles: the authors claims of reduced decompression stress and additional safety due to deep stops are analyzed. An in-depth analysis of the calculated inertgas partial pressures in theoretical tissue compartments reveals that the additional safety and micro-bubble control can not be substantiated seriously. The manually inserted deep stops are following basically the DAN rule, thus the safety record of the original Bühlmann ZH-86 table is not substantially improved.
The SAA Bühlmann DeeP-Stop System Handbook
  • Bob Cole
Cole, Bob (2008) The SAA Bühlmann DeeP-Stop System Handbook, AquaPress Ltd., ISBN: 978-0-9532904-2-0
Out of the Decompression Matrix
  • Bob Cole
Cole, Bob (2014) Out of the Decompression Matrix, AquaPress Ltd., ISBN 978-1-905492-28-2