Monday, October 22, 2007

Courses for Scuba

Good day to you all. Today's topic, Scuba Courses in beautiful Sidney BC.
We have people come into Liquid Heaven dive store everyday to shop for scuba courses. Everyone today that is interested in scuba lessons might think all courses are equal in all stores. This is absolutely incorrect. Each stores course prices are different, course materials vary and schedules are different. Just remember, you get what you pay for! Courses are not equal in all dive stores. You might have 2 or more Padi facilities in the same city that offer Padi beginner scuba courses, but they are indeed different. Padi (Professional Association of Diving Instructors) is the worlds largest scuba diver certifier. All the Padi facilities must adhere to strict Padi guidelines and standards to keep divers well taught and safe. The guidelines keep the dive store honest and reputable in the industry. Eg. Dive store instructors must have personal liability insurance. When conducting ocean dives, the instructor must have a dive flag in the water letting boaters know that there are divers in the water. The instructor must have oxygen and first aid supplies at the dive site, just to name a few things.

When students sign on the dotted line to enroll in a scuba course, they should be anticipating the following: An explanation on the course, academic, confined pool and ocean dives requirements, what equipment is provided, what equipment must be purchased prior to the course, and of course, an explanation and briefing on what is entailed in the ocean dives portion of the course. Liquid Heavens scuba beginner course consists of 5 to 7 classroom sessions, 5 to 7 pool sessions and and a minimum of 5 open water ocean dives. All of our courses are 100% guaranteed. Liquid Heaven believes in building great divers. So that's what we do: build great divers.
OPEN WATER BEGINNER COURSE


Confined Water Dives:
Confined water training serves two purposes. First, it establishes the basic skills that all divers need (or may need in the unlikely event of a problem)in a relatively low stress environment. Second, it reinforces and supplements Knowledge Development training by having student divers practice and apply what they learn from reading the manual and watching the videos. There are five confined water dives that correspond to the five knowledge development sections.


Knowledge Development:
The Knowledge Development portion establishes a foundation of principles, procedures and general information fivers need. There are five sections, each of which is normally accomplished through independent study with the PADI Open Water Manual and Open Water Diver Video, or with the Open Water Diver Multimedia. Liquid Heaven students answer exercise questions within reading, and complete a Knowledge Review for each section that you check for completeness and understanding. Students demonstrate mastery by completing the appropriate PADI Quiz, or, following the fifth section, a comprehensive (but easy) Final Exam, then they receive a brief elaboration during which you answer questions and apply the material to specific student needs and local environments.


Open Water Dives:
The Open Water Dives complete the integration of the principles learned in Knowledge Development and the skills learned in the Confined Water Dives by having student divers apply both in the open water dive environment. By practicing skills mastered in the Confined Water Dives, students continue to learn as they use these skills in the open water.

Scuba Equipment (NEW) is provided for Liquid Heaven students except for mask, fins and snorkel as this is considered personal gear and must be purchased and professionally fit for the utmost comfort and enjoyment prior to the course start up. We have the largest selection of masks on Vancouver Island and Liquid Heaven professionals will spend much time individually with you to get the best fitting mask for comfort. Please stay away from cheap knock off masks that appear to look the same as a name brand mask. They are not, they usually are made of inferior products that give a very short life span and usually leak. Stick with reputable name brands that have been in the dive industry for a long time. These name brands have exceptional warranties and life spans. You get what you pay for!


Accommodating Motor Skill Development Abilities and People with Disabilities:
To earn the PADI Open Water Diver or Scuba Diver certification, student divers must demonstrate mastery of each performance requirement. As in the confined water dives, we have the latitude to accommodate individual needs by modifying techniques to meet requirements. In the open water environment, we may need to assist individuals with physical challenges to accommodate access to boats, shore and other facilities.


PADI Open Water Divers are qualified to:
Dive with a buddy independent of supervision while applying the knowledge and skills they learn in this course, within the limits of their training and experience.
Obtain air fills, scuba equipment and other services.


Plan, conduct and log open water no stop (no decompression) dives when properly equipped and when accompanied by a buddy in conditions with which they have training and/or experience.
Continue their dive training with a specialty dive (Adventure Dive), in the PADI Adventures in diving program or in PADI Specialty courses.


Part of the Liquid Heaven PADI Open Water Diver course includes informing student divers that they are responsible for diving within limits of their training and experience. Students read and sign the relevant PADI Safe Diving Practices Statement of Understanding and by explaining to Scuba Divers the limitations of their certification. The minimum age for Open Water Diver or Scuba Diver Certification is 15, which must be reached by the end of the course. We also train individuals under the age of 15 according to the Junior Open Water Diver and Junior Scuba standards given by Padi. Student divers in the Junior Open Water Diver and Junior Scuba Diver courses must be 10 years old prior to the start date of the course.


