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History of Hyperbaric Medicine ROBERT S
American Osteopathic College of Occupational and Preventive Medicine 2015 Mid Year Educational Conference, Ft. Lauderdale, Florida How Did We Get From Here History of Hyperbaric Medicine ROBERT S. MICHAELSON, DO, MPH MARCH 14, 2015 To Here 3 History of Hyperbaric Medicine Discuss history of diving Discovery of the atmosphere Five major milestones in the development of hyperbaric medicine Triger’s caisson Eads and Brooklyn Bridge Haldane and staged decompression Rescue of the USS Squalus Donnell and Norton 5 Gourd Breathing About 375 AD Diving as a Profession Salvage Operations From as early as 9th century BC Pay scale based on depth of dive Military Operations Early attempts to bore into hull of ships or attach crude explosives to vessels Confined to shallow waters and for short duration dives Very Hard to be Stealthy and Effective T-1 American Osteopathic College of Occupational and Preventive Medicine 2015 Mid Year Educational Conference, Ft. Lauderdale, Florida DivingHood by Flavius Vegetius Renatus about 375 AD in Leonardo’s (1452-1519) Design For Swim Fins Epitome Institutionum Rei Militaris Diving Rig of Niccolo Tartaglia Canon Recovery Mid-1600’s about 1551 Probably First Diving Bell Mid-1600’s T-2 American Osteopathic College of Occupational and Preventive Medicine 2015 Mid Year Educational Conference, Ft. Lauderdale, Florida T-3 American Osteopathic College of Occupational and Preventive Medicine 2015 Mid Year Educational Conference, Ft. Lauderdale, Florida Diving as a Profession Salvage Operations From as early as 9th century BC Pay scale based on depth on dive Military Operations Early attempts to bore into hull of ships or attach crude explosives to vessels Confined to shallow waters and for short duration dives Very Hard to be Stealthy and Effective Diving Bell-1664 Klingert’s Diving Suit -1797 The Vasa, a Swedish ship sunk within a This equipment is the first to be called mile of her maidenvoyage in 1628. -
Nitrox CONFIRME
Formation théorique NITROX Patrick Baptiste MF1 n° 22108 Formation théorique Nitrox confirmé Sommaire de la formation • Rappels • La réglementation • La crise Hyperoxique l’effet Paul Bert l’effet Lorrain Smith • La table NOAA • Le compteur SNC • Les UPDT ou OTU • Les autres effets physiologiques La syncope Hypoxique Effet vasoconstricteur de l’O2 • La fabrication des mélanges Patrick Baptiste MF1 n° 22108 Formation théorique Nitrox confirmé Composition de l’air L'air sec au voisinage du sol est approximativement composé de: • 78,08 % d’azote, • 20,95 % d’oxygène, • moins de 1 % d'autres gaz dont : • argon 0,93%, • néon 0,0018%, • krypton 0,00011%, • xénon 0,00009% • dioxyde de carbone 0,033 %. Il contient aussi des traces d'hydrogène 0,000072%, mais aussi d'ozone et de radon. Patrick Baptiste MF1 n° 22108 Formation théorique Nitrox confirmé Composition de l’air Nous considérons que la composition de l’air est la suivante : - Oxygène (O²) 21 % - Azote (N²) 79 % Convention d’appellation Par convention, on désigne ce mélange en citant en premier sa teneur en O² puis sa teneur en N², on obtient une indication du type : O²/N² ou XX / YY . un mélange définit comme suit : 40/60 Désigne un NITROX contenant 40 % d’O² et 60 % de N² Patrick Baptiste MF1 n° 22108 Formation théorique Nitrox confirmé Limites et contraintes Liés à l’augmentation de la pression partielle d’oxygène (PpO²) - Limitation de la profondeur maximum par rapport à l’air( PpO²max = 1,6b .) - Limitation variable de la profondeur en fonction du mélange respiré - Risque d’accident hyperoxique si les profondeurs planchées ou la durée d’utilisation sont dépassés, - Manipulation plus contraignante et plus dangereuse, - Nécessite un matériel spécifique ( compresseur, équipement spécifique si Nitrox > 40/60) - Planification des plongées obligatoires et plus complexes - Prix de revient plus élevé que l’air. -
