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Decompression Illness in Cave Divers This copy of Diving and Hyperbaric Medicine is for personal use only. Distribution is prohibited by Copyright Law. The Journal of the South Pacifi c Underwater Medicine Society and the European Underwater and Baromedical Society Volume 45 No. 3 September 2015 Decompression illness in cave divers Middle ear barotrauma and language of instruction Australian diving-related fatalities 2010 Cardiac disease in UK divers Cone shell envenomation Underwater blast injury Oro-facial barotrauma Print Post Approved PP 100007612 ISSN 1833-3516, ABN 29 299 823 713 This copy of Diving and Hyperbaric Medicine is for personal use only. Distribution is prohibited by Copyright Law. Diving and Hyperbaric Medicine Volume 45 No. 3 September 2015 PURPOSES OF THE SOCIETIES To promote and facilitate the study of all aspects of underwater and hyperbaric medicine To provide information on underwater and hyperbaric medicine To publish a journal and to convene members of each Society annually at a scientifi c conference SOUTH PACIFIC UNDERWATER EUROPEAN UNDERWATER AND MEDICINE SOCIETY BAROMEDICAL SOCIETY OFFICE HOLDERS OFFICE HOLDERS President President David Smart <[email protected]> Costantino Balestra <[email protected]> Past President Vice President Michael Bennett <[email protected]> Jacek Kot <[email protected]> Secretary Immediate Past President Douglas Falconer <[email protected]> Peter Germonpré <[email protected]> Treasurer Past President Peter Smith <[email protected]> Alf Brubakk <[email protected]> Education Offi cer Honorary Secretary David Wilkinson <[email protected]> Peter Germonpré <[email protected]> Chairman ANZHMG Member-at-Large 2014 John Orton <[email protected]> Robert van Hulst <[email protected]> Committee Members Member-at-Large 2013 Denise Blake <[email protected]> Pierre Lafère <[email protected]> Simon Mitchell <[email protected]> Member-at-Large 2012 Janine Gregson <[email protected]> Lesley Blogg <[email protected]> Webmaster Liaison Offi cer Joel Hissink <[email protected]> Phil Bryson <[email protected]> ADMINISTRATION ADMINISTRATION Membership Honorary Treasurer and Membership Secretary Steve Goble <[email protected]> Patricia Wooding <[email protected]> 16 Burselm Avenue, Hainault, Ilford MEMBERSHIP Essex, IG6 3EH, United Kingdom For further information on SPUMS and to complete a membership Phone & Fax: +44-(0)20-85001778 application, go to the Society’s website: <www.spums.org.au> The offi cial address for SPUMS is: MEMBERSHIP c/o Australian and New Zealand College of Anaesthetists, For further information on EUBS and to complete a membership 630 St Kilda Road, Melbourne, Victoria 3004, Australia application, go to the Society’s website: <www.eubs.org> SPUMS is incoprorated in Victoria A0020660B DIVING AND HYPERBARIC MEDICINE <www.dhmjournal.com> Editor: Editorial Board: Michael Davis <[email protected]> Michael Bennett, Australia P O Box 35 Alf Brubakk, Norway Tai Tapu 7645 David Doolette, USA New Zealand Peter Germonpré, Belgium Phone: +64-(0)3-329-6857 Jane Heyworth, Australia Jacek Kot, Poland European (Deputy) Editor: Simon Mitchell, New Zealand Lesley Blogg <[email protected]> Claus-Martin Muth, Germany Editorial Assistant: Neal Pollock, USA Nicky McNeish <[email protected]> Monica Rocco, Italy Journal distribution: Martin Sayer, United Kingdom Steve Goble <[email protected]> Erika Schagatay, Sweden David Smart, Australia Journal submissions: Robert van Hulst, The Netherlands Submissions should be made at http://www.manuscriptmanager.com/dhm Diving and Hyperbaric Medicine is published jointly by the South Pacifi c Underwater Medicine Society and the European Underwater and Baromedical Society (ISSN 1833-3516, ABN 29 299 823 713) This copy of Diving and Hyperbaric Medicine is for personal use only. Distribution is prohibited by Copyright Law. Diving and Hyperbaric Medicine Volume 45 No.3 September 2015 145 The Editor’s offering Barotrauma from pressure changes, decompression sickness and its management.3 From a clinical standpoint, the take- related to inert gas kinetics, toxic marine organisms, overhead home message is that the neurotoxins released are paralytic environments, cardiovascular disease, stupid decision- and that victims die of asphyxia from acute respiratory making – these are just some of the familiar challenges, failure unless respiratory support is provided promptly and natural and man-made, of entering the underwater world. effi ciently. Medical support providers also need to remember Underwater blast injury, however, is a topic that has not been that victims may be paralysed but conscious – a terrifying previously addressed in this journal and will be unfamiliar experience for them. to all but those with military training. Anyone diving a tropical island and having experienced dynamite fi shing Of particular value in the Blake et al. paper4 on the impact nearby knows how unpleasant is the sensation of the shock of language of instruction on the incidence of middle ear wave even from a relatively