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MEDICATION and DIVING QUESTION I’M Taking Meds – Can I Dive?

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MEDICATION and DIVING QUESTION I’M Taking Meds – Can I Dive? LITE AlertYour compact Alert Diver companion October/November 2017DIVER MEDICATION AND DIVING QUESTION I’m taking meds – can I dive? CAUTION Some meds can heighten the narc effect DAN-SA Consider the risks of diving with a medical condition SUSPENSION 4 EXERCISES WOMEN’S HEALTH AND DIVING Focus on issues affecting women divers BAROTRAUMA IN BONAIRE Recognise the symptoms Messages Perspectives YOUR ADVENTURE, YOUR SAFETY! For 20 years, DAN has been supporting divers in need, regardless of location, time of day, type of diving or nature of the problem. DAN is always available and has the expertise and resources to handle a wide variety of water-related emergencies. Whether a recreational diver shows signs of decompression sickness or a commercial diver sustains an injury, DAN will help that diver get the medical care he or she needs. The wealth of knowledge and experience DAN has cultivated over these 20 years is available to support the entire range of divers in Southern Africa, including ON THE COVER recreational, technical, breath-hold, scientific, and even commercial and military divers. Many divers question whether it is safe to dive Divers today are enjoying more extreme diving activities than ever before. Recreational divers, while taking medication; however, the greater empowered by new technology and advanced training, are venturing into the world of technical diving. threat to your safety is likely to be the underlying Because of this, the small community of technical divers is growing at a steady pace. These divers often medical condition. The article on page 82 will experience extreme environmental conditions, diving beyond recreational boundaries and often outside guide you on how to mitigate the risks. well-tested limits. Although these practices are becoming normalised with time, these divers face many questions that are not fully answered by current diving research. In light of this, our partnership with the International DAN research departments allows us to continue studying the effects of extreme diving so as to understand more fully the risks involved. In particular, the study analyses various aspects of safety including, but not limited to, decompression safety, physical fitness requirements and CONTENTS the cardiovascular effects of extreme diving. The purpose of these studies is to explore the effects of extreme dive exposures on divers and the requirements for participation in such dives. 78 PERSPECTIVES A renewed interest in freediving, both recreationally and competitively, can be seen in the Message from DAN-SA’s Regional Manager astounding increases in diving depths and breath-hold times achieved. These performance changes have far-reaching implications for human physiology and safety. DAN continues to monitor incidents 79 SAFETY STOP associated with breath-hold diving and has also organised research studies to deal with the specialised Statistics for 2016-2017 nature of the sport. Many of the different dive disciplines rely on DAN’s suite of first-aid courses to train their divers. 80 INCIDENT INSIGHT The Diving Emergency Management Provider course is one of the most useful courses: Developed by Barotrauma in Bonaire physicians and subject experts, it provides training in neurological assessment, emergency oxygen administration, automated external defibrillators and hazardous marine life injuries. 82 SAFETY Regardless of the type of diving you do, DAN is working hard to make it safer. Through I am taking meds - can I dive? innovative research designed to improve our understanding of diving injuries, improved dive accident management protocols and enhanced membership products to cover the cost of injuries, DAN is here 86 MEDICAL for all divers! Women’s health and diving In 2016, the DAN Hotline received 744 inquiries and managed 244 medical cases for injured divers. DAN is available to members and non-members alike: 90 MEDLINE Q&A Many of the queries received via the DAN Hotline come from non-members. If Your diving medical questions answered you know divers who are not DAN members, encourage them to join. Now it is time to sit back and relish another jam-packed Alert Diver LITE. 92 CATALOGUE Enjoy the read! Latest from the DAN-SA shop Morné Christou Regional Manager and Special Projects FITNESS 94 Suspension training DIVING DOCTOR DIRECTORY 96 Find a diving doctor TEAM & CONTACT TEAM CONTRIBUTORS Dr Frans Cronjé Jessica B. Adams ALERT DIVER LITE PHILOSOPHY Morné Christou Brian Harper The views expressed by contributors are not necessarily those advocated by the publisher or DAN-SA. While Sabrina