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 -
Scuba Diving History
Scuba diving history Scuba history from a diving bell developed by Guglielmo de Loreno in 1535 up to John Bennett’s dive in the Philippines to amazing 308 meter in 2001 and much more… Humans have been diving since man was required to collect food from the sea. The need for air and protection under water was obvious. Let us find out how mankind conquered the sea in the quest to discover the beauty of the under water world. 1535 – A diving bell was developed by Guglielmo de Loreno. 1650 – Guericke developed the first air pump. 1667 – Robert Boyle observes the decompression sickness or “the bends”. After decompression of a snake he noticed gas bubbles in the eyes of a snake. 1691 – Another diving bell a weighted barrels, connected with an air pipe to the surface, was patented by Edmund Halley. 1715 – John Lethbridge built an underwater cylinder that was supplied via an air pipe from the surface with compressed air. To prevent the water from entering the cylinder, greased leather connections were integrated at the cylinder for the operators arms. 1776 – The first submarine was used for a military attack. 1826 – Charles Anthony and John Deane patented a helmet for fire fighters. This helmet was used for diving too. This first version was not fitted to the diving suit. The helmet was attached to the body of the diver with straps and air was supplied from the surfa 1837 – Augustus Siebe sealed the diving helmet of the Deane brothers’ to a watertight diving suit and became the standard for many dive expeditions. -
Chapter 23 ENVIRONMENTAL EXTREMES: ALTERNOBARIC
Environmental Extremes: Alternobaric Chapter 23 ENVIRONMENTAL EXTREMES: ALTERNOBARIC RICHARD A. SCHEURING, DO, MS*; WILLIAM RAINEY JOHNSON, MD†; GEOFFREY E. CIARLONE, PhD‡; DAVID KEYSER, PhD§; NAILI CHEN, DO, MPH, MASc¥; and FRANCIS G. O’CONNOR, MD, MPH¶ INTRODUCTION DEFINITIONS MILITARY HISTORY AND EPIDEMIOLOGY Altitude Aviation Undersea Operations MILITARY APPLIED PHYSIOLOGY Altitude Aviation Undersea Operations HUMAN PERFORMANCE OPTIMIZATION STRATEGIES FOR EXTREME ENVIRONMENTS Altitude Aviation Undersea Operations ONLINE RESOURCES FOR ALTERNOBARIC ENVIRONMENTS SUMMARY *Colonel, Medical Corps, US Army Reserve; Associate Professor, Military and Emergency Medicine, Uniformed Services University of the Health Sci- ences, Bethesda, Maryland †Lieutenant, Medical Corps, US Navy; Undersea Medical Officer, Undersea Medicine Department, Naval Medical Research Center, Silver Spring, Maryland ‡Lieutenant, Medical Service Corps, US Navy; Research Physiologist, Undersea Medicine Department, Naval Medical Research Center, Silver Spring, Maryland §Program Director, Traumatic Injury Research Program; Assistant Professor, Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland ¥Colonel, Medical Corps, US Air Force; Assistant Professor, Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland ¶Colonel (Retired), Medical Corps, US Army; Professor and former Department Chair, Military and Emergency Medicine, Uniformed Services University of the Health Sciences, -
Medical News. Regulations for the M.B
605 interested in the welfare of Epsom College, which he did so Smith, M.B. Liverp., Liverpool University; Frank Harold much to Stephens, St. Mary’s Hospital; Hugh Stott, Guy’s Hospital; Gilbert promote. Francis Syms, Guy’s Hospital; Wilfrid Reginald Taylor, St. Mary’s Dr. Galton leaves a widow and five daughters. The funeral Hospital; Ernest William Toulmin, St. Mary’s Hospital; took place at Shirley cemetery on Feb. llth. The ceremony Nusserwanji Hormasji Vakeel, Bombay University and St. Bar- attended old friends and and tholomew’s Hospital; Cuthbert Ferguson Walker, B.A., Royal was largely by patients many University of Ireland. Galway, Belfast, and St. Mary’s Hospital; medical men from London and his neighbourhood, amongst Alan Geoffrpy Wells, St. Mary’s Hospital; Ernest Godfrey Wheat, those present being Mr. Edmund