distant, small explosion. The barotrauma (MEBt) are a new set of photographs to illustrate review by Lance and Bass1 highlights the surprising lack of the Edmonds classifi cation of MEBt.5 These are of superior consistency in the data and the understanding of the effects quality to the original set of otoscopic photos, two of which of underwater blast. Peer review of this paper generated (grades 1 and 2) on close examination appeared to be controversy amongst ‘experts’ in this fi eld. It appears that the same image, presented with different orientation and such a review has been long overdue and has highlighted colouration but depicting the same tympanic membrane. the need for better research data. References In a large cave diving database, Harris et al. have made considerable efforts to establish a reliable denominator for 1 Lance RM, Bass CR. Underwater blast injury: a review of determining the incidence of decompression illness (DCI).2 standards. Diving Hyperb Med. 2015;45:190-9. The detailed description of their methodologies highlights 2 Harris RJD, Frawley G, Devaney BC, Fock A, Jones AB. A 10-year estimate of the incidence of decompression illness how diffi cult this is to achieve. Nevertheless, they have in a discrete group of recreational cave divers in Australia. demonstrated that well-controlled recreational diving in an Diving Hyperb Med. 2015;45:147-53. overhead environment does not appear to carry any greater 3 Halford ZA, Yu PYC, Likeman RK, Hawley-Molloy risk for DCI than reported in open-water studies. However, JS, Thomas C, Bingham JP. Cone shell envenomation: a small subset of deep, technical dives again highlights the epidemiology, pharmacology and fi rst aid medical care.Diving increased risk of injury from this type of diving, and suggests Hyperb Med. 2015;45:200-7. that more forethought is needed amongst divers involved in 4 Blake DF, Gibbs CR, Commons KH, Brown LH. Middle ear ‘pushing the limits’. This is not to say that we should not barotrauma in a tourist-oriented, condensed open water diver condone such pursuits, any more than other adventure sports. certifi cation course: incidence and effect of language of instruction. Diving Hyperb Med. 2015;45:176-80. 5 Edmonds C, Freeman P, Thomas R,Tonkin J, Blackwood F. Past papers in DHM have reviewed the toxicology of Otological aspects of diving. Sydney: Australian Medical jellyfi sh, especially the box jellyfi sh, Chironex fl exeri, and Publishing Co; 1974. the clinical management of envenomed victims. Halford et al. now provide a useful review of coneFor shell envenomationpersonal use only Michael Davis Editor-in-Chief, Diving and Hyperbaric Medicine Journal Call for expressions of interest – closing date: 31 October 2015 Diving and Hyperbaric Medicine is published jointly by The Editor of the Journal is a prominent position for both the South Pacifi c Underwater Medicine Society (SPUMS) Societies, and the successful applicant is expected to be open and the European Underwater and Baromedical Society minded and adaptable, given the multicultural, multilingual (EUBS). The journal is indexed on Medline, SciSearch® and intercontinental origins of the Societies. and Embase/Scopus. Please forward all enquiries with a curriculum vitae to Expressions of interest are called for the position of Editor- both the SPUMS President, Assoc. Prof. David Smart, in-Chief from 01 January 2016. This is a contracted position <[email protected]> and EUBS President, Asst. Prof. for fi ve (5) years and attracts a modest honorarium. Jacek Kot, <[email protected]> Applicants must have an established academic track record in medicine and experience in editing and publishing peer Front-page photo taken by Richard ‘Harry’ Harris in reviewed journals. Preference will be given to medically Kilsbys Sinkhole, Mount Gambier region. The CCR qualifi ed applicants, given the journal’s track record as a diver is at about 45 m depth, with light from the entrance leading publication in diving medicine. silhouetting him and another diver’s light in the distance. This copy of Diving and Hyperbaric Medicine is for personal use only. Distribution is prohibited by Copyright Law. 146 Diving and Hyperbaric Medicine Volume 45 No. 3 September 2015 The President’s page David Smart, President SPUMS A joint journal Governance Group has been established with EUBS (two members from each Society) in the last 12 It is hard to believe a year has passed since my election months. Although established, it has not yet become fully as President. During the past year we have achieved some operational. This operational capability is required urgently milestones, and have multiple projects underway. I am to guide the governance of the Journal. It will be a focus of pleased to report that SPUMS has continued to grow as coming months for it to get into its stride. an organisation, in size and infl uence, and with a sound fi nancial base. Our relationship with the EUBS continues There is also work being undertaken to create at least one to progress positively.
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