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HSE Scuba > Chapter 5 - Diving Related Disorders > Flashcards

Chapter 5 - Diving Related Disorders Flashcards

1
Q

What are the different types of tissue?

A 
Blood
Nerves
Organs
Muscles
Bone
Cartilage
Fat
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2
Q

What are fast tissues?

A

Blood and tissues with good blood supply because they absorb and release nitrogen quickly

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3
Q

What are slow tissues?

A

Fat, cartilage and bone that take longer to absorb and release nitrogen

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4
Q

What is the absorption and release of nitrogen known as?

A

On gassing - absorb

Off gassing - release

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5
Q

What are the symptoms of DCI?

A 
Dizzy
Loss of balance and coordination 
Rashes and itches
Joint aches
Collapse 
Loss of sensation and motor control
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6
Q

When do DCI symptoms mostly occur?

A

After the diver has surfaced - less than an hour (50%) within 6 hours (90%)

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7
Q

What are the two principal components to the descriptive term used?

A

Evolution - progression of the illness

Manifestation - the signs and symptoms noted

Acute (evolution) (manifestation) decompression illness

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8
Q

What is progressive evolution?

A

The severity of the signs and symptoms is increasing

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9
Q

What is static evolution?

A

Neither the number or severity of the signs and symptoms increases

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10
Q

What is spontaneously improving evolution?

A

Certain signs and symptoms may improve without recompression treatment

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11
Q

What is relapsing evolution?

A

Cases where they spontaneously improved may undergo a secondary deterioration

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12
Q

What is pain only manifestations?

A

Limb pain - joints most common

Girdle pain - poorly localised aching or constricting feeling in the abdomen, pelvis or chest

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13
Q

What is a neurological manifestation?

A

Loss of memory, seizures, loss of coordination and balance, loss of strength and loss of sensation etc

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14
Q

What is nystagmus?

A

The rapid uncontrolled movement of the eyes, the pupils appear to tremble and wobble

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15
Q

What is the neurological manifestation of the spinal cord?

A

Pins and needles
Numbness
Muscular weakness
Paraplegia - paralysis

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16
Q

What is an audio vestibular manifestation?

A

Barotrauma and tissue injury may be involved

Symptoms are...
Vertigo 
Tinnitus
Nystagmus 
Hearing loss
Loss of balance
Severe nausea
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17
Q

What is a pulmonary manifestation?

A

May be caused by nitrogen bubbles released into the blood or by lung over pressurisation

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18
Q

What is a cutaneous manifestation?

A

Severe itching around the shoulders that develops into a rash then mottling or marbling of the skin

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19
Q

What is a lymphatic manifestation?

A

Lymph nodes may become enlarged and tender - may be associated with oedema (excess fluid in body tissues)
The skin feels thick and may have a the pitted appearance of orange peel

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20
Q

What is a constitutional manifestation?

A 
Non specific signs and symptoms that occur after diving eg.
Headache
Fatigue
Malaise
Anorexia (loss of appetite)
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21
Q

How many types of pulmonary decompression illness are there?

A

4

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22
Q

What is pulmonary DCI - Venous gas embolism?

A

Micro bubbles are formed in the venous system. Under a controlled ascent they are trapped in the lung fields and dissolve.
When the ascent isn’t controlled, masses of bubbles may be formed causing cardio-pulmonary consequences

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23
Q

What are the symptoms of Venous gas embolism?

A 
Chest pain
Cough
Haemoptysis
Shortness of breath
Cyanosis
Shock
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24
Q

What is pulmonary DCI air embolism?

A

Caused by excess pressure. It allows air to leak through the alveolar wall into the blood stream. The air bubbles can be lodged anywhere within the human body.

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25
Q

What are some of the signs and symptoms of air embolism?

A 
Giddiness
Numbness
Paralysis
Visual disturbances 
Respiratory problems 
Heart failure
Death
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26
Q

What is pulmonary DCI pneumothorax?

A

Caused by air escaping the alveoli and getting trapped in the pleural cavity cause a collapsed lung.

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27
Q

What is the most serious form of pneumothorax?

A

Tension pneumothorax where the size of the collapsed lung increases in size with each breath.

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28
Q

What are the signs and symptoms of pneumothorax?

A 
Pain on respiration 
Shortness of breath
Cyanosis
Displacement of the trachea 
Frothy blood from mouth or nose
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29
Q

What is pulmonary DCI emphysema?

