2018 September;48(3):132−140
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Urinary Problems in Decompression Sickness*
Paraplegia 23 (1985) 20-25 © 1985 International Medical Society of Paraplegia Urinary Problems in Decompression Sickness* Athanasios Dounis, M.D. and Dionisios Mitropoulos, M.D. The Naval Medical Hyperbaric Center) Piraeus Naval Hospital and Department of Urology) Athens Naval Hospital) Greece Summary The records of 25 patients with type II decompression sickness and urinary problems have been reviewed. Seventeen patients were professionals and 8 were above the age of 40. The disease appeared within the 1st hour of emergence from the water in 70% of the cases and within the first 4 hours in the remaining 30%. Nine patients were diagnosed as paraplegic and two as tetraplegic. All patients had urinary disturbances and 14 were on Foley-catheter drainage during the decompression while 11 were on intermittent catheterisation. Fifteen patients had improved urinary function after recompression) 8 had some difficulty) 2 underwent a sphincterotomy and one a transurethral prostatectomy. The low percentage of complete recovery was due to the delayed arrival at the decompression chamber. Key words: Diving; Decompression sickness; Urinary disturbances. Introduction Diving for sponge fishery is the main professional occupation of the young men in the South-East Aegean islands. Although the use of recompression has decreased the number of decompression sickness victims, patients with remaining neurological problems still present. During the last 20 years, although there is a decrease of the professional divers' accidents there is an increase of the number of patients with decompression sickness. This is due to the continuously increasing numbers of sport divers in Greece. In Greece, the field of underwater medicine is covered mainly by the Naval Medical Service. -
Mansfield, NG18 2AD to the Editor: Dear Sir, VERTIGO in DIVERS Thank You for Asking for My Comments on Noel Roydhouse's Letter Which I Have Read with Interest
Br J Sports Med: first published as 10.1136/bjsm.17.3.210 on 1 September 1983. Downloaded from 210 CORRESPONDENCE 14 Woodhouse Road, Mansfield, NG18 2AD To the Editor: Dear Sir, VERTIGO IN DIVERS Thank you for asking for my comments on Noel Roydhouse's letter which I have read with interest. He is technically correct in stating that vertigo is not inevitable when the tympanic membrane ruptures. Vertigo is not dependent on the size of perforation that is sustained, but is dependent on the rate of ingress of cold water into the tympanic cavity. The caloric effect produced by rapid ingress of water is entirely dependent on the temperature difference between the water that has entered the tympanic cavity and body temperature. Once the water temperature reaches approximate body temperature then the caloric effect ceases as does the vertigo. As ENT surgeons we use this caloric phenomenon for testing labyrinthine function (vestibular function); and under test conditions we use water at 300C and 440C, in ears with intact tympanic membranes, in order to induce a vertigo. If an article were to be directed at "diving doctors" I think that it would be fair comment for it to be stated that a vertigo sustained on descent should be assumed to be due to a tympanic membrane rupture with rapid ingress of water, until proven otherwise, by inspection of the ear; if the tympanic membrane is found to be intact, then a diagnosis of perilymph fistula must be made, which will only be proved or disproved by performing an exploratory tympanotomy. -
Hyperbaric Physiology the Rouse Story Arrival at Recompression
Hyperbaric Physiology The Rouse Story • Oct 12, 1992, off the New Jersey coast • father/son team of experienced divers • explore submarine wreck in 230 ft (70 m) • breathing compressed air • trapped in wreck & escaped with no time for decompression Chris and Chrissy Rouse Arrival at recompression Recompression efforts facility • Both divers directly ascend to dive boat • Recompression starts about 3 hrs after • Helicopter arrives at boat in 1 hr 27 min ascent • Bronx Municipal Hospital recompression facility – put on pure O2 and compressed to 60 ft – Chris (39 yrs) pronounced dead • extreme pain as circulation returned – compressed to 165 ft, then over 5.5 hrs – Chrissy (22 yrs) gradually ascended back to 30 ft., lost • coherent and talking consciousness • paralysis from chest down • no pain – back to 60 ft. Heart failure and death • blood sample contained foam • autopsy revealed that the heart contained only foam Medical Debriefing Gas Laws • Boyle’s Law • Doctors conclusions regarding their – P1V1 = P2V2 treatment • Dalton’s Law – nothing short of recompression to extreme – total pressure is the sum of the partial pressures depths - 300 to 400 ft • Henry’s Law – saturation treatment lasting several days – the amt of gas dissolved in liquid at any temp is – complete blood transfusion proportional to it’s partial pressure and solubility – deep helium recompression 1 Scuba tank ~ 64 cf of air Gas problems during diving Henry, 1 ATM=33 ft gas (10 m) dissovled = gas Pp & tissue • Rapture of the deep (Nitrogen narcosis) solubility • Oxygen -