Hindley John U. Lee every effort is made to ensure the accuracy of information and reports, the publisher as well as DAN-SA does Marty McCafferty not accept any responsibility, whatsoever, for any errors, omissions, or for any effects resulting therefrom. As CONTACT US Lana Sorrell to the best of the publisher and DAN-SA’s knowledge, contributors have not indulged in plagiarism. Although Please contact us at Brittany Trout the utmost is done to avoid such occurrences, the publisher and DAN-SA will not be held responsible for the [email protected] or phone contributors’ or writers’ indulgence in plagiarism. No part of this publication may be used or reproduced in any 0860 242 242 from inside 78 form without the written permission of DAN-SA. E&OE. South Africa. Statistics 2016-2017 Safety stop STATISTICS 2016-2017 24-HOUR DAN HOTLINE The hotline is available 24/7/365 at 0800 020 111 locally or +27 82 810 6010 from outside of South Africa. If you travel internationally, remember to ensure that your party has at least one phone available for emergencies with roaming activated. Contact the DAN hotline as soon as possible in the event of an emergency. DAN Hotline Gender Usage Split: 2016-2017 Male DAN Hotline Member Usage: 2016-2017 Non-Member Female DAN Member 11 18 47 42 10 14 7 47 16 15 18 16 51 58 56 53 50 43 16 32 12 18 29 36 54 49 82 83 85 41 41 69 72 41 22 27 26 44 21 22 45 42 69 67 86 34 43 81 Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul DAN Hotline Cases: 2016-2017 DAN Hotline Case Category: 2016-2017 Fatalities Non-Emergencies 101 97 95 Emergencies 92 88 92 85 82 87 1 1 59 54 52 90 83 95 97 87 94 92 1 83 79 58 51 51 1 3 2 3 2 1 1 4 4 1 1 Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul DAN Hotline Sub-categories: 2016-2017 DAN Hotline Transport Method: 2016-2017 708 67 95 78 7 2 23 38 1 3 16 6 3 11 3 Rotary Ambulance Commercial Own AGE Other Wing flight transport DCI/DCS Fatality Barotrauma Trip advisory MedicationNon-diving query related Diving-relatedFitness-to-dive trauma query 79 Hazardous marine life injury Incident Insight Barotrauma in Bonaire ©iStock.com/yodiyim By Lana Sorrell, EMT, DMT Recognising the symptoms of pulmonary barotrauma is essential for your diving safety. People with lung conditions which can increase the risk of pulmonary barotrauma are advised to avoid diving. Learn about the causes and effects and consult with a diving doctor before an incident occurs. THE DIVER his voice, a sore throat and crackles under the skin of On a recent trip to Bonaire with his dive club, Rick (a his neck. pseudonym) was completing his fourth dive of the day, A year before, when Rick had just completed the which was his 14th dive in a three-day series and his 145th second dive of his wreck diver course, he surfaced lifetime dive. Certified approximately two years prior, Rick completely exhausted, with a burning sensation in his was 38 years old and in good health, with no significant throat. After he had removed his gear, he noticed a change medical history except what he described as “athlete’s in his voice and what he described as water under the skin asthma” as a child. of his neck. Others in his group disregarded his symptoms as bad gas or water in the ears. That evening, he took an THE INCIDENT over-the-counter pain reliever and a Benadryl and went to Before beginning his third dive of the day, Rick’s chest felt bed early. All his symptoms had resolved by the following tight. He discounted it as a result of the leftover pizza he morning and he completed the last two dives of the had eaten for lunch and even mentioned that he needed to certification without any problems. take an antacid. The chest discomfort resolved during the boat ride to the dive site, so he proceeded with the dive, THE DIAGNOSIS descending to a maximum depth of 15 m. He took many Back on Bonaire, a doctor at the local hospital performed a photographs during the dive and occasionally turned upside complete neurological assessment of Rick and diagnosed down to see inside the reef. pulmonary barotrauma (pressure injury to the lungs) and After he had surfaced from his uneventful fourth dive, subcutaneous emphysema (air under the skin). The chest 80 Rick boarded the boat and immediately noticed a change in X-ray was unremarkable. The treating physician noted no Incident Insight complications besides the subcutaneous emphysema in the aggravated by deep breathing, swallowing, movement of the neck, which did not affect the airway, so he administered neck or trunk, coughing or lying flat. Voice changes, such as high-flow oxygen and allowed Rick to return to his resort. the “Donald Duck” voice that results from breathing helium, A CT scan the following day revealed abundant mediastinal are also common.
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