Basic Dive Medicine Flashcards
- Mechanics of Breathing
- Gas Exchange
- Respiration
- O2 is diffused from the alveolar air into the alveolar capillaries due to change in pp.
- elevated ppCO2 in the plasma is driven into the lungs c/ lower ppCO2 (Daltons and Henry’s law).
- cells utilize the O2 and during metabolism, produce CO2 as a bi-product.
6 phases of respiration
- ventilation
- gas exchange from alveoli to capillaries
- transport of gases via blood
- gas exchange from blood to tissues
- gas exchange from tissue to cells
6 cells metabolize the gas
define circulatory system
closed system that delivers O2, nutrients, and hormones to cells and removes CO2, waste a, chemicals, and heat.
The most prevalent gas to in diving is…
CO2 Tox
Define CO
- colorless, oderless, tasteless gas produced from incomplete combustion.
CO:
- s/s
- why do s/s typical occur during ascent or upon RS?
- Tiny - Tightness across the head Headhunters - H/A Practice - Pounding H/A Ninja - Nausea Chicken - Confusion Voodoo - Vomitting - while @ depth the increased ppO2 allows O2 to be delivered s/ binding to hgb.
Metallic tastes
Multiple casualties
Dizziness
Unconscious
*s/s may not exist due to rapid occurring toxicity (can go straight LOC).
CO tx
remove the Pt from the environment switch to 2ndary air source 100% O2 Neuro to r/o AGE contact DMO HBO2 tx (maybe)
Hypoxia:
- define
- causes
- s/s result at ___ ppO2
- diminished O2 to tissues
- air supply failure
lost mouthpiece
airway obstruction
LARV or MK16 rebreather malfunction
depleted O2 levels
poor ventilation - < 0.16 ppO2
Hypoxia s/s
Cilli wld
Cyanosis Increase HR & BP Lack of concentration Lack of muscle control Inability to perform difficult task
Weakness
LOC
Drowsiness
Hypoxia Tx
In water EP's 100% O2 contact DMO CPR PRN Neuro r/o AGE
CO2 Tox
- define
- causes
- hypercapnia, increased CO2 levels
- skip breathing
excessive workload
over breathing dive apparatus
CO2 scrubber malfunction
CO tox:
- s/s
- ex’s usually apparent c/
- I Child
Increased Hr and RR Confusion H/A Inability to concentrate LOC (can be the 1st sx) Drowsiness
- Euphoria
- heavy work at depths >120 fsw
CO2 tox tx:
- in water
- on surface
- ventilate notify buddy decrease workload abort dive contact DMO/DMT - remove dive apparatus 100% O2 Neuro r/o AGE
N2 Narcosis define
narcotic effect on the CNS due to increased ppN2.
- it is progressive with increased pp not time @ depth, usually onset at ~4 at a (99 fsw)
N2 narcosis s/s
Clasi
Confusion Lack of concern for safety Apparent stupidity Sense of well being Impaired judgement
others: inappropriate laughter, tingling of the lips, gums, and legs.
N2 narcosis tx
work up dives to build tolerance
substitute N2 for He c/ jobs deeper than 165’
ascend above the depths of sx onset
- sx’s typically resolve c/in :01
O2 tox:
- 2 types and define
- CNS O2 tox, increased pp)2 over short periods usually encountered as low as 1.3 ata but typically onset @ 1.6 ata.
- Pulmonary O2 tox, long exposures to increased ppO2.
Risk factors that increase O2 to (5)
individual susceptibility CO2 retention exercise immersion in H2O depth
CNS O2 tox:
- s/s
- tx
- VENTTID-CVision - blurred/tunnel
Ears - tinnitus or roaring
Nausea
Twitching/Tingling - facial or extremities
Irritability - change in behavior
Dizziness - clumsiness or incoordination
Convulsions - can be 1st sx- 1st sx usually is tachycardia, not taught in dive manual, taught in civilian Chamber tech course.
- vent hat
switch air
chamber EP’s
Pulmonary O2 tox:
- s/s
- tx
- CBS coughing burning SOB/dyspnea * Ex - O2 therapy at sealevel >12hrs can cause Pulmonary O2 tox.
- ventilate off O2 Chamber EP's contact DMO Pt may have to stay on O2 even c/ sx's
An O2 hit can occur ___ to ___ mins after being off O2.
1 to 2 mins
Hypothermia
- define
- levels of insulation (3)
- when the core temp is <40 F hot water suit
- Passive Rewarming
- Active Rewarming
- why never give caffeine, alcohol, or tabacco?
- remove Pt from the environment dry clothes blankets hot soup/drink - warm bath or shower (100-110 F) place Pt in a warm space - dehydration.
Mild Hypothermia:
- s/s
- tx
- shivering
slurred speech
poor judgement - passive or active rewarming