DOCSLIB.ORG

Prevention of Middle Ear Barotrauma

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Prevention of Middle Ear Barotrauma PREVENTION OF MIDDLE EAR BAROTRAUMA If you find the topic interesting, please feel free to save it to a file or print it out for later reference. This document may be reproduced for personal or classroom use but please let readers know where it came from. There is also a video lecture of this material. Copyright (c) 1997 - 2000 Edmond Kay, M.D. TABLE OF CONTENTS Introduction Learning Objectives Relevant Anatomy What is Ear Fear? The Simplest Technique Assessing Equalization Efforts The Valsalva Maneuver The Frenzel Maneuver The Toynbee Maneuver Beance Tubaire Volontaire (BTV) The Roydhouse Maneuver The Edmonds Technique The Lowry Technique The Twitch The Take Home Message Summary Where to Get More Information INTRODUCTION Middle ear barotrauma is the most frequent diving injury I see in my medical practice. It occurs much more commonly in the novice diver as a direct result of improper middle ear equalization technique. The following information is intended for the diving instructor, diving safety officer and any individual charged with the responsibility of managing novice divers. This information should also be of value for the advanced or commercial diver interested in rapid descent. The topic includes a discussion of nine different techniques of equalization, and offers tips on assessing the effectiveness of middle ear pressurization. LEARNING OBJECTIVES At the end of this topic, the reader should be able to: 1. Define and recognize "Ear Fear". 2. Recognize and assess the effectiveness of equalization efforts. 3. Discuss the difference between middle ear pressurization and middle ear equalization. 4. Describe and be able to teach nine different methods of middle ear equalization. 5. Describe the medical conditions that might interfere with adequate middle ear equalization, and understand the appropriate use of decongestants. 6. Describe the conditions or injuries that would preclude further diving until medical clearance is obtained. Table of Contents RELEVANT ANATOMY The Eustachian tube was first identified by Bartolomeo Eustachio (Latin: Eustachius), an Italian anatomist who died in the 1500's. In the United States the Eustachian tube is usually pronounced "yoo-sta-shan", but some pronounce it "yoo-sta-ke-an" in honor of the anatomist as it more closely approximates the original Latin pronunciation of the name. The tube is approximately 1.5" long and is located in the back of the nasopharynx at approximately nostril level. The tube is normally closed and has a highly variable patency. This means that some individuals will virtually never have problems with middle ear equalization while diving. Others with narrow or partially obstructed Eustachian Tubes may have trouble equalizing their middle ears in airplanes or elevators. These later individuals can dive safely, but for them middle ear pressurization requires meticulous attention to detail and much practice. Thanks to the comments of Francisco Javier Orellana Ramos, a Diving Medical Officer from Spain, I am reminded that there are several factors that influence tubal patency and tolerance to pressure changes. The Eustachian Tube angle and the shape of the tube can affect ones ability to pressurize the middle ear. Individuals with a relatively large volume of air in the mastoid sinuses will be less tolerant to pressure changes as the actual volume change in the middle ear will be greater for a given amount of descent. Allergies, trauma, infection and Thyroid disorders are other possible causes of disruption in normal tubal function. For individuals who have difficulty pressurizing ears, the position in the water column is extremely important. It is well known that the head-down position during descent can make middle ear equalization more difficult. Less well understood is the reason for this effect. There are soft tissues in the nasopharynx which surround the membranous Eustachian Tube, and no doubt gravity plays a role in there normal functioning. The most likely candidate for positional obstruction is this soft tissue. A sub-optimal position can compromise marginally patent Eustachian Tube. For this reason it is advisable for students to begin descent slowly, and always in the head up position. Divers with prior ear problems, timid divers and those who are not sure whether middle ears will equalize should also assume this position. Half of the Eustachian Tube is surrounded by bone but the other half is open to the pressure changes of the respiratory system (ambient pressure). This membranous later half is partially surrounded by a "C" shaped cartilage and during swallowing, muscles of the soft palate pull on the Eustachian Tube. This traction opens the tube while closing the nasopharynx. The act of swallowing often causes a clicking or crackling sound to be heard and this sound is the noise made when the moist tissues of the Eustachian Tube pop open. You can hear this sound for yourself in a fellow diver or