208 Dysbarism and Complications of Diving

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References 1 208 Dysbarism and Complications of Diving REFERENCES 1. Strauss MB, Borer RC: Diving medicine: contemporary topics and their controversies. Am J Emerg Med 19: 232, 2001. 2. Becker GD, Parell GJ: Barotrauma of the ears and sinuses after scuba diving. Euro Arch Otorhinolaryngol 258: 159, 2001. 3. Harker CP, Neuman TS, Olson LK, et al: The roentgenographic findings associated with air embolism in sport SCUBA divers. J Emerg Med 11: 443, 1993. 4. Neuman TS: Arterial gas embolism and decompression sickness. News Physiol Sci 17: 77, 2001. 5. Doolette DJ, Mitchell SJ: The physiologic kinetics of nitrogen and the prevention of decompression sickness. Clin Pharmacokinet 40: 1, 2001. 6. Neuman TS, Bove AA: Combined arterial gas embolism and decompression sickness following no-stop dives. Undersea Biomed Res 17: 429, 1990. 7. Millar I: Post diving altitude exposure. SPUMS J 26: 135, 1996. 8. Newton HB: Neurologic complications of scuba diving. Am Fam Physician 63: 2211, 2001. 9. Grover IR, Reed W, Neuman TS: The SANDHOG criteria and its validation for the diagnosis of DCS arising from bounce diving. Undersea Hyper Med 34: 165, 2007. 10. Martin JD, Thom SR: Vascular leukocyte sequestration in decompression sickness and prophylactic hyperbaric oxygen therapy in rats. Aviat Space Environ Med 73: 565, 2002. 11. Cianci P, Slade JB Jr: Delayed treatment of decompression sickness with short, no-air- break tables: review of 140 cases. Aviat Space Environ Med 77: 1003, 2006. 12. Catron PW, Flynn ET: Adjuvant drug therapy for decompression sickness: a review. Undersea Biomed Res 9: 161, 1982. 13. Dutka AJ, Mink R, McDermott J, et al: Effect of lidocaine on somatosensory evoked response and cerebral blood flow after canine cerebral air embolism. Stroke 23: 1515, 1992. 14. Mitchell SJ, Pellett O, Gorman DF: Cerebral protection by lidocaine during cardiac operations. Ann Thorac Surg 67: 1117, 1999. 15. Mitchell SJ: Lidocaine for the treatment of decompression illness: a review of the liter- ature. Undersea Hyper Med 28: 165, 2001. 16. Tetzlaff K, Muth CM, Waldhauser LK: A review of asthma and scuba diving. J Asthma 39: 557, 2002. 17. Hampson NB, Dunford RG: Pulmonary edema of scuba divers. Undersea Hyper Med 24: 29, 1997. 18. Demchenko IT, Boso AE, O’Neill TJ, et al: Nitric oxide and cerebral blood flow responses to hyperbaric oxygen. J Appl Physiol 88: 1381, 2000. ■ USEFUL WEB RESOURCES Divers Alert Network—http://www.diversalertnetwork.org DAN Japan—http://www.danjapan.gr.jp DAN Europe—http://www.daneurope.org DAN Asia-Pacific—http://www.danasiapacific.org DAN Southern Africa—http://www.dansa.org Undersea and Hyperbaric Medical Society—http://www.uhms.org Copyright © 2010 The McGraw-Hill Companies, Inc. All rights reserved..

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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
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