Full Paper/Talk Deep Stops and Shallow Stops – Fact and Fancy
Full Paper/Talk Deep Stops and Shallow Stops – Fact and Fancy B.R. Wienke1 and T.R. O’Leary2 1 C&C Dive Team Ldr, Program Manager Computational Physics, LANL, MS D490, Los Alamos, NM 87545 [email protected] 2 Director, NAUI Technical Diving Operations, 33256 State Rd 100, South Padre Island, TX, 78597 Abstract The question of deep stops and shallow stops is interesting and fraught with controversy in diving circles and operations, training, exploration and scientific endeavors. Plus frought with some misunderstanding which is understandable as the issues are complex. We therefore attempt a short history of deep and shallow stops, physical aspects, staging differences, diving tests, models with data correlations and data banks with user statistics and DCS outcomes as diver amplification. Pros and cons of both deep stop and shallow stop staging are presented. Misfacts are righted when appropriate. Chamber, wet and Doppler tests are contrasted. A compendium of Training Agency Standards regarding deep and shallow stops is included. Dive software is also detailed. Some commercial diving operations are discussed. A short tabulation of dive computer and software algorithms is given. From diving data, tests, DCS outcomes and field usage, we conclude that both deep stops and shallow stops are safely employed in recreational and technical diving. That is a good thing but choose your deco wisely and know why. Keywords: computational models, decompression staging, profile data, risk, statistical correlations, tests Acronyms and Nomenclature ANDI: Association of Nitrox Diving Instructors. BM: bubble phase model dividing the body into tissue compartments with halftimes that are coupled to inert gas diffusion across bubble film surfaces of exponential size distribution constrained in cumulative growth by a volume limit point. -
Lake Huron Scuba Diving
SOUTHERN LAKE ASSESSMENT SOUTHERN RECREATION PROFILE LAKE Scuba Diving: OPPORTUNITIES FOR LAKE HURON ASSESSMENT FINGER LAKES SCUBA LAKES FINGER The southern Lake Huron coast is a fantastic setting for outdoor exploration. Promoting the region’s natural assets can help build vibrant communities and support local economies. This series of fact sheets profiles different outdoor recreation activities that could appeal to residents and visitors of Michigan’s Thumb. We hope this information will help guide regional planning, business develop- ment and marketing efforts throughout the region. Here we focus on scuba diving – providing details on what is involved in the sport, who participates, and what is unique about diving in Lake Huron. WHY DIVE IN LAKE HURON? With wildlife, shipwrecks, clear water and nearshore dives, the waters of southern Lake Huron create a unique environment for scuba divers. Underwater life abounds, including colorful sunfish and unusual species like the longnose gar. The area offers a large collection of shipwrecks, and is home to two of Michigan’s 12 underwater preserves. Many of the wrecks are in close proximity to each other and are easily accessed by charter or private boat. The fresh water of Lake Huron helps to preserve the wrecks better than saltwater, and the lake’s clear water offers excellent visibility – often up to 50 feet! With many shipwrecks at different depths, the area offers dives for recreational as well as technical divers. How Popular is Scuba Diving? Who Scuba Dives? n Scuba diving in New York’s Great Lakes region stimulated more than $108 In 2010, 2.7 million Americans went scuba A snapshot of U.S. -
Heat Stroke Heat Exhaustion
Environmental Injuries Co lin G. Ka ide, MD , FACEP, FAAEM, UHM Associate Professor of Emergency Medicine Board-Certified Specialist in Hyperbaric Medicine Specialist in Wound Care The Ohio State University Wexner Medical Center The Most Dangerous Drug Combination… Accidental Testosterone Hypothermia and Alcohol! The most likely victims… Photo: Ralf Roletschek 1 Definition of Blizzard Hypothermia of Subnormal T° when the body is unable to generate sufficient heat to sustain normal functions Core Temperature < 95°F 1979 (35°C) Most Important Temperatures Thermoregulation 95°F (35° C) Hyper/Goofy The body uses a Poikilothermic shell to maintain a Homeothermic core 90°F (32°C) Shivering Stops Maintains core T° w/in 1.8°F(1°C) 80°F (26. 5°C) Vfib, Coma Hypothalamus Skin 65°F (18°C) Asystole Constant T° 96.896.8-- 100.4° F 2 Thermoregulation The 2 most important factors Only 3 Causes! Shivering (10x increase) Decreased Heat Production Initiated by low skin temperature Increased Heat Loss Warming the skin can abolish Impaired Thermoregulation shivering! Peripheral vasoconstriction Sequesters heat Predisposing Predisposing Factors Factors Decreased Production Increased Loss –Endocrine problems Radiation Evaporation • Thyroid Conduction* • Adrenal Axis Convection** –Malnutrition *Depends on conducting material **Depends on wind velocity –Neuromuscular disease 3 Predisposing Systemic Responses CNS Factors T°< 90°F (34°C) Impaired Regulation Hyperactivity, excitability, recklessness CNS injury T°< 80°F (27°C) Hypothalamic injuries Loss of voluntary -