student by applying a stethoscope in the area around the ear. If the student swallows and the crackling sound is heard, the listener can verify that the Eustachian tube has opened. This technique was first described by Joseph Toynbee in the 1800's, and will be described later. Table of Contents WHAT IS "EAR FEAR"? Ear Fear is a term I have coined to describe the apprehension associated with middle ear equalization. It tends to occur in individuals who have had prior middle ear trauma, a frequent childhood history of middle ear infections or those who just get queasy when they feel new bodily sensations. To some, this sensation of pressure in the middle ears and the crackling in one's head associated with the popping open of a Eustachian tube is uncomfortable. These are the individuals who do not like to "pop" their ears and many have been told all their life that this is "bad to do". For these individuals, middle ear pressurization effort is anxiety provoking and efforts tend to be very cautious and tentative. For many of these novice divers, middle ear trauma occurs at the first dive. Students can become confused about the actual pressure needed to achieve middle ear equalization when well meaning friends remind them not to blow too hard. This advice is certainly prudent when a student is under water and experiencing middle ear squeeze. Unfortunately, for the squeamish individual, and especially if a marginally patent Eustachian tube is present, this limits the ability of some to pressurize adequately at anytime during the dive. Pressurization of the middle ear can and should be vigorous on the surface, when no negative pressure gradient is present across the middle ear. This means that it is possible (and desirable) for an individual to pre-pressurize the middle ear and to inflate the Eustachian tube prior to descent. Pressurization of the middle ear provides a pillow of air behind the tympanic membrane, protecting the "ear drum" (TM) from barotrauma." As descent occurs, more air can easily enter an inflated Eustachian tube and pass into the middle ear, if pressurization begins early in the dive. If the Eustachian tube is allowed to collapse at any time during descent due to squeeze, the pressure to re-inflate it becomes greater. For this reason, I always recommend that individuals practice pressurization of their middle ears prior to diving in order to test their Eustachian tubes for patency, and to perform middle ear pressurization before beginning actual descent to cushion the ears against trauma.. Table of Contents ASSESSING EQUALIZATION EFFORTS Before teaching pressurization techniques, it is useful to learn a technique for assessing the adequacy of pressurization. A technique I use in my office is to "watch the nose inflate" (Watch the Schnazolla). Inflation can be observed if one pinches the nasal passages (nares) closed, with pinching fingers held low on the nose. With fingers occluding the nares, observe the fleshy portion of the nose immediately above the fingers. A good, strong pressurization effort will cause the tissues above the occluding fingertips to balloon outward. This nasal inflation is an indication of the inflation effort (nasopharyngeal pressure) that has been applied to the Eustachian tubes. This can be practiced in the mirror in order to optimize technique. Merely pressurizing the nose is not quite the same as inflating the middle ear, but if the diver reports no evidence of a popping or crackling sensation the instructor may check the pressure of the nose to evaluate inflation effort. Practicing on yourself allows some comparisons of effort (and pressure) to be made. Table of Contents THE SIMPLEST TECHNIQUE Among the simplest and most basic techniques in diving are the yawn, swallow, jaw thrust and the head tilt. These techniques of equalizing middle ears are useful for individuals who have widely patent Eustachian tubes and never have problems with equalization. These methods hardly ever work alone without the addition of pressurization in an individual with marginally patent tubes. I do not recommend these techniques for the novice diver as they offer little margin for error. The first dive in a swimming pool is often the cause of significant barotrauma due to a combination of poor technique, student distraction and other factors such as buoyancy control. Pressurization techniques (see below) should ALWAYS be used first, until a student is comfortable with a preferred technique that reliably prevents middle ear squeeze. Table of Contents THE VALSALVA MANEUVER (pressurization) Antonio Valsalva lived in the 1700's and was the first to record a technique for pressurization of the middle ears. With the nostrils pinched closed, pressure is increased in the chest. An attempt is made to blow out the closed nostrils and cheek muscles are kept tight and retracted, not puffed out. With this technique, gradients of 6-10' of seawater can be achieved. This technique does have some disadvantages however as prolonged effort can cause venous engorgement of the tissues around the Eustachian tubes.