Performance Based Training.
The PADI Open Water Diver course builds upon the concept of performance-based learning. This means student divers progress through the course demonstrating that they meet measurable learning objectives. The courses instructional design sequences these objectives from simple to complex, so students built upon previous learning as they progress. Attempting to learn something without mastering prerequisite objectives can complicate and interfere with development and development and learning. For this reason, students must satisfactory demonstrate meeting knowledge development and water skills performance requirements (objectives) in their required sequences. Satisfactory demonstration is called “mastery”.


This is done by building good safety practices as there are no short cuts in diving safety. If you do not like the way your taught in the course you will receive 100% refund on the course as mentioned earlier. Just because a person pays for the course and goes through 1 week of lessons doesn't mean they will get certified if they know they have struggled with skills in the pool or ocean. Liquid Heaven will allow that student to re-enroll in scuba lessons for FREE to continue to develop diving skills and good habits building confidence in the diver. We are so confident about the way we teach. We are the only dive store that offers this guarantee to assure customers that were here to educate with no short cuts. Dive stores we feel put to much emphasise on selling not educating. It is true that buying customers are very important to the dive store for survival. How a dive store gets rewarded with selling scuba gear is to build consistency with their patrons, is to offer more than gear sales. Offering International dive trips, daily local dives, diving projects and events, selling quality name brand scuba gear, quality instruction and honesty. Go visit all the dive shops in your area and you be the judge. Liquid Heaven could be your second home as it is for many. Come on in and have a coffee on us and talk to us about your passion of diving.


Liquid Heaven offers so much more than just gear sales. Were committed to excellence in education. Get to heaven while you're still around to enjoy it.
"Dream Deep, Dive Inspired"
Darryll
Padi GranDadi

Friday, October 12, 2007

Quality gear (name brand) VS Garbage gear (no name brand)

I was asked by students as of late to do a short talk on scuba gear. As a professional, it is easy to determine if a mask, regulator or snorkel are of high quality or a cheap copycat. Canada,USA, Japan and certain parts of Europe have always been known to make quality dive gear. Due to the fact that we live and dive in colder more demanding conditions than anywhere in the world, we need top quality dive gear to keep us safe. It is very evident that our store Liquid Heaven carries top of the line gear manufactured in Canada, USA and Japan. We will never sell a low end, copycat masks that are made in certain parts of ASIA, bought wholesale (by the dive store or big box store) for $3.99 Canadian and resold as a bargain at $79.99. Liquid Heaven sells professional gear that is warrantied and has a name reputable in the dive industry.

As a dive professional leader, it is up to us to educate students (future divers), that Big Box store masks, snorkels and fins won't cut it in our diving conditions or any conditions for that matter. These are the stores that sell look alike copies of quality masks and flood the market with garbage, leaving many enthused future divers with a very bad experience and no longer wanting to try scuba diving because they think back to an experience of the constant flooding of the mask.

Ask yourself when you took your first snorkeling or diving vacation down in Australia, Mexico or the Caribbean and rented gear. Was it great gear? Did it fit well? Did the mask have mold in it and looked like a half chewed piece of rubber, the snorkel smelling like fish and fins that hurt you feet causing blisters? Most people that try snorkeling or diving in exotic destinations are really put off and have no desire to try scuba on the beautiful West Coast of Canada because the gear they used was inferior. Even some dive stores sell garbage because the price points are greater, they make money but in the end have disappointed customers. Liquid Heaven says "NO" to selling garbage. Liquid Heaven would be doing a disservice to you, our customer. We educate our customer on making the right decision on dive gear. It is a big investment to make and you should trust your dive instructors experience for showing you options on your scuba purchases.

No one cares about the customers scuba purchases, more than your personal instructor. He should educate you on what the difference is between a good regulator and a great regulator. The answer: breathing of course and accessibilty (by the technician) to parts in a timely service fashion. A diver does not have to buy the best gear but do if you want to. Support your local dive store so they can be of service to you and your dive buddies needs. If you get educated and taught locally how to scuba dive, spend your money with them, not EBay and the Internet. If you buy on-line you get NO warranties or guarantees, and if arrives damaged, tough luck. I'm sure you know people that have been cheated on the Internet, I have. Be wise with your purchases as they are costly investment into the greatest experience you'll ever participate in, SCUBA DIVING. Buoyancy compensator devices known as BCD's are also a a very important purchase. I'm surprised at the number of divers that buy warm water BCD's to dive here locally on the West Coast. Warm water BCD's don't have the lift capacity, nor enough support straps to keep you safe and give you the ability to clip on accessory equipment like lights, signal tubes etc. There is so much to discuss on these topics of scuba gear equipment.

