Editing In-water recompression (section)

== Risks ==
Any potential benefits of using IWR for earlier recompression should be balanced against the risks. These risks are well known, and their potential mitigations are fairly well understood.<ref name="Doolette and Mitchell 2018" />

The [[Royal Australian Navy School of Underwater Medicine]] was charged to supervise the then non-sanctioned practice of IWR,<ref name=edmonds1979/><ref name=edmonds1995 /> in response to the very long delays that often occurred between the presentation of DCS and recompression treatment. The issues identified include:
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* Inappropriate cases for treatment,
* [[Oxygen toxicity]],
* Emergency termination of treatment,
* [[Hypothermia]]
* Adequacy of equipment in remote areas,
* [[Seasickness]],
* Operator expertise and training,
* Safety of the [[diving attendant]] and the boat tenders,
* Requirement for medical supervision,
* Transport availability,
* Misuse of equipment,
* Pulmonary [[barotrauma]] cases.
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===Risk management===
In 2018, a group of diving medical experts issued a consensus guideline on pre-hospital decompression sickness management and concluded that IWR is only appropriate in groups that have been trained and are competent in the skills required for IWR and have appropriate equipment.<ref name="Mitchell et al 2018" />

Mitigation of a CNS oxygen toxicity [[seizure]] focuses on protecting the airway to prevent drowning. A full-face mask or mouthpiece retaining strap is reasonably effective though not guaranteed. Tethering the diver to prevent sinking, and providing a safety diver to accompany the diver under treatment at all times, who can recover the diver to the surface immediately in the event of a seizure are also recommended, following the recommended procedures for [[recovery of a convulsing diver]].<ref name="Doolette and Mitchell 2018" />