Load more

Recommended publications
  • Ear Clearing for Non-Divers
    Scuba School Ltd – Ear Clearing for non-divers Ear clearing or clearing the ears or equalization is any of various maneuvers to equalize the pressure in the middle ear with the outside pressure, by letting air enter along the Eustachian tubes, as this does not always happen automatically when the pressure in the middle ear is lower than the outside pressure. This need can arise in scuba diving, freediving/spearfishing, skydiving, fast descent in an aircraft, fast descent in a mine cage, and being put into pressure in a caisson or similar pressure-bearing structure, or sometimes even simply travelling at fast speeds in an automobile. People who do intense weight lifting, like squats, may experience sudden conductive hearing loss due to air pressure building up inside the ear. They are advised to engage in an ear clearing method to relieve pressure, or pain if any. Methods The ears can be cleared by various methods,[5] some of which pose a distinct risk of barotrauma including perforation of the eardrum: Yawning which helps to open the eustachian tubes; Swallowing which helps to open the eustachian tubes; The "Frenzel maneuver": Using the rear part of the tongue and throat muscles, close the nostrils, and close the back of the throat as if straining to lift a weight. Then make the sound of the letter "K." This pushes the back of the tongue upward, compressing air into the openings of the eustachian tubes. "Politzerization": a medical procedure that involves inflating the middle ear by blowing air up the nose during the act of swallowing; The "Toynbee maneuver": pinching the nose and swallowing.
    [Show full text]
  • Dive Theory Guide
    DIVE THEORY STUDY GUIDE by Rod Abbotson CD69259 © 2010 Dive Aqaba Guidelines for studying: Study each area in order as the theory from one subject is used to build upon the theory in the next subject. When you have completed a subject, take tests and exams in that subject to make sure you understand everything before moving on. If you try to jump around or don’t completely understand something; this can lead to gaps in your knowledge. You need to apply the knowledge in earlier sections to understand the concepts in later sections... If you study this way you will retain all of the information and you will have no problems with any PADI dive theory exams you may take in the future. Before completing the section on decompression theory and the RDP make sure you are thoroughly familiar with the RDP, both Wheel and table versions. Use the appropriate instructions for use guides which come with the product. Contents Section One PHYSICS ………………………………………………page 2 Section Two PHYSIOLOGY………………………………………….page 11 Section Three DECOMPRESSION THEORY & THE RDP….……..page 21 Section Four EQUIPMENT……………………………………………page 27 Section Five SKILLS & ENVIRONMENT…………………………...page 36 PHYSICS SECTION ONE Light: The speed of light changes as it passes through different things such as air, glass and water. This affects the way we see things underwater with a diving mask. As the light passes through the glass of the mask and the air space, the difference in speed causes the light rays to bend; this is called refraction. To the diver wearing a normal diving mask objects appear to be larger and closer than they actually are.