Our equipment course dated October 19Th, 2007 at the Liquid Heaven, we will discuss in detail all equipment topics. I look forward to seeing you all there. Bring your simple questions & concerns and technical questions to this course to be answered.

"Dream Deep, Dive Inspired"
Darryll
Padi GranDadi

Tuesday, October 2, 2007

Decompression sickness ( DCI )

Decompression Illness:

What is it and what is the treatment?

Decompression Illness or DCI is a term used to describe illness that results from a reduction in the ambient pressure surrounding a body. A good example of that is what happens when you're surfacing after a dive.

DCI encompasses 2 diseases, decompression sickness (DCS) and arterial gas embolism (AGE). DCS is thought to result from bubbles growing in tissue and causing local damage, while AGE results from bubbles entering the lung circulation, travelling through the arteries and causing tissue damage at a distance by blocking blood flow at the small vessel level.

Who Gets DCI? Decompression Illness affects scuba divers, aviators, astronauts and compressed air workers. It occurs in approximately 1,000 US divers each year. Moreover , DCI hits randomly. The main risk factor for DCI is a reduction in ambient pressure, but there are other risk factors that will increase the chance of DCI occurring. These known risk factors are deep / long dives, cold water, hard exercise at depth, rapid ascents and of course other contributors such as age, health, dehydration, lack of sleep and scar tissue past damage.

Rapid ascents are closely linked to the risk of AGE. Other factors thought to increase the risk of DCI for which evidence is not conclusive are obesity, major dehydration, hard exercise immediately after surfacing, and pulmonary disease. In addition, there seem to be individual risk factors that have not been yet identified. This is why some divers seem to get DCI more frequently than others although they are following the same dive profile.

Since DCI is a random event, almost any dive profile can result in DCI. no matter how safe it seems. The reason is that the risk factors, both known and unknown, can influence the probability of DCI in myriad ways. Because of this, evaluation of a diver for possible decompression illness must be made case-by-case basis by evaluating the diver's signs and symptoms and not just based on the dive profile.

Decompression Sickness (DCS)

Decompression sickness (DCS, also called the bendsor caisson disease) is the result of inadequate decompression following exposure to increased pressure. In some cases, the disease is mild and not an immediate threat. In other cases, the serious injury does occur: when this happens, the quicker the treatment begins, the better the chance for a full recovery.

During a dive, the body tissues absorb nitrogen from the breathing gas in proportion to the surrounding pressure. As long as the diver remains at pressure, the gas presents no problem. If the pressure is reduced too quickly, however, the nitrogen comes out of solution and forms bubbles in the tissues and bloodstream. This commonly occurs as a result of violating or approaching too closely the diving table limits, but it can also occur even when accepted guidelines have been followed.

Bubbles forming in or near joints are the presumed cause of the joint pain of a classical "bends." When high levels of bubbles occur, complex reactions can take place in the body, usually in the spinal cord or brain. Numbness, paralysis and disorders of higher cerebral function may result. If great amounts of decompression are missed and large numbers of bubbles enter the venous bloodstream, congestive symptoms in the lung and circulatory shock can then occur.

SYMPTOMS OF DCS

  • Unusual fatigue

  • Skin Itch

  • Pain in joints and / or muscles of the arms, legs or torso

  • Dizziness, vertigo, ringing in the ears

  • Numbness, tingling and paralysis, shortness of breath

SIGNS OF DCS


  • Skin may show a blotchy rash

  • Paralysis, muscle weakness

  • Difficulty urinating

  • Confusion, personality changes, bizarre behavior.

  • Amnesia, tremors

  • Staggering

  • Coughing up bloody, frothy sputum

  • Collapse or unconsciousness

NOTE: Symptoms and signs usually appear within 15 minutes to 12 hours after surfacing: but in severe cases, symptoms may appear before surfacing or immediately afterwards. Delayed occurance of symptoms is rare, but it does occur, especially is air travel follows diving.


DENIAL AND RECOGNITION


The most common manifestations of DCS are joint pain and numbness or tingling Next most common are muscular weakness and inability to empty a full bladder. Severe DCS is easy to identify because the signs and syptoms are obvious. However, most DCS manifests or a paraethesia (and abnormal sensation like burning, tingling or tickling) in an extremity.


