Clinical Care of Dive Injuries

Question 1

what determines the classification of DCS

Answer 1

location of the bubble

Question 2

what type of DCS involves the skin, lymphatic system, muscles, and joints and not life threatening

Answer 2

DCS type I

Question 3

what are the Symptoms of DCS type I

Answer 3

Joint pain (outside the thorax. Ankle, elbow, and wrist)

Skin Symptoms (itching, marbling)

Lymph Nodes (pain, swelling)

Question 4

what exam must be done to rule out a arterial Gas embolism (AGE)

Answer 4

Neurological Exam

Question 5

what is the treatment of DCS type I

Answer 5

100% Surface O2

transport to recompression chamber

Question 6

if transporting a DCS patient by air what is the max ceiling

Answer 6

1000ft

Question 7

DCS II symptoms are divided into what three categories

Answer 7

Neurological

Inner Ear

Cardiopulmonary

Question 8

what causes the Sx of Neurological symptoms of DCS

Answer 8

bubble formation within the brain & Spine

Question 9

what are the symptoms of Neurological DCS type II

Answer 9

Paresthesia

Numbness

Urinary Function Impairment

Muscle Weakness

Mental Status Changes

Question 10

what are the symptoms of Inner Ear (Staggers) DCS type II decompression Sickness

Answer 10

Tinnitus

Hearing Loss

Vertigo

Dizziness

Nausea

Vomiting

Question 11

where does the bubble in Inner Ear (Staggers) DCS type II DCS form

Answer 11

Vestibular Apparatus

Question 12

what are the symptoms of cardiopulmonary (Chokes) DCS type II DCS

Answer 12

chest pain

Pain w/ inspiration

irritating cough

Tachypnoea

lung congestion

complete circulatory collapse

Question 13

what occurs when gas is forced through the lung tissue into the loose mediastianal tissues in the middle of the chest of the chest surrounding the heart, trachea, and major vessels

Answer 13

Pulmonary Over Inflation Syndrome (POIS)

Question 14

what are the 4 types of POIS

Answer 14

Arterial Gas Embolism

Mediastinal

Subcutaneous Emphysema

Pneumothorax

Question 15

what is caused by Damage to body tissues from the mechanical effects of pressure, results when pressure differentials between body cavities During normal ascent and decompression procedures, these gasses come out of the divers body at a manageable rate.

Answer 15

Barotrama

Question 16

what are the 3 types of barotrauma

Answer 16

ear squeeze

Sinus Squeeze

Tooth Squeeze

Question 17

what is damaged in ear squeeze barotruama

Answer 17

Cochlea/ vestibular apparatus

Question 18

what is the Tx for Ear squeeze barotrauma

Answer 18

Heart / lung PE

Decongestants

pain medication

Antibiotics if TM rupture

Question 19

what type of gas seriously interferes with the bloods ability to carry O2 required for normal body function

Answer 19

Carbon Monoxide

Question 20

what are Symptoms of Carbon Monoxide Poisoning

Answer 20

Tightness across the forehead

Headache

Dizziness

Confusion

Nausea

Vomiting

Question 21

what is the definitive treatment of choice for carbon monoxide poisoning

Answer 21

Hyperbaric Therapy

Question 22

define abnormally high level of carbon DIOXIDE in the blood and body tissues

Answer 22

Hypercapnia

Question 23

what are Symptoms of Hypercapnia

Answer 23

Confusion of feelings of euphoria

Inability to concentrate

SOB

Loss of consciousness

Drowsiness

Convulsions

Increase Sweating

Increase Respiratory Rate

Question 24

what is the Treatment for Hypercapnia

Answer 24

Decrease level of exertion

Increase Ventilation/ Helmet Flow

Answer 25

Central Nervous System Oxygen Toxicity.

Question 26

what are the symptoms for CNS O2 toxicity

Answer 26

Vision Symptoms Ear Symptoms Confusion / euphoria

Question 27

what is the treat treatment for CNS O2 toxicity

Answer 27

ascend shift to breathing mixture with a lower %

Question 28

Pulmonary Oxygen Toxicity occurs at what partial pressure

Answer 28

exposure to 1 ata for 12 hrs

Question 29

exposure to partial pressure for how long at 1 ata will produce mild sx of Pulmonary Oxygen Toxicity

Answer 29

12 hrs

Question 30

what are symptoms of Pulmonary Oxygen Toxicity

Answer 30

Burning sensation during inspiration Pain during inspiration cough decrease pulmonary function

Question 31

what are symptoms of Shallow water blackout

Answer 31

hypoxia subsequent drowning cardiac respiratory

Question 32

what is the treatment for shallow water blackouts on the water

Answer 32

ventilation ONLY, 5 rescue breaths No chest compressions

Question 33

what is believed to be related to exertion, immersion in cold water and over hydration

Answer 33

Swimmer induced pulmonary edema (SIPE)

Question 34

what are the symptoms of Swimmer induced pulmonary edema (SIPE)

Answer 34

dull to sharp substernal chest pain hemoptysis shortness of breath frothy sputum shortness of breath

Question 35

what is the Treatment for Swimmer induced pulmonary edema (SIPE)

Answer 35

remove pt from wet/cold environment supplemental O2 Complete heart / lung exam EKG X-Ray within 24 hrs