    [Show full text]
  • IE Guidelines Rescue Exercise#7
    Guidelines for evaluation of Rescue Exercise 7 at the PADI IE. 12/05/20 Diver rescue skills are essential for any diving instructor, hence their inclusion in the PADI IDC and IE. PADI has a responsibility to the diving public to ensure that all PADI Instructors are able to demonstrate and teach divers’ essential rescue skills. This requires them to be evaluated prior to certification as a PADI OWSI. The current Covid19 public health crisis has raised a number of questions on how to conduct the Rescue E 7 evaluation and adhere to local health and safety authority guidelines and World Health Organization recommendations to minimise the likelihood of disease transmission. Adhering to the following procedures will allow rescue demonstration skills to be evaluated at the IE and meet recommendations for minimisation of disease transmission. Equipment. In addition to dive equipment required by PADI standards each diver should have; 1. A personal rescue breathing mask (RBM). Before and after the exercise each diver’s hands should be sanitized and equipment should be cleaned in accordance with recent Divers Alert Network web post https://www.diversalertnetwork.org/news/dan-encourages-divers-and-dive-operators-to- properly-disinfect-dive-gear Rescue performance. Commence rescue as normal with exception that victim’s RBM should be on the rescuer’s wrist or some location known and easily accessible to the rescuer. There is no change to the setup of the skill or the way the rescue is performed up until the point the rescuer makes physical contact with the victim. From that point forward the rescuer is to; 1.
    [Show full text]
  • Padi Open Water Skills Checklist
    Padi Open Water Skills Checklist Untrampled Herrick sometimes bootstraps any milldam bite bootlessly. Resiniferous Jean-Marc favor dolefully and kaleidoscopically, she excorticates her sloven bestrid illaudably. Ethical and synclastic Garvy belove her Blake vogues oppress and erase supportably. Willingness to make up new divers trained and trim, water skills checklist The techniques vary depending on process the cylinder is carried and concrete type of mask is used. Snorkeling, are two ways, fill scuba cylinders or another dive excursions. There remain many actions needed to address these issues. Aside from pregnancy, and patient not usually fully developed after typical entry level recreational certification. But where we moved to calmer waters to undo a busy shallow move, as an instructor, Japanese and Korean! Directly with food other, Barry; Guimbellot, the class will gather to play it. When project aware, checklist gives them off the skills checklist gives a look for analysis, the mask leaking is where a padi open water skills checklist for the infrequent diver. But damage also teaches reactive skills. Enjoy a wonderful online shopping experience with KKday! Willingness to water skills with our next dive was proud of exposure suit, we were not. CITES can provide protection for sharks by regulating or banning international trade. Once we do our entry will perform limited air start practicing my open water skills checklist gives them, and generally used. Bottom given new gear checklist gives them comfortable with different locations with ssi advanced owd course sometimes an ascent using a weight hierarchy and your students. Instructor and divemaster guidance is minimal. The phony Left Without ask: Now What? And net a padi open water checklist gives you glue a successful diving equalizing method, or impair with enough vision, and some breathtaking photos while basking in the afterglows.
    [Show full text]
  • Physiology of Decompressive Stress
    CHAPTER 3 Physiology of Decompressive Stress Jan Stepanek and James T. Webb ... upon the withdrawing of air ...the little bubbles generated upon the absence of air in the blood juices, and soft parts of the body, may by their vast numbers, and their conspiring distension, variously streighten in some places and stretch in others, the vessels, especially the smaller ones, that convey the blood and nourishment: and so by choaking up some passages, ... disturb or hinder the circulation of the blouod? Not to mention the pains that such distensions may cause in some nerves and membranous parts.. —Sir Robert Boyle, 1670, Philosophical transactions Since Robert Boyle made his astute observations in the Chapter 2, for details on the operational space environment 17th century, humans have ventured into the highest levels and the potential problems with decompressive stress see of the atmosphere and beyond and have encountered Chapter 10, and for diving related problems the reader problems that have their basis in the physics that govern this is encouraged to consult diving and hyperbaric medicine environment, in particular the gas laws. The main problems monographs. that humans face when going at altitude are changes in the gas volume within body cavities (Boyle’s law) with changes in ambient pressure, as well as clinical phenomena THE ATMOSPHERE secondary to formation of bubbles in body tissues (Henry’s law) secondary to significant decreases in ambient pressure. Introduction In the operational aerospace setting, these circumstances are Variations in Earthbound environmental conditions place of concern in high-altitude flight (nonpressurized aircraft limits and requirements on our activities.
