Reid Michael P, Fock Andrew, Doolette David J
Submarine Underwater Medicine Unit, Royal Australian Navy, Sydney, Australia.
John Hunter Hospital, Department of Anaesthesia, Locked Bag 1, Hunter Region, Mail Centre, NSW, 2310, Australia,
Diving Hyperb Med. 2017 Sep;47(3):159-167. doi: 10.28920/dhm47.3.159-167.
Personnel rescuing survivors from a pressurized, distressed Royal Australian Navy (RAN) submarine may themselves accumulate a decompression obligation, which may exceed the bottom time limits of the Defense and Civil Institute of Environmental Medicine (DCIEM) Air and In-Water Oxygen Decompression tables (DCIEM Table 1 and 2) presently used by the RAN. This study compared DCIEM Table 2 with alternative decompression tables with longer bottom times: United States Navy XVALSS_DISSUB 7, VVAL-18M and Royal Navy 14 Modified tables.
Estimated probability of decompression sickness (P), the units pulmonary oxygen toxicity dose (UPTD), the volume of oxygen required and the total decompression time were calculated for hypothetical single and repetitive exposures to 253 kPa air pressure for various bottom times and prescribed decompression schedules.
Compared to DCIEM Table 2, XVALSS_DISSUB 7 single and repetitive schedules had lower estimated P, which came at the cost of longer oxygen decompressions. For single exposures, DCIEM schedules had P estimates ranging from 1.8% to 6.4% with 0 to 101 UPTD and XVALSS_DISSUB 7 schedules had P of less than 3.1%, with 36 to 350 UPTD.
The XVALSS_DISSUB 7 table was specifically designed for submarine rescue and, unlike DCIEM Table 2, has schedules for the estimated maximum required bottom times at 253 kPa. Adopting these tables may negate the requirement for saturation decompression of rescue personnel exceeding DCIEM limits.
从一艘处于受压困境的澳大利亚皇家海军(RAN)潜艇中营救幸存者的人员自身可能会累积减压义务,这可能会超过澳大利亚皇家海军目前使用的国防与民用环境医学研究所(DCIEM)空气和水下氧气减压表(DCIEM表1和2)的水底停留时间限制。本研究将DCIEM表2与水底停留时间更长的替代减压表进行了比较:美国海军XVALSS_DISSUB 7、VVAL-18M和皇家海军14修正表。
针对不同水底停留时间和规定减压方案的假设单次和重复暴露于253 kPa气压的情况,计算减压病估计概率(P)、单位肺氧中毒剂量(UPTD)、所需氧气量和总减压时间。
与DCIEM表2相比,XVALSS_DISSUB 7的单次和重复方案的估计P较低,代价是氧气减压时间更长。对于单次暴露,DCIEM方案的P估计值在1.8%至6.4%之间,UPTD为0至101,而XVALSS_DISSUB 7方案的P小于3.1%,UPTD为36至350。
XVALSS_DISSUB 7表是专门为潜艇救援设计的,与DCIEM表2不同,它有253 kPa时估计最大所需水底停留时间的方案。采用这些表格可能会消除对超过DCIEM限制的救援人员进行饱和减压的要求。