Owen, Mr. Frederic Cambridge University and King’s College Hospital; James Norman Durham, Dr. Henry Hetley, Mr. J. B. Lamb (secretary of Wheeler, B.A. Cantab., Cambridge University and St. Thomas’s Mr. and Hospital; Edward Barton Cartwright White, London Hospital ; Epsom College), G. C. Parnell, Mr. J. Sidney Turner, William Cecil Wigan, Oxford University and St. Bartholomew’s Mr. E. Oswald Oxford Williams, St. Bartholomew’s Hos- Reynolds Ray. - Hospital; Cyril pital ; Rajaiya Robert Williams, L.R.C.P. & S. Edin., Edinburgh, Madras, and University College Hospital; John Samuel Williamson, DEATHS OF EMINENT FOREIGN MEDICAL MEN.-The deaths St. Bartholomew’s Hospital; and William Louis Rene Wood, L.S.A. of the following eminent foreign medical men are announced : Leeds University. - Dr. Martin Bloch, formerly assistant to the late Professor Diplomas of M.R.C.S. -
HYSTERIA at the EDINBURGH INFIRMARY: the CONSTRUCTION and TREATMENT of a DISEASE, 1770-1800 by GUENTER B
Medical History, 1988, 32: 1-22. HYSTERIA AT THE EDINBURGH INFIRMARY: THE CONSTRUCTION AND TREATMENT OF A DISEASE, 1770-1800 by GUENTER B. RISSE* I In the introduction to his History of sexuality, Michel Foucault pointed to the eighteenth century as the period in which sexuality became a medical concern and women were, in his words, subjected to "hysterization".' By this term, Foucault probably meant that medicine began to pay greater attention to female bodily functions, trying to explain anew women's behaviour and physical complaints within the prevailing theoretical frameworks of the time. Thus, Foucault's seemingly novel "medicine of hysteria" replaced traditional and popular views based on humours, vapours, and the effects of a wandering womb. In his view, this was just one aspect of the medicalization imposed on eighteenth-century life with its inherent shifts in power relationships which constitutes one of the central motifs in his writings.2 The present investigation started out as an effort to organize a rich source ofprimary clinical material: lecture notes and patient case histories from the Royal Infirmary of Edinburgh during the late-eighteenth century.3 The analysis focused on hospitalized patients labelled as suffering from "hysteria", trying to document and perhaps clarify Foucault's ideas on the subject. Using such historical evidence, this study made some rather unexpected discoveries. It not only exposed the ambiguities inherent in the construction of disease entities, but also refuted Foucault's account of the sexualization ofworking-class women, at least for late-eighteenth-century Edinburgh. Before presenting the archival data, however, it will be useful briefly to consider the views regarding women's health and especially hysteria prevalent in the medical literature during the latter part of the eighteenth century. -
A Cephalopod Approach to Rethinking About the Importance of the Bohr and Haldane Effects·
Pacific Science (1982), vol. 36, no. 3 © 1983 by the University of Hawaii Press. All rights reserved A Cephalopod Approach to Rethinking about the Importance of the Bohr and Haldane Effects· G. LYKKEBOE2 and K. JOHANSEN2 ABSTRACT: This study concerns the physiological implications of the Bohr and Haldane effects and the buffer values in the blood from the cephalopods Nautilus pompilius, Octopus macropus, Sepia latimanus, Nototodarus sloani philippinensis, and Sepioteuthis lessoniana. All species studied except one (Nautilus) have Bohr and Haldane coefficients numerically higher than unity, and the two effects were found to be nearly identical in all cases, in accord with the theoretical prediction of Wyman (1964). However, the functional Haldane coefficient was significantly lower than the Haldane coefficient in two cases (Sepia and Sepioteuthis). Buffer values were highest in the two species with the lowest oxygen requirement (Nautilus and Octopus), whereas the three fast swim mers studied (Nototodarus, Sepia, and