Decompression Illness in Cave Divers
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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. -
The Use of Heliox in Treating Decompression Illness
The Diving Medical Advisory Committee DMAC, Eighth Floor, 52 Grosvenor Gardens, London SW1W 0AU, UK www.dmac-diving.org Tel: +44 (0) 20 7824 5520 [email protected] The Use of Heliox in Treating Decompression Illness DMAC 23 Rev. 1 – June 2014 Supersedes DMAC 23, which is now withdrawn There are many ways of treating decompression illness (DCI) at increased pressure. In the past 20 years, much has been published on the use of oxygen and helium/oxygen mixtures at different depths. There is, however, a paucity of carefully designed scientific studies. Most information is available from mathematical models, animal experiments and case reports. During a therapeutic compression, the use of a different inert gas from that breathed during the dive may facilitate bubble resolution. Gas diffusivity and solubility in blood and tissue is expected to play a complex role in bubble growth and shrinkage. Mathematical models, supported by some animal studies, suggest that breathing a heliox gas mixture during recompression could be beneficial for nitrogen elimination after air dives. In humans, diving to 50 msw, with air or nitrox, almost all cases of DCI can be adequately treated at 2.8 bar (18 msw), where 100% oxygen is both safe and effective. Serious neurological and vestibular DCI with only partial improvements during initial compression at 18 msw on oxygen may benefit from further recompression to 30 msw with heliox 50:50 (Comex therapeutic table 30 – CX30). There have been cases successfully treated on 50:50 heliox (CX30), on the US Navy recompression tables with 80:20 and 60:40 heliox (USN treatment table 6A) instead of air and in heliox saturation. -
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 -
Title: Drowning and Therapeutic Hypothermia: Dead Man Walking
Title: Drowning and Therapeutic Hypothermia: Dead Man Walking Author(s): Angela Kavenaugh, D.O., Jamie Cohen, D.O., Jennifer Davis MD FAAP, Department of PICU Affiliation(s): Chris Evert Children’s Hospital, Broward Health Medical Center ABSTRACT BODY: Background: Drowning is the second leading cause of death in children and is associated with severe morbidity and mortality, most often due to hypoxic-ischemic encephalopathy. Those that survive are often left with debilitating neurological deficits. Therapeutic Hypothermia after resuscitation from ventricular fibrillation or pulseless ventricular tachycardia induced cardiac arrest is the standard of care in adults and has also been proven to have beneficial effects that persist into early childhood when utilized in neonatal birth asphyxia, but has yet to be accepted into practice for pediatrics. Objective: To present supportive evidence that Therapeutic Hypothermia improves mortality and morbidity specifically for pediatric post drowning patients. Case Report: A five year old male presented to the Emergency Department after pool submersion of unknown duration. He was found to have asphyxial cardiac arrest and received bystander CPR, which was continued by EMS for a total of 10 minutes, including 2 doses of epinephrine. CPR continued into the emergency department. Upon presentation to the ED, he was found to have fixed and dilated pupils, unresponsiveness, with a GCS of 3. Upon initial pulse check was found to have return of spontaneous circulation, with sinus tachycardia. His blood gas revealed 6.86/45/477/8/-25. He was intubated, given 2 normal saline boluses and 2 mEq/kg of Sodium Bicarbonate. The initial head CT was normal. -
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 -
Traveler Information
Traveler Information QUICK LINKS Marine Hazards—TRAVELER INFORMATION • Introduction • Risk • Hazards of the Beach • Animals that Bite or Wound • Animals that Envenomate • Animals that are Poisonous to Eat • General Prevention Strategies Traveler Information MARINE HAZARDS INTRODUCTION Coastal waters around the world can be dangerous. Swimming, diving, snorkeling, wading, fishing, and beachcombing can pose hazards for the unwary marine visitor. The seas contain animals and plants that can bite, wound, or deliver venom or toxin with fangs, barbs, spines, or stinging cells. Injuries from stony coral and sea urchins and stings from jellyfish, fire coral, and sea anemones are common. Drowning can be caused by tides, strong currents, or rip tides; shark attacks; envenomation (e.g., box jellyfish, cone snails, blue-ringed octopus); or overconsumption of alcohol. Eating some types of potentially toxic fish and seafood may increase risk for seafood poisoning. RISK Risk depends on the type and location of activity, as well as the time of year, winds, currents, water temperature, and the prevalence of dangerous marine animals nearby. In general, tropical seas (especially the western Pacific Ocean) are more dangerous than temperate seas for the risk of injury and envenomation, which are common among seaside vacationers, snorkelers, swimmers, and scuba divers. Jellyfish stings are most common in warm oceans during the warmer months. The reef and the sandy sea bottom conceal many creatures with poisonous spines. The highly dangerous blue-ringed octopus and cone shells are found in rocky pools along the shore. Sea anemones and sea urchins are widely dispersed. Sea snakes are highly venomous but rarely bite. -
Exploration/Survey in Whigpistle Cave System Patricia Kambesis Cave Research Foundation, [email protected]