A

Air migrates to other parts of the body. In diving it usually moves towards the chest and neck area

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30
Q

What are the three different types of emphysema?

A

Mediastinal - air trapped in the chest

Subcutaneous - air trapped below the skin

Interstitial - air trapped in and around tissues

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31
Q

What are the signs and symptoms of emphysema?

A

Difficulty swallowing
Difficulty breathing
A swollen neck
A change in voice tone

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32
Q

What is the first aid for DCI?

A
  1. Diver kept still - lying down and warm
  2. Fluids administered at a rate of >1 litre per hour
  3. 100% oxygen
  4. Primary assessment conducted
  5. Immediate transportation to a recompression chamber
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33
Q

Which factors may increase DCI?

A 
Obesity
Hard work 
Dehydration 
Alcohol
Cold
Being female 
Increase in age
Infection
Drugs
Previous DCI
Patent Foramen Ovale - atrial septal defect
Lack of fitness
Sawtooth profile dives - ups and downs
34
Q

What is hyperventilation?

A

When you take a series of long deep breaths to get more time on a snorkel dive underwater

35
Q

What does hyperventilation do?

A

Delays the urge to breathe by lowering the levels of carbon dioxide in your body which is dangerous

36
Q

What are the effects of taking deep breaths before snorkel diving?

A

It takes longer before any stimulus to breathe is triggered

Oxygen is required but not replenished
Oxygen levels fall
Unconsciousness quickly follows

37
Q

What is anoxia?

A

No oxygen and would cause death

38
Q

What is hypoxia?

A

A partial lack of oxygen

39
Q

What are the causes of hypoxia?

A

A gas mixture with a bad percentage of oxygen
Obstruction in the respiratory tract - asphyxia
Diseased or damaged lungs
Blood defect such as anaemia
General lack of blood
Carbon monoxide

40
Q

What are the causes of hypoxia specific to divers?

A 
Incorrect gas mixture
Running out of air
Equipment malfunction 
Contamination
Restriction in the bloods ability to transport oxygen - DCI embolism
41
Q

What are he signs and symptoms of hypoxia?

A

Cyanosis

Become less and less pink in colouration - blue colour develops at the nail beds, ear lobes and lips

42
Q

What is the first aid for hypoxia?

A

Removal from immediate danger
Alert EMS
CPR if required
Administer oxygen

43
Q

What are the causes of asphyxia?

A 
Lack of oxygen
Drowning
Airway obstruction
Poisoning
Disease
Electric shock
44
Q

What are the signs and symptoms of asphyxia?

A 
Shortness of breath
Dizziness
Rapid pulse
Swelling of veins
Cyanosis 
Unconsciousness
45
Q

What is the first aid for asphyxia?

A

Remove from source
Alert EMS
CPR if required
Oxygen administration

46
Q

What is pulmonary oedema?

A

Fluid in the lungs

47
Q

What are the causes of pulmonary oedema?

A

High blood pressure
Water in the lungs from drowning
Heart failure

48
Q

What are the signs and symptoms of pulmonary oedema?

A 
Shortness of breath
Dizziness 
Cyanosis
Weak pulse
Unconsciousness
49
Q

What is the first aid for pulmonary oedema?

A

Treat as for asphyxia

50
Q

What is exhaustion?

A

When the body is mentally or physically incapable of meeting the demands placed on it

51
Q

What are the causes of exhaustion?

A

Over exertion

Stress

52
Q

What are the signs and symptoms of exhaustion?

A 
Breathlessness
Anxiety
Erratic pulse
Muscular complaints
Skin might take on bright red appearance
53
Q

What is the first aid for exhaustion?

A

Stop activity
Hold on to a stable object
Stabilise breathing pattern - control/extend the exhalations
Change work or abort dive

54
Q

What is hypothermia?

A

Caused when heat loss is greater than the heat production. Defined as a 2° loss of core body temperature

55
Q

How much quicker does water conduct heat away from the body than air?

A

25x faster

56
Q

At what sea temperature is the body incapable of maintaining the core body temperature?

A

23°

57
Q

What are the causes of hypothermia?

A

Exposure to wind chill
Immersion in cold water without sufficient thermal protection
Exposure to cold air temperatures

58
Q

What are the signs and symptoms of hypothermia?