Sepioteuthis) display comparatively low buffer values. It is concluded that the large Bohr effects seen in four of the five species may have their primary effect on oxygen loading in the gills. THE OXYGEN AFFINITY ofcephalopod blood is Since the Bohr effect is generally acredited pH-sensitive in all reported cases. However, physiological significance in respiratory blood for no other group of animals does the pH gas transport, variations in it that are related sensitivity ofthe O 2 binding, expressed by the to behavior, habitat, or systemic factors Bohr coefficient (Lllog P50/LlpH), show such a should be easily discernible in cephalopods. large variability between species (P50 denotes The present study compares blood respi the oxygen tension at half02 saturation ofthe ratory properties and discusses their possible blood). -
Mine Rescue Team Training: Metal and Nonmetal Mines (MSHA 3027, Formerly IG 6)
Mine Rescue Team Training Metal and Nonmetal Mines U.S. Department of Labor Mine Safety and Health Administration National Mine Health and Safety Academy MSHA 3027 (Formerly IG 6) Revised 2008 Visit the Mine Safety and Health Administration website at www.msha.gov CONTENTS Introduction Your Role as an Instructor Overview Module 1 – Surface Organization Module 2 – Mine Gases Module 3 – Mine Ventilation Module 4 – Exploration Module 5 – Fires, Firefighting, and Explosions Module 6 – Rescue of Survivors and Recovery of Bodies Module 7 – Mine Recovery Module 8 – Mine Rescue Training Activities Introduction Throughout history, miners have traveled underground secure in the knowledge that if disaster strikes and they become trapped in the mine, other miners will make every possible attempt to rescue them. This is the mine rescue tradition. Today’s mine rescue efforts are highly organized operations carried out by groups of trained and skilled individuals who work together as a team. Regulations require all underground mines to have fully-trained and equipped professional mine rescue teams available in the event of a mine emergency. MSHA’s Mine Rescue Instruction Guide (IG) series is intended to help your mine to meet mine rescue team training requirements under 30 CFR Part 49. The materials in this series are divided into self-contained units of study called “modules.” Each module covers a separate subject and includes suggestions, handouts, visuals, and text materials to assist you with training. Instructors and trainers may wish to use these materials to either supplement existing mine rescue training, or tailor a program to fit their mine-specific training needs. -
5. the Lives of Two Pioneering Medical Chemists.Indd
The West of England Medical Journal Vol 116 No 4 Article 2 Bristol Medico-Historical Society Proceedings The Lives of Two Pioneering Medical-Chemists in Bristol Thomas Beddoes (1760-1808) and William Herapath (1796-1868) Brian Vincent School of Chemistry, University of Bristol, Bristol, BS8 1TS. Presented at the meeting on Dec 12th 2016 ABSTRACT From the second half of the 18th century onwards the new science of chemistry took root and applications were heralded in many medical-related fields, e.g. cures for diseases such as TB, the prevention of epidemics like cholera, the application of anaesthetics and the detection of poisons in forensics. Two pioneering chemists who worked in the city were Thomas Beddoes, who founded the Pneumatic Institution in Hotwells in 1793, and William Herapath who was the first professor of chemistry and toxicology at the Bristol Medical School, located near the Infirmary, which opened in 1828. As well as their major contributions to medical-chemistry, both men played important roles in the political life of the city. INTRODUCTION The second half of the 18th century saw chemistry emerge as a fledgling science. Up till then there was little understanding of the true nature of matter. The 1 The West of England Medical Journal Vol 116 No 4 Article 2 Bristol Medico-Historical Society Proceedings classical Greek idea that matter consisted of four basic elements (earth, fire, water and air) still held sway, as did the practice of alchemy: the search for the “elixir of life” and for the “philosophers’ stone” which would turn base metals into gold. -
