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Abstract

Risk Assessment in the Norwegian Diving & Treatment Tables: our offer for improvement Abstract: The NDTT 5th. Ed. describes a transparent & straight-forward score-based risk assessment with 3 clear parameters (Ref. [1], p. 65). We used (de-)hydration as a 4th. parameter, based on our experience [2], as an offer for quick & easy improvement.
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Risk Assessment in the
Norwegian Diving & Treatment
Tables:
our offer for improvement
Miri Rosenblat, TAU
Nurit Vered, Technion Haifa
Yael Eisenstein & Albi Salm,
SubMarineConsulting
13.01.2022
DOI: t.b.d.
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Abstract:
The NDTT 5th. Ed. describes a transparent
& straight-forward score-based
risk assessment with 3 clear parameters
(Ref. [1], p. 65). We used (de-)hydration as
a 4th. parameter, based on our
experience [2] as an offer for
quick & easy improvement.
Methods:
Modification of table 8, p. 65 from [1]
Results:
pls. cf. slides # 6 & 7
References:
slide # 8
Bonus Material:
slides # 9 & 10
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[1], page 65:
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Based on our experience ([2], and of that of many hyperbaric
treatment centers around the world) that nearly 100 % of the
so-called “un-deserved” decompression sickness hits are just
the contrary, ie. deserved because of the divers not being properly
hydrated (pls. cf. as well the bonus material, slides # 9 & 10, and the
following, # 5):
(private communication DCSI, Stuttgart, 1999, source:
http://www.divetable.eu/BOOKS/209.pdf )
Thus we suggest using a 4th. parameter for the risk-assessment matrix on p.
65 with the following modifications for the decompression phases
(slides # 6 & 7):
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Source:
[145] Merritt, D (2002) Mending the Bends. Assessment, Management, and
Recompression Therapy, Best Publishing Company, ISBN 0-930536-05-4
p. 45
And, as well, by the same token:
"Bennett and Elliott's Physiology and Medicine of Diving" Alf Brubakk,
Neuman et al., 5 th Ed. Saunders, ISBN 0-7020-2571-2,
on p. 544: Risk Factors
And:
Edmonds, Carl; Bennett, Michael et al.(2016) Diving and Subaquatic
Medicine, Fifth Edition, CRC Press; ISBN 978-1-4822-6012-0,
on p. 164: Hydration
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Suggested 4th. parameter: Dehydration
Score
Risk Factor: 0 1 2 3
Work Load None Low Medium High
Thermal comfort
during
decompression
Warm Neutral Cool Cold
Individual
Factors:
Age > 50
BMI > 30
Sedentary
None of
these 1 of these 2 of these 3 of these
Dehydration Not
noticeable Mild Noticeable:
Thirst Pronounced:
very thirsty,
difficult
salivation
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Suggested changes to the text on p. 65:
By adding the scores for the various groups of risk factors you will achieve
a total score ranging 0 to 12. The highest score will be achieved with a
dive with a high work load, where the diver has been cold during
decompression, noticeable dehydration and has all 3 of the individual risk
factors. For scores 1 3 we recommend that the decompression is
adjusted according to a bottom time one step longer than the required.
For scores 4 6 we recommend decompression according to a bottom
time two steps longer than prescribed. For scores 7 9 we recommend
decompression according to a bottom time two steps longer than
prescribed plus the next depth step. For scores 10 12: two time steps
longer, one step deeper and as well considering decompression on 100 %
oxygen from 9 m on should be an option. As well thermal comfort should
regained and re-hydration should be initiated immediately.
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References:
[1] (NDTT):
Norwegian Diving- and Treatment Tables, Fifth Edition,
available @: www.dykketabeller.no
[2] Rosenblat, Miri; Vered, Nurit (11/2021)
Synopsis & Fact Sheet for DIVE Version 3_11; DOI:
https://dx.doi.org/10.13140/RG.2.2.17024.56326
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Bonus Material, Source:
Adel Taher, Sharm el-Sheikh, Egypt, 2018,
private communication
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Bonus Material, Source:
Adel Taher, Sharm el-Sheikh, Egypt, 2018
private communication
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