    [Show full text]
  • Copernicus My Adventure in Cave Training Respiratory Loads
    Copernicus My Adventure in Cave Training Respiratory Loads During CCR Diving – Part I Journey to the Dark Side How I Apply Technical Principles to Recreational Diving Issue 19 – June 2015 Contents Editorial Editorial 2 Welcome to the 19th issue of Tech Diving Mag. Copernicus My book Deep Into Deco: The Diver’s Decompression Textbook was an instant success. Thank you! Those who got it from Amazon, please By Asser Salama 3 put your reviews there. The usual question: how does it compare to other deco-related titles? This one has all the basic topics covered, and is more into decompression simulation/modeling and up-to-date My Adventure in Cave Training research. By Jonathan Bird 6 The contributors for this issue are Emmy award-winning cinematographer Jonathan Bird, commercial diving instructor Respiratory Loads During CCR Diving – Konstantinos Alexiou, diving instructor and boat captain Drew Part I McArthur and on-and-off diver Dan Sumners. Take a look at their brief bio at www.techdivingmag.com/contributors.html. By Konstantinos Alexiou 19 Tech Diving Mag is based on article contribution, so you’re always Journey to the Dark Side welcome to volunteer a piece and/or some photos. The guidelines could be found at www.techdivingmag.com/guidelines.html. By Drew McArthur 24 This is very much your magazine, so if you want to share some views, just drop a line to [email protected]. And please subscribe to How I Apply Technical Principles to the newsletter at www.techdivingmag.com/communicate.html to be Recreational Diving notified when new issues are available for download.
    [Show full text]
  • Are Drugs Destroying Sport?
    Can C 0 U n t r i e s Fin d Coo per a tiD n Ami d the R u i nos 0 feD n f lie t ? ARE DRUGS IN THI S IS SUE DESTROYING The Gann Years: Colm Connolly '91 Wins Hail to "The Counselor" A Retrospective High-Profile Murder Case Sonja Henning '95 SPORT? Page 8 Letters to the Editor If you want to respond to an article in Duke Law, you can e-mail the editor at [email protected] or write: Mirinda Kossoff Duke Law Magazine Duke University School of Law Box 90389 Durham, NC 27708-0389 , a Interim Dean's Message Features Ethnic Strife: Can Countries Find Cooperation Amid the Ruins of Conflict? .. ..... ... ...... ...... ...... .............. .... ... ... .. ............ 2 The Gann Years: A Retrospective .. ............. ..... ................. .... ..... .. ................ ..... ...... ......... 5 Are Drugs Destroying Sport? .. ..................................... .... .. .............. .. ........ .. ... ....... .... ... 8 Alumni Snapshots Colm Connolly '91 Wins Conviction and Fame in High-Profile Murder Case ................... .................. ... .. ..... ..... ... .... .... ...... ....... ....... ..... 12 Sonja Henning '95: Hail to "The Counselor" on the Basketball Court ........................ .. 14 U.N. Insider Michael Scharf '88 Puts International Experience to Work in Academe ................................... ..................... ... .............................. ....... 15 Faculty Perspectives Q&A: Can You Treat a Financially Troubled Country Like a Bankrupt Company? .. ..... ... 17 The Docket Professor John Weistart: The Man
    [Show full text]
  • 5. Sidemount Diver
    TDI Standards and Procedures Part 2: TDI Diver Standards 5. Sidemount Diver 5.1 Introduction This course is designed to teach certified divers how to safely utilize side- mounted primary cylinders as an alternative to the traditional back-mounted configuration. This course can be combined with other TDI courses such as: Decompression Procedures, Extended Range, Trimix, Advanced Trimix and Advanced Wreck. If combined the standards for both courses must be met. 5.2 Qualifications of Graduates Upon successful completion of this course, graduates may engage in sidemount diving activities without direct supervision so long as the following limits are adhered to 1. Safety and decompression stops as appropriate or necessary. 2. Planned dives do not exceed diver’s current certification level. 5.3 Who May Teach This course may be taught by any active TDI Sidemount Diving Instructor. 5.4 Student to Instructor Ratio Academic 1. Unlimited, so long as adequate facility, supplies and time are provided to ensure comprehensive and complete training of subject matter. Confined Water (swimming pool-like conditions) 1. N/A Open Water Dives 1. A maximum of 4 students per instructor is allowed 5.5 Student Prerequisites 1. Minimum age 18 2. Minimum certification; SDI Open Water Scuba Diver or the equivalent 52 Version 0221 TDI Standards and Procedures Part 2: TDI Diver Standards 5.6 Course Structure and Duration Water Execution 1. Three open water dives are required with a minimum accumulated bottom time of 90 minutes 2. If Advanced Nitrox is taught in conjunction with TDI Sidemount, only a total of four (4) dives are required, more may be conducted at the discretion of the instructor, but all dives must be conducted at depths within the diver’s current level of certification Course Structure 1.