Adm Issue 10 Finnished
4x4x4x4 Four times a year Four times the copy Four times the quality Four times the dive experience Advanced Diver Magazine might just be a quarterly magazine, printing four issues a year. Still, compared to all other U.S. monthly dive maga- zines, Advanced Diver provides four times the copy, four times the quality and four times the dive experience. The staff and contribu- tors at ADM are all about diving, diving more than should be legally allowed. We are constantly out in the field "doing it," exploring, photographing and gathering the latest information about what we love to do. In this issue, you might notice that ADM is once again expanding by 16 pages to bring you, our readers, even more information and contin- ued high-quality photography. Our goal is to be the best dive magazine in the history of diving! I think we are on the right track. Tell us what you think and read about what others have to say in the new "letters to bubba" section found on page 17. Curt Bowen Publisher Issue 10 • • Pg 3 Advanced Diver Magazine, Inc. © 2001, All Rights Reserved Editor & Publisher Curt Bowen General Manager Linda Bowen Staff Writers / Photographers Jeff Barris • Jon Bojar Brett Hemphill • Tom Isgar Leroy McNeal • Bill Mercadante John Rawlings • Jim Rozzi Deco-Modeling Dr. Bruce Wienke Text Editor Heidi Spencer Assistants Rusty Farst • Tim O’Leary • David Rhea Jason Richards • Joe Rojas • Wes Skiles Contributors (alphabetical listing) Mike Ball•Philip Beckner•Vern Benke Dan Block•Bart Bjorkman•Jack & Karen Bowen Steve Cantu•Rich & Doris Chupak•Bob Halstead Jitka Hyniova•Steve Keene•Dan Malone Tim Morgan•Jeff Parnell•Duncan Price Jakub Rehacek•Adam Rose•Carl Saieva Susan Sharples•Charley Tulip•David Walker Guy Wittig•Mark Zurl Advanced Diver Magazine is published quarterly in Bradenton, Florida. -
A Primer for Technical Diving Decompression Theory
SCUBA AA PPRRIIMMEERR FFOORR TECH TTEECCHHNNIICCAALL DDIIVVIINNGG DDEECCOOMMPPRREESSSSIIOONN PHILIPPINES TTHHEEOORRYY 1 | P a g e ©Andy Davis 2015 www.scubatechphilippines.com Sidemount, Technical & Wreck Guide | Andy Davis First Published 2016 All documents compiled in this publication are open-source and freely available on the internet. Copyright Is applicable to the named authors stated within the document. Cover and logo images are copyright to ScubaTechPhilippines/Andy Davis. Not for resale. This publication is not intended to be used as a substitute for appropriate dive training. Diving is a dangerous sport and proper training should only be conducted under the safe supervision of an appropriate, active, diving instructor until you are fully qualified, and then, only in conditions and circumstances which are as good or better than the conditions in which you were trained. Technical scuba diving should be taught by a specialized instructor with training credentials and experience at that level of diving. Careful risk assessment, continuing education and skill practice may reduce your likelihood of an accident, but are in no means a guarantee of complete safety. This publication assumes a basic understanding of diving skills and knowledge. It should be used to complement the undertaking of prerequisite training on the route to enrolling upon technical diving training. 2 | P a g e ©Andy Davis 2015 www.scubatechphilippines.com This primer on decompression theory is designed as a supplement to your technical diving training. Becoming familiar with the concepts and terms outlined in this document will enable you to get the most out of your theory training with me; and subsequently enjoy safer, more refined dive planning and management in your technical diving activities.