Dr Craig Challen SC OAM
Dr Craig Challen SC OAM Australian of the Year 2019, Thai Cave Rescue Diver, Aviator and Keynote Speaker Dr Craig Challen was named Australian of the Year 2019 in recognition of his work to rescue 12 young soccer players and their coach from a flooded Thai cave in Chiang Rai, Thailand in July 2018. Craig is in high demand as a keynote speaker. He presents alone or in partnership with fellow cave rescue diver Dr Richard Harris. An internationally recognised diver, a former vet, CEO and keen aviator, Craig is able to tailor his presentations to suit the audience and is available for question and answer sessions. More about Dr Craig Challen: Craig was about to go on a caving holiday in the Nullarbor Plains, when he was called to help the rescue mission based on his technical expertise. Although he initially thought the rescue would be too difficult to accomplish, he played a leading role in the successful mission. Working 10 to 12 hours a day in extremely dangerous conditions, he repeatedly risked his life as the children were swum, one by one, through the dark and narrow flooded caves. Craig was awarded the Star of Courage for his unwavering and selfless bravery. In 2019 he was recognised as Australian of the Year for Western Australia. One of Australia’s leading technical divers, Craig is a member of the Wet Mules, a diving group that takes on some of the world’s deepest caves. After commencing cave diving in the 1990s he was an early adopter of closed-circuit mixed gas rebreathers. -
BSAC Membership Handbook | 2 Your BSAC Membership Handbook | 3 Contact Information
Cover Photo: Simon Rogerson Cover Your BSAC Membership Handbook | 2 BSAC has 1,000+ branches, is run by volunteers and is the biggest dive club in Britain. Thank you for being part of it. We hope this Membership Handbook will help you get the most out of being part of the club… Photo: Nicholas Watson Your BSAC Membership Handbook | 2 Your BSAC Membership Handbook | 3 Contact information: BSAC, Telford's Quay, South Pier Road, Ellesmere Port, Cheshire CH65 4FL W: bsac.com E: [email protected] T: +44 (0)151 350 6200 facebook.com/BritishSubAquaClub twitter.com/BSACdivers BSAC is proud to be in partnership with: Photo: Charles Hood Your BSAC Membership Handbook | 4 CONTENTS Discover more about your BSAC membership inside… Welcome from Mary ................................ 7 Your membership benefits ......................47 BSAC’s Chief Executive Insurance cover Magazine and email newsletters Tips to make the most of BSAC Shop your membership ..................................... 9 Save money with… – Scuba Financial Services BSAC clubs .......................................... 13 – BSAC Travel Partners (sometimes called branches) – BSAC Plus What to expect Working for you ..................................... 55 Diving and training .................................17 Safety and training Training and instructing opportunities Marine conservation Safe diving Underwater heritage Safeguarding children and vulnerable adults Welcome PADI (and other agency) divers ...................... 37 Support for clubs................................... 59 Getting -
Giant Stride
OZDIVER October/ December 2018 AUSTRALIA’S PREMIER DIVE MAGAZINE IT IS THE JOURNEY AND NOT THE DESTINATION - WWW.OZDIVER.COM.AU THE DESTINATION NOT AND JOURNEY IT IS THE CHRISTMAS ISLAND THE SALEM EXPRESS TO DIVE OR NOT SHARKS REBREATHER CLEANING TECHNICAL STATIONS TRAINING NORTHERN SULAWESI MANADO TO LEMBEH O ctober / ctober / D ecember 2018 ecember FREE Digital Diving Magazine - www.ozdiver.com.au -They don’t care what they eat on the trip, as long as the diving is good. -They don’t care how far they have to travel in order to blow some bubbles. -They care for the environment. Editor-in-chief -They will dive, no matter how big the Johan Boshoff party was last night. [email protected] -They become grumpy if they haven’t Marketing Editor’s [email protected] dived for a couple of weeks. + 61 (00) 44 887 9903 Photographer Believe me, I meet interesting divers in Christopher Bartlett & David Caravias Deco Stop my line of work – divers who go and sit in a swimming pool once a week just to blow Contributing Editor Irene Groenewald Johan Boshoff bubbles, because the ocean is too far. Who Having met many interesting people on take better care of their diving equipment Proof Readers my dive travels, I’ve realised that divers Irene Groenewald than most other possessions they own. Charlene Nieuwoudt are a unique breed. It doesn’t matter what Diving is the only lifestyle they know and Izak Nieuwoudt language they speak or what culture they they live every day to dive. -
Dysbarism - Barotrauma