Western Kentucky University TopSCHOLAR® Mammoth Cave Research Symposia 10th Research Symposium 2013 Feb 15th, 10:45 AM The akM ing of a Connection: Exploration/Survey in Whigpistle Cave System Patricia Kambesis Cave Research Foundation, [email protected] Joel Despain Cave Research Foundation Chris Groves Hoff am n Environmental Research Institute, Western Kentucky University Follow this and additional works at: http://digitalcommons.wku.edu/mc_reserch_symp Part of the Animal Sciences Commons, Forest Sciences Commons, Geology Commons, Hydrology Commons, Other Earth Sciences Commons, and the Plant Sciences Commons Recommended Citation Patricia Kambesis, Joel Despain, and Chris Groves, "The akM ing of a Connection: Exploration/Survey in Whigpistle Cave System" (February 15, 2013). Mammoth Cave Research Symposia. Paper 8. http://digitalcommons.wku.edu/mc_reserch_symp/10th_Research_Symposium_2013/Day_two/8 This is brought to you for free and open access by TopSCHOLAR®. It has been accepted for inclusion in Mammoth Cave Research Symposia by an authorized administrator of TopSCHOLAR®. For more information, please contact [email protected]. The Making of a Connection – The Potential of a Mammoth Cave System-Whigpistle Cave Connection 1 1 2 Patricia Kambesis , Joel Despain , Chris Groves 1 Cave Research Foundation 2 Hoff man Environmental Research Institute, Western Kentucky University Abstract The current length of the Flint Ridge-Mammoth Cave System (to be called Mammoth Cave System for the rest of this paper) has been attained by a series of connections instigated by cave explorers/mappers of the Cave Research Foundation (CRF) and Central Kentucky Karst Coalition (CKKC). Between 1961 and 2011, connections have expanded the surveyed extent of the cave system to its current “offi cial” length of 390 miles (650 km). -
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 ................................................................................................. -
Asphyxia Neonatorum
CLINICAL REVIEW Asphyxia Neonatorum Raul C. Banagale, MD, and Steven M. Donn, MD Ann Arbor, Michigan Various biochemical and structural changes affecting the newborn’s well being develop as a result of perinatal asphyxia. Central nervous system ab normalities are frequent complications with high mortality and morbidity. Cardiac compromise may lead to dysrhythmias and cardiogenic shock. Coagulopathy in the form of disseminated intravascular coagulation or mas sive pulmonary hemorrhage are potentially lethal complications. Necrotizing enterocolitis, acute renal failure, and endocrine problems affecting fluid elec trolyte balance are likely to occur. Even the adrenal glands and pancreas are vulnerable to perinatal oxygen deprivation. The best form of management appears to be anticipation, early identification, and prevention of potential obstetrical-neonatal problems. Every effort should be made to carry out ef fective resuscitation measures on the depressed infant at the time of delivery. erinatal asphyxia produces a wide diversity of in molecules brought into the alveoli inadequately com Pjury in the newborn. Severe birth asphyxia, evi pensate for the uptake by the blood, causing decreases denced by Apgar scores of three or less at one minute, in alveolar oxygen pressure (P02), arterial P02 (Pa02) develops not only in the preterm but also in the term and arterial oxygen saturation. Correspondingly, arte and post-term infant. The knowledge encompassing rial carbon dioxide pressure (PaC02) rises because the the causes, detection, diagnosis, and management of insufficient ventilation cannot expel the volume of the clinical entities resulting from perinatal oxygen carbon dioxide that is added to the alveoli by the pul deprivation has been further enriched by investigators monary capillary blood. -
Caverns Measureless to Man: Interdisciplinary Planetary Science & Technology Analog Research Underwater Laser Scanner Survey (Quintana Roo, Mexico)
Caverns Measureless to Man: Interdisciplinary Planetary Science & Technology Analog Research Underwater Laser Scanner Survey (Quintana Roo, Mexico) by Stephen Alexander Daire A Thesis Presented to the Faculty of the USC Graduate School University of Southern California In Partial Fulfillment of the Requirements for the Degree Master of Science (Geographic Information Science and Technology) May 2019 Copyright © 2019 by Stephen Daire “History is just a 25,000-year dash from the trees to the starship; and while it’s going on its wild and woolly but it’s only like that, and then you’re in the starship.” – Terence McKenna. Table of Contents List of Figures ................................................................................................................................ iv List of Tables ................................................................................................................................. xi Acknowledgements ....................................................................................................................... xii List of Abbreviations ................................................................................................................... xiii Abstract ........................................................................................................................................ xvi Chapter 1 Planetary Sciences, Cave Survey, & Human Evolution................................................. 1 1.1. Topic & Area of Interest: Exploration & Survey ....................................................................12 -
DIVEMASTER Love Scuba Diving? Want to Share It with Others on a Whole New Level? Take the PADI Divemas- Ter Course and Do What You Love to Do As a Career
DIVEMASTER Love scuba diving? Want to share it with others on a whole new level? Take the PADI Divemas- ter course and do what you love to do as a career. Scuba divers look up to Divemasters because they are leaders who mentor and motivate others. As a Divemaster, you not only get to dive a lot, but also experience the joy of seeing others have as much fun diving as you do. The PADI Divemaster course is your first level of professional training. Working closely with a PADI Instructor, you’ll fine tune your dive skills like perfecting the effortless hover, and refine your rescue skills so you anticipate and easily solve common problems. You’ll gain dive knowledge, management and supervision abilities so you become a role model to divers everywhere. As a PADI Divemaster, you’ll lead others as you supervise scuba diving activities and assist with diver training. Whether you want to work at a faraway dive destination or close to home at a local dive shop, the adventure of a lifetime awaits you. PADI Divemasters are respected dive professionals who are aligned with the largest and most respected dive organization in the world—PADI. Who should take this course? Be at least 18 years of age or older. Have a PADI Rescue Diver certification (or have a qualifying certifi- cation from another organization). Emergency First Response Primary & Secondary Care training within the last 24 months. What will I learn? The role & characteristics of a Divemaster. Mapping an open water site. Supervising dive activities and assisting with Conducting dive briefings student divers.