A 
Shivering at first 
Skin cold, dry and pale
Disorientation and apathy 
Irrational behaviour 
Lethargy
Unconsciousness 
Pulse slows and weakens
Finally cardiac arrest
59
Q

What is the first Aid of hypothermia?

A

Remove from cause
Primary assessment
Remove all wet clothing
Wrap the patient in anti hypothermia blanket
Monitor patients vital signs and symptoms
Always be gentle

60
Q

What is hyperthermia?

A

When the temperature of the body rises. First the capillaries dilate and try to lose heat through radiation and then the sweat glands begin to produce more sweat and finally an increase in breathing rate.

61
Q

What are the two types of hyperthermia?

A

Heat exhaustion and heat stroke

62
Q

What are the causes of heat exhaustion?

A

A loss of salt and water from the body

63
Q

What are the signs and symptoms of heat exhaustion?

A 
Exhausted but restless 
Headache
Tired 
Dizzy
Nausea 
Muscular cramps
Pale cold and clammy skin
Rapid and weak pulse
Breathing fast and shallow 
Casualty may faint if moved suddenly
64
Q

What is the first aid for heat exhaustion?

A

Cool place
Sips of cold water
Add salt if they have been sweating
Primary assessment if they fall unconscious

65
Q

What is the causes of heat stroke?

A

Feverish illness

High humidity or temperature

66
Q

What are the signs and symptoms of a heat stroke?

A 
Headache
Dizzy
Feeling of being hot
Restlessness 
Flushed appearance
Dry skin
Full and bounding pulse
67
Q

What is the first aid for a heat stroke?

A

Same as heat exhaustion as well as a cold wet sheet being placed over the victim

68
Q

What are the causes of vomiting under water?

A

Seasickness
Dysbaric vertigo
DCI
Consumption of too much food or fluids

69
Q

What are the signs and symptoms of vomiting underwater?

A

A feeling of nausea

70
Q

What is the first aid of vomiting underwater?

A

Breathe with great control to prevent panic
Use the purge button and aim the stream of air towards the lips whilst vomiting
This will blow away the vomitus
When vomiting has ceased the diver will automatically take in a big gulp of air. If the free flowing air is pointed over the lips they should breath in air rather than water

71
Q

What should you do when the person has finished vomiting underwater?

A

Achieve positive buoyancy
Remove breathing apparatus
Ensure airway is clear
Remove from water and conduct primary assessment
Administer oxygen and or take to the nearest recompression chamber

72
Q

What are the causes of drowning?

A

Caused by the inhalation of liquid.
Causes a blockage of the airways
Leads cells to become hypoxic and then eventually anoxic

73
Q

How are liquids, food and drink distinguished?

A

By the pharynx which directs liquids and foods down the oesophagus and air down the trachea.

74
Q

What do you do if food or liquid accidentally enters the trachea?

A

Cough to remove them. This is caused by the laryngeal spasm. This helps to push the obstruction back up.

75
Q

What is the difference between wet and dry drowning?

A

In 20-25% of casualties the laryngeal spasm is so powerful that little or no fluid enters the lungs
In 75-80% of casualties water is found in the lungs - wet drowning

76
Q

How long should a nearly drowned patient be observed?

A

3 days

77
Q

What is secondary drownif?

A

When after successful resuscitation the lungs may start to fill with fluid again - should be treated in hospital immediately

78
Q

What are the causes of underwater blast injuries?

A

Explosions underwater represent a serious risk to divers due to the shock wave and noise of detonation.

79
Q

What happens when there is an explosion underwater?

A

Explosion produces bubbles of gas which rapidly expands and collapses due to temperature and pressure. This means there are a number of repeated blows which become progressively weaker over time.

80
Q

Why do divers need to be out of the water if explosives are being used?

A

Pressure waves are transmitted over a greater distance and with potentially lethal intensity. Pressure waves near the seabed can inflict more damage. The extent of the damage will be influenced by the initial charge, depth and distance from the diver

81
Q

What are the signs and symptoms of underwater blast injuries?

A

The pressure waves pass through the body so the areas of most damage are lungs, sinuses, ear cavities and the abdomen. A shredding effect can take place and tissues can end up torn apart

82
Q

What is the first aid for underwater blast injuries?

A

Admitted to hospital - May have internal injuries

HSE Scuba (13 decks)

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