DYSBARISM - BAROTRAUMA Introduction Dysbarism is the term given to medical complications of exposure to gases at higher than normal atmospheric pressure. It includes barotrauma, decompression illness and nitrogen narcosis. Barotrauma occurs as a consequence of excessive expansion or contraction of gas within enclosed body cavities. Barotrauma principally affects the: 1. Lungs (most importantly): Lung barotrauma may result in: ● Gas embolism ● Pneumomediastinum ● Pneumothorax. 2. Eyes 3. Middle / Inner ear 4. Sinuses 5. Teeth / mandible 6. GIT (rarely) Any illness that develops during or post div.ing must be considered to be diving- related until proven otherwise. Any patient with neurological symptoms in particular needs urgent referral to a specialist in hyperbaric medicine. See also separate document on Dysbarism - Decompression Illness (in Environmental folder). Terminology The term dysbarism encompasses: ● Decompression illness And ● Barotrauma And ● Nitrogen narcosis Decompression illness (DCI) includes: 1. Decompression sickness (DCS) (or in lay terms, the “bends”): ● Type I DCS: ♥ Involves the joints or skin only ● Type II DCS: ♥ Involves all other pain, neurological injury, vestibular and pulmonary symptoms. 2. Arterial gas embolism (AGE): ● Due to pulmonary barotrauma releasing air into the circulation. Epidemiology Diving is generally a safe undertaking. Serious decompression incidents occur approximately only in 1 in 10,000 dives. However, because of high participation rates, there are about 200 - 300 cases of significant decompression illness requiring treatment in Australia each year. It is estimated that 10 times this number of divers experience less severe illness after diving. Physics Boyle’s Law: The air pressure at sea level is 1 atmosphere absolute (ATA). Alternative units used for 1 ATA include: ● 101.3 kPa (SI units) ● 1.013 Bar ● 10 meters of sea water (MSW) ● 760 mm of mercury (mm Hg) ● 14.7 pounds per square inch (PSI) For every 10 meters a diver descends in seawater, the pressure increases by 1 ATA. -
Aerospace Physiology
AEROSPACE PHYSIOLOGY ALTITUDE CHAMBER Human Factors in Flight Introductory Course Manual Revised: March 30, 2009 TABLE OF CONTENTS INTRODUCTION ............................................................................................................ v SYMBOLS USED ............................................................................................................ vi CHAPTER I PHYSICS OF THE ATMOSPHERE ............................................................... 1 Objectives ................................................................................................. 1 Functions of the Atmosphere .................................................................... 1 Main Component Gases and Percentages ................................................. 1 Atmospheric Pressure ............................................................................... 2 Measurement of Altitude .......................................................................... 2 Physical Divisions of the Atmosphere ...................................................... 3 Physiological Divisions of the Atmosphere .............................................. 4 The Gas Laws ........................................................................................... 5 II RESPIRATION/CIRCULATION .................................................................... 7 Objectives ................................................................................................. 7 Definition ................................................................................................. -
Deadly Acute Decompression Sickness in Risso's Dolphins
www.nature.com/scientificreports OPEN Deadly acute Decompression Sickness in Risso’s dolphins A. Fernández, E. Sierra, J. Díaz-Delgado, S. Sacchini , Y. Sánchez-Paz, C. Suárez-Santana, M. Arregui, M. Arbelo & Y. Bernaldo de Quirós Received: 19 April 2017 Diving air-breathing vertebrates have long been considered protected against decompression sickness Accepted: 5 October 2017 (DCS) through anatomical, physiological, and behavioural adaptations. However, an acute systemic gas Published: xx xx xxxx and fat embolic syndrome similar to DCS in human divers was described in beaked whales that stranded in temporal and spatial association with military exercises involving high-powered sonar. More recently, DCS has been diagnosed in bycaught sea turtles. Both cases were linked to human activities. Two Risso’s dolphin (Grampus griseus) out of 493 necropsied cetaceans stranded in the Canary Islands in a 16-year period (2000–2015), had a severe acute decompression sickness supported by pathological fndings and gas analysis. Deadly systemic, infammatory, infectious, or neoplastic diseases, ship collision, military sonar, fsheries interaction or other type of lethal inducing associated trauma were ruled out. Struggling with a squid during hunting is discussed as the most likely cause of DCS. Pathologies related to efects of changes in pressure are well known among human divers. Decompression sick- ness (DCS) is a syndrome related to the formation of gas bubbles in blood and/or tissues when the sum of the dissolved gas tensions exceeds the local absolute pressure. Gas bubbles may have biochemical efects and disrupt the tissues or occlude the vessels with clinical and pathological signs and, in certain cases, death1.