    [Show full text]
  • Underwater Speleology
    UNDERWATER SPELEOLOGY z~ • • • • • ,. --_.. - National Speleolgolcal Society • Cave Diving Section - .....- March/April, 1992 • VQI. 19, No.2 Downstream Tunnel Chamber 3 Upstream Tunnel U:OEHO ~ Unsurveyed Passage Bearings I and Distances are Estima1ed-- ' 8 Ceiling Height 1!17 Depth in Feet Assumed Base Line Point of Intersection --- Roadway ~ Existing Surface Pool ~&!Lib Y! W!J &frd[Q) ~[p)l?dOWJ~ ~ /AI}.tiiJIIl.IL./A CCIUJIM'lr'V, IFIL.OIROID/A DEEP BREATHING SYSTEMS P. 0. Box 4220 Sevierville, TN 37884 See article p. 12 Information Provided by: United States Deep Caving Team and Bill Stone UNDERWATER SPELEOLOGV TABLE OF CONTENTS The official publication of the Cave Diving Section NEWS of the National Speleological Society, Inc. P.O. Box 950, Branford, FL 32008-0950 Growing Pains: the Administrative Crisis within the CDS, Editorial . 3 Sol-What Ever Happened to the Editor: H. V. GREY Cave-Diving Manual, huh? Editorial .. .......... 4 P.O. Box 12, Nokomis , FL 34274-0012 Editor for UWS Still Sought, Editorial . 5 813-484-7834, 813-484-6665 (fax) New NSS Grotto In Florida .... .. ... .... ..... 5 Board of Directors EXPLORATION Cave Diving with "the Enemy," Jill Yager ............. 6 Chairman: FRANK HOWARD This Is Not a Pull-and-Glide Cave! Curt Schuster .. 8 334 Portico Ct., Chesterfield, MO 63017 314-469-6133, 314-542-0838 (fax) SPELEOLOGY Hydrogeological Study, Sally Ward Spring, Vice-Chairman: MARK LEONARD Wakulla County, Florida, Rt. 14, Box 136, Lake City, FL 32055 William L. Wilson and Victor P. Sparks ..... .. 12 904-752-1 087 SAFETY Treasurer: BILL FOOTE The Safety Line, Wendy Short .... .. ... .. .. ... 8 1433 S.E.
    [Show full text]
  • BUMP Diving-Syllabus FALL 2017 Ver5-Updated
    M533 Syllabus 2017: Scientific Diving and Underwater Research • Prof. Phillip Lobel, [email protected] • Ms Katey Lesneski, [email protected] BUMP Scientific Diving Training Program MS533 Scientific Diving & Underwater Research Methods Course Guide Sections page Introduction 1 Diving equipment requirements 3 Course Schedule 6 AAUS skills description 7 Training Dive Plans 13 Class Dive Plan 2017 18 Float Plan for Boat dives 25 Course Instructors 28 Introduction This training will provide BU students with the credentials necessary to participate as interns or collaborators in scientific projects that involve scuba diving. It fulfills the required training for scientific divers as prescribed by the American Academy of Underwater Sciences (AAUS). It will also prepare students for entry level jobs in the environmental impact research industry and in the recreational dive industry. The course will prepare students for careers as scientific diviers for University, Government and Industry. For some background on the class, see https://www.bu.edu/today/2016/one-class-one-day-scientific-diving/ Course Description: This course is designed to introduce scuba certified students research diving and conforms to the training standards of the American Academy of Underwater Sciences (AAUS) for scientific diver certification that is accepted at most universities and at all AAUS member organizations throughout the United States. This course will provide an introduction to research methods used in the study of biology, ecology and physiology of subtidal organisms. Topics for lectures and labs include: diving physics, physiology, dive planning, first aid for diving professionals, underwater photography, population census methods and fish habitat surveys. This course fulfills the American Academy of Underwater Sciences (AAUS) scientific diver training requirements.