In many cases these symptoms are as described to another cause such as overexertion, heavy lifting or even a tight wetsuit. This delays seeking help and is why it is aften noted that the first symptom of DCS is denail. Sometimes these symptoms remain mild and go away by themselves, but mant times they increase in severity until it is obvious to you that something is wrong and that you need help.


What happens if you don't seek medical treatment in severe DCS, a permanent residual handicap may result: this can be a bladder dysfunction, sexual dysfunction or muscular weakness, to name a few.


In some cases of neurological DCS, there may be permanent damage to the spinal cord, which may or may not cause syptoms. However, this type of damage may decrease the likihood of recovery from a subsequent bout of DCS.


Untreated joint pain that subside are thought to cause small areas of bone damage called osteonecrosis. Usually this will not cause sypmtoms unless there are many bouts of untreated DCS. If this happens, however, there may be bone to become brittle or for joints to collapse or become arthritic.


PREVENTION OF DCS

Recreational divers should know dive conservatively, whether they are using dive tables or computers. Experienced divers often select a table depth (versus actual depth) of 10 feet/ 3 meteres deeper than called for by standard procedure. This practice is highly recommended for all divers, especially when diving in cold waters or when diving under strenous conditions. Compiuter divers should be caustious in approaching no- decompression limits, especially when diving deeper thatn 100 feet/ 30 meters.


Avoiding the risk factors noted above (deep/ long dives, exercise at depth or after a dive) will decrease the chance of DCS occuring. Exposure to altitude or flying too soon after a dive can also increase the risk of decompression sickness.


ARTERIAL GAS EMBOLISM (AGE)


If a diver surfaces without exhaling, air trapped in the lungs expands with ascent and may rupture lung tissue - called pulmonary barotrauma - which releases gas bubbles into the arterial circulation. This distributes them to body tissues in proportion to the blood flow. Since the brain recieves the highest proportion of blood flow, it is the main target organ where bubbles may interupt circulation if they become lodged in small artieries.


This is arteriel gas embolism, or AGE, considered the more serious form of DCI. In some cases the diver may have made a panicked ascent, or he may have held his breath during ascent. However, AGE can occur even if ascent apperared completely normal, and pulmonary disease such as obstructive lung disease may increase the risk of AGE.


The most dramatic presentation of air embolism is the diver who surfaces unconcious and remains so, or the diver who loses concienceness within 10 minutes of surfacing. In these cases, a true medical emrgency exists, and rapid evacuation to a treatment facilty is paramount.


On the other hand, air embolism may cause less spectacular symptoms of neurological dysfunction, such as sensations of tingling or numbness, a sensation of weakness without obvious paralysis, or complaints of difficulty in thinking without obvious confusion in individuals who are awake and easily aroused. In these cases, there is time for a more thourough evaltuion by a diving medical specialist to rule out other causes of symptoms.


Like DCS, mild symptoms may be ascribed to causes other than the dive, which only delays treatment. Sometimes symptoms may resolve spontaneosly and the diver will not seek treatment.The consequecnces of this are similar to untreated DCS: residual damage to the brain may occur, making it more likely there will be residual symptoms after a future bout of AGE, even if the later bout is treated.


SYMPTOMS OF AGE


  • Dizziness

  • Visual bluring

  • Areas of decreased sensation

  • Chest pain

  • Disorientation

SIGNS OF AGE


  • Bloody froth from mouth or nose

  • Paralysis or wekness

  • Convulsions

  • Unconsciousness

  • Cessation of breathing

  • Death

Currently cerebral gas embolism is repondsible for approximately 10 percent of all DCI cases annually. AGE has decreased significatly over the past decade, however, moving from 18 percent of all cases in the late 1980's and early 1990's to much lower numbers. By 1997, the fraction had fallen to 7-8 percent.


In 2001, AGE was still citied in 7-8 percent but by 2002 it had fallen to 6.6 percent of the total diving population reporting DCI. It has been speculated that one of the reasons for the decrease is the advent of dive computers, which help chart the rate of acesnt, thus reminding divers to slow down.


PREVENTION OF AGE


Always relax and breathe normally during ascent. Lung conditions such as asthma, infections, cysts, tumours, scar tissue from surgey or obstuctive lung disease may predipose a diver to air embolism. If you have any of these conditions, it warrants an evaluation by a physician knowledgeable in diving medicine.


TREATMENT - Call D.A.N. (Divers Alert Network)


The treatment for DCI is recompression. However, the early management of air embolkism and decompression sicknessis is the same. Although a diver with severe DCS or and air embolism requires urgent recompression for definative treatment, it is essential that he be stabilized at nearest facility before transporation to a chamber.


