HWN Suggests

“Twenty Thousand Leagues Under the ED”: Common Diving Emergencies

Any neurological symptoms or loss of consciousness upon surfacing is considered AGE until proven otherwise. Treatment is supplemental O2, IV fluids, and most importantly, a hyperbaric chamber.

Decompression sickness is more appropriately categorized by the organ system affected, as even minor manifestations can progress to more serious forms.

While AGE and neurological DCS may be clinically indistinguishable, both are managed similarly with supplemental oxygen, IV fluids, and hyperbaric oxygen therapy.  In general, AGE and DCS are clinical diagnoses. Labs and imaging should not delay transfer to a hyperbaric facility.

read full article

Featured

  Emergency Contacts

For diving-related emergencies, contact Divers Alert Network worldwide. 1-919-684-9111 (they accept Collect calls).

 A Comprehensive Review of Decompression Sickness, Ear Barotrauma and Diving Safety

Having worked as both an Emergency Doctor and a Dive Doctor I know that diving, when not done correctly, can be very dangerous but when done safely it is the most wondrous thing; the sense of adventure and exploration can be overwhelming.

 Diving Injuries and Dysbarism

The majority of dive injuries are diagnosed on the basis of the focused dive history and physical examination alone; they are best differentiated into disorders of descent, disorders of depth, and disorders of ascent.

 SCUBA Diving Injuries and Treatments

First, barotrauma exists because of Boyle’s Law (P1V1=P2V2). There is no way to go around this law of nature, only ways to prevent negative outcomes.

 Scuba Pathology

I have to say that scuba injuries are not my strong suit. However, in doing this blog post, I have to say it’s not the worst thing to read about. For instance, you get a lot of random information like for some reason depth is measured in fathoms (which is just 2 yards, and seems completely unnecessary to have this).

Articles of Interest

Diving Emergencies

The effects of the change in air volume and the other gas laws form the basis of decompression illness (DCI), which includes arterial gas embolism (AGE), and decompression sickness (DCS), commonly known as “the bends.”

Diving Emergencies for Dummies, Part II

In contrast to AGE, symptoms of DCS do not usually begin during ascent or immediately after the diver leaves the water. In most cases, symptoms appear after a short interval, usually within the first hour after the dive is finished. The vast majority occur within 6 hours of diving.

Emergency Ascents: Managing the Risks

As divers, we all learn never to hold our breath underwater. Unfortunately, in an emergency situation, divers often forget this information and why it is important. As a diver ascends and the surrounding pressure drops, the air in his lungs expands. If the diver is breathing normally, this isn’t a problem as the expanding gas escapes with every exhaled breath. The danger comes when the ascent is too rapid for this expanding gas to escape or when a diver holds his breath on ascent.

Experience: I got the bends

The hospital staff, horrified to see me arrive on foot, confirmed I had neurological bends (when the bubbles from the nitrogen go to your brain and spinal cord which is what causes the paralysis) and put me straight into a hyperbaric chamber – a metal portal that looks like something from a Bond movie. It was very hot and noisy, like being in an overheating engine room. I had to wear a heavy flight mask, which fed me pure oxygen. This would shrink the nitrogen bubbles and I would then breathe them out.

Scuba Diver Emergencies – Stories From The Deep

Most people have heard of ‘the bends’, or decompression illness. Decompression illness is the umbrella term for both decompression sickness (an evolved gas issue) and arterial gas embolism (an escaped gas issue):

Scuba Emergencies (ascent)

includes sinus barotrauma, “face squeeze,” pulmonary barotrauma, decompression sickness, arterial gas embolism, nitrogen narcosis, oxygen toxicity, carbon monoxide toxicity, hypothermia, and even caustic injuries.

Resources

Charlie's ED

This document contains general information on the assessment, management and disposition of patients presenting with suspected decompression sickness or other diving related emergencies

CDC

Decompression illness (DCI) describes the dysbaric injuries (such as AGE) and decompression sickness (DCS). Because scientists consider the two diseases to result from separate causes, they are described here separately. However, from a clinical and practical standpoint, distinguishing between them in the field may be impossible and unnecessary, since the initial treatment is the same for both.