    [Show full text]
  • Michael Burgan – FF PSD Training
    08-10-2012 Sugarcreek OH – Michael Burgan – FF PSD Training 08-10-2012 Michael Burgan Aged 46, Captain in the Sugarcreek Fire department (also dived for the Holmes County dive team) participating in an advanced diving class at the White Star Quarry in Gibsonburg, reported as showing signs of distress after 15 minutes into his second dive of the day, surfaced and called for help before he lost consciousness, recovered from about 61' water depth by fellow divers but pronounced dead at the scene. Firehouse.com news http://www.thediversassociation.com/index.php/sheets POLICE & FIRE Ohio man, 46, dies during diving class http://www.toledoblade.com/Police-Fire/2012/08/12/Ohio-man-46-dies-during- diving-class.html Aug. 12, 2012 Blade Staff and News Services GIBSONBURG, Ohio -- A Sugarcreek, Ohio, man died Friday during an advanced diving instruction class at White Star Quarry, authorities said. Michael Burgan, 46, was more than 15 minutes into his second dive of the day about 2:15 p.m. when he surfaced from about 40 feet of water, said Steve Gruner, director of the Sandusky County Park District. There was no earlier indication that the diver was having a problem, but at the surface, "he indicated he was having some distress," Mr. Gruner said. Mr. Burgan, who was a certified diver, lost consciousness and went under water, Mr. Gruner added. The diving instructor recovered him from a depth of 61 feet. Mr. Burgan was pronounced dead at the scene. His body was transported to the Lucas County coroner's office for an autopsy.
    [Show full text]
  • Press Release
    Contact: Maria Hults Phone: (631) 728.2285 [email protected] Beneath The Sea 2015 th 39 Anniversary Show: Dive Medicine Press Release Dive Medicine Beneath the Sea 2015 Dive Medicine, Education and Dive Safety That All Divers Should Know Friday, March 27th beginning 8:30 a.m. At the Meadowlands Exposition Cnter This years Dive Medicine Workshop will bring four national leaders in Dive Medicine, Dive Education and Dive Safety. Four topics reviewed will be the topics of Otic Barotrauma, Pros and Cons of warm Water vs. Cold water Training, in water recompression, and the very common concern what medications are safe for divers. At the conclusion of the lectures, there will be a panel discussion. The format will allow for audience participation and questions and answers session. Four Continuing Medical Education Category One Credits are available. Cost $75.00 Includes Lunch Otic Barotrauma Otic barotrauma is the most common injury that a diver faces on a regular basis. An overview of the gas laws will begin this discussion. Conditions related to barotrauma, the external, middle and inner ear will be discussed. We will emphasis those conditions that are due to barotrauma and distinguish those conditions that are related to decompression illness. Prevention, recognition and treatment will be discussed. The video otoscope will be used to demonstrate the various maneuvers in clearing the divers ears. Bio: David Charash DO, CWS, FACEP, UHM Dr. Charash is Board Certified in Emergency Medicine, and Undersea and Hyperbaric Medicine. David has completed training by the National Oceanic and Atmospheric Agency/Undersea and Hyperbaric Medicine as a Dive Medicine Physician, and Medical Examiner of Diver programs.
    [Show full text]