Early Oxygen first aid is important and may reduce symptoms substantaially, but this should not change the treatment plan. Symptoms of air embolism and serious decompression sickness often clear after initial oxygen breathing, but they may reappear later. Because of this, always contact D.A.N. (Divers Alert Network) or a dive physician in cases of suspected DCI- even if the symptoms and signs appear to have resolved.


Treament involves compression to a treatment depth, usually 60 feet / 18 meteres and breathing oxygen fraction gases at an oxygen partial pressure of between 2.8 ata (atmospheres) and 3.0 ata. Delays in seeking treatment have a higher risk of residual symptoms: over time, the initially reversible damage may become permanent. After a delay of 24 hours or more, treatment may become inaffective and symptoms may not respondto treatment. Even if there has been a delay, however, consult a diving medical specialist before drawing any conclusions about possible treatment effectiveness.


In some cases, there may may be residual symptoms after treatment. Soreness in and around a joint that was affected by DCS is common and usually resolves in a few hours. If the DCI was severe, significant residual neurological dysfuction may be present, even after the most agressive treatment. In these cases, there may be follow-up treatments, along with phsical therapy. The good news is that the usual outcome is eventual complete releif from all symptoms, provided treatment was begun promply.


RETURNING TO DIVING AFTER DCI


The US navy has set down rules for returning to diving after treatment. For pain-only DCI where there are no neurological symptoms, divers may begin diving two to seven days after treatment, depending on the treatment table used.


If there are neurological symptoms, the diver may resume diving two to four weeks after treatment, depending on symptom severity. For very severe symptoms, the the diver must be reevaluated three months after treatment and cleared by a diving medical officer.


The Navy guidlelines are for professionals, where time off must be minimized so so operations are not comprimised.


GUIDLINES FOR SPORT DIVERS


For recreational divers, where diving is not a livlihood, a more conservative approoach is called for to further minimize the chance that a diving injury will recur


  • After pain-only DCI where there are no neurological symptoms, a minimum of two weeks without diving is recomended.

  • If there are minor neurological symptoms, six weeks without diving is recommended

  • If there are are severe neurological symptoms or any residual symptoms, no furthere diving is recommended.

Even if symptoms were not severe and they resolved completely, a diver who has had multiple bouts of DCI must take special considerations. If DCI is occuring where other divers on the same profile are DCI free, the diver may have an increased susceptabilty to DCI. In these cases, a Diving Medical Specialist must be consulted to detemine if diving can be resumed safely. Remeber, your good health needs to lastas long as you do.


D.A.N. (Divers Alert Network)


Founded in 1980, DAN has served as a lifeline for the scuba industry by operating diving's only 24 hour emergency hotline, a lifesaving service for injured divers. Additionally, DAN operates a diving medical information line, conducts vital diving medical research, and developes and provides a number of educational programs for everyone from begining divers to medical professionals.


Divers Alert Network is supported by membership dues and doantions. In return, members recieve a number of importnat benifits including $100,000 emergency medical evacuation assistance, DAN educational publications, a subscription to Alert Diver magazine, and access to diving's first and foremost accident insurance coverage.


For 24 hour D.A.N. Emergency number is 1.919.684.8111


Hyperbaric Chambers


HOC Hyperbaric Care Center- Victoria 1.250.995.1811


Fleet Diving Unit (Pacific) Victoria, BC 24hr. 1.250.363.2379 Chamber 1.250.363.4981


Array of Life Hyperbaric Oxygen Unit, Burnaby 1.604.421.1951


Angel Hyperbaric Care center, Langley BC 1.888.357.9133 or 1.604.534.2155


Richmond Hyperbaric Health Centre, Richmond BC 1.888.373.0888 or 1.604.277.8608


Canadian Hyperbaric Institute, Vancouver BC 1.604.732.3422


Vital Path Health Centre, Vernon, BC 1.250.549.1400


Hyparbaric Care Centre, Coquitalm BC 1.604.520.6867

Baromedical Research Cener - Hyperbaric Oxygen Clinic and Wound Care Centre, Burnaby BC 1.604.777.7055

Enviromental Physiology Unit - Kinesiology, Simon Fraser University, Burnaby BC 1.604.291.3782

Vancouver Hospital & Health Science Centre Hyperbaric Unit, Vancouver BC, 1.604.875.4007

Diving Dynamics, Kelowna BC, 1.866.861.1848

Written By Dr. E.D.Thalmann, DAN Assistant Medical Director

and yours truly

Darryll W. Harasemow MSDT Instructor / Liquid Heaven