UK SPORT DIVING MEDICAL

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UK SPORT DIVING MEDICAL COMMITTEE A DIVERS
EXPERIENCE OF DCI AND ITS TREATMENT DAVID
PELLY 24th March 2006
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A DIVERS EXPERIENCE OF DCI AND ITS TREATMENT
David Pelly

• Diving Background
• Age 54
• Started diving 1975 recreationally with BS-AC
• Started commercial diving 1978
• BS-AC branch instructor 1979
• Offshore commercial 1980
• TDI technical dive instructor 2003

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A DIVERS EXPERIENCE OF DCI AND ITS TREATMENT
David Pelly

• Diving Career
• Recreational depth to 120m
• Commercial air diving to 50m surface O2 deco
• Commercial surface supplied gas to 90m surface O2
  deco
• Bell bounce to 150m
• Bell sat to 220m
• Total number of dives 4,000
• No symptoms of DCI at all during this 30 year
• period

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A DIVERS EXPERIENCE OF DCI AND ITS TREATMENT
David Pelly

• Dive History in 4 Weeks Prior To Incident
• 07/02/05 28m 46 mins
• 16/02/05 118m 15 mins
• 27/02/05 23m 46 mins
• 28/02/05 60m 20 mins
• 28/02/05 28m 15mins
• 07/03/05 118m 15 mins
• All uneventful no DCI

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A DIVERS EXPERIENCE OF DCI AND ITS TREATMENT
David Pelly
07/03/05 118m 15 mins
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A DIVERS EXPERIENCE OF DCI AND ITS TREATMENT
David Pelly

• Diving Incident 8th March 2005
• Diving 30 miles south of Irish coast, inspecting
  a wreck cargo
• Closed circuit rebreather
• 7/67 diluent END 30m
• Well fed, hydrated and rested
• 20 hour surface interval from previous dive
• 14.45 Very slow descent sticky ears
• 5 mins on the bottom at 118.7m
• Decompression schedule- Buhlmann with 20/80 GF
• Just started ascent, 110m experienced very
  severe, incapacitating back pain,
  weakness in both arms and legs and warm feeling
  spreading throughout trunk area.
• Thoughts at the time, anticipating trouble
  reaching the surface

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A DIVERS EXPERIENCE OF DCI AND ITS TREATMENT
David Pelly

• Diving Incident 8th March 2005
• Continued ascent as remaining at depth would have
  incurred severe decompression penalties
• Pain in back gradually improved and general
  condition felt better
• Completed decompression uneventfully, surfaced at
  17.06
• Dive ladder on the boat less than perfect foot
  slipped on wet deck at first attempt and had to
  make a second climb
• Felt dizzy after making second climb symptoms
  disappeared after sitting and lowering head
• Felt cold, went to cabin to lie down in bed, legs
  working
• 30 60 mins later, pins and needles in both
  feet, progressing upwards
• Started breathing 100 O2 at 18.30
• Contacted coastguard
• When helicopter arrived, unable to walk

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A DIVERS EXPERIENCE OF DCI AND ITS TREATMENT
David Pelly

• Diving Incident 8th March 2005
• Lifted to hyperbaric facility in Southern Ireland
• Quick examination by anaesthetist
• Blown down in chamber to 18m on USN table 6 at
  22.07
• Oxygen bib system very hard work in breathing
• Continual vomiting, unable to retain fluids
• Asked for saline drip and catheter
• No improvement at all during treatment, symptoms
  still progressing total paralysis from chest
  down and both arms affected
• Completed table 6, transferred to intensive care
  for several hours with gastric baratrauma
• Helicopter 07.00 on 9th March, transfer to DDRC
  in Plymouth

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A DIVERS EXPERIENCE OF DCI AND ITS TREATMENT
David Pelly
Diving Incident 8th March 2005

• 3 Hour flight
• No movement in legs
• No sensation below waist
• Right arm not working very well
• Left arm slightly affected
• Abdomen greatly distended and extremely painful
• My thoughts were will I ever recover from
  this and if I do what will I be left with ?

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A DIVERS EXPERIENCE OF DCI AND ITS TREATMENT
David Pelly

• Diving Incident 8th March 2005
• Arrived DDRC 10.00 and examined by staff
• Treated on Comex 30 schedule on Heliox
• During treatment, distension in abdomen reduced
  and small improvement in motor function, able to
  move toes on left foot
• brilliant
• On decompression, abdomen distended again which
  persisted for a full week
• Treatment followed by two extended USN table 6s
  on consecutive days
• Daily 12m 2 hour treatments with Physiotherapy
• Total of 37 hyperbaric treatments with weekends
  off

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A DIVERS EXPERIENCE OF DCI AND ITS TREATMENT
David Pelly
08/03/05 118.7m 15m
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A DIVERS EXPERIENCE OF DCI AND ITS TREATMENT
David Pelly

• Diving Incident 8th March 2005 - Aftermath
• Arms returned to normal function within a few
  days
• Bowel function returned in three weeks
• Motor functions improved steadily and was able to
  walk with the aid of crutches after two months
• Spent total of 3 weeks in a neurological ward and
  6 weeks in Rowans Spinal Rehab Unit in Plymouth,
  undergoing intensive physiotherapy
• In November 2005 ultrasound tests conducted to
  look for evidence of PFO these proved negative
  and showed the heart to be perfectly normal

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A DIVERS EXPERIENCE OF DCI AND ITS TREATMENT
David Pelly

• Present Day One Year On
• Still gaining significant improvements
• Balance is improving able to walk short
  distances without aids
• Bladder function slowly improving
• I have regular Bowen therapy sessions which is a
  light manipulation and massage technique and
  helps me to relax
• Visit gym 3 times each week to improve strength
  and range of movement
• When can I go diving again?????????????

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A DIVERS EXPERIENCE OF DCI AND ITS TREATMENT
David Pelly

• Thank you for your kind attention
• I would appreciate any specialist comment or
  advice