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SCUBA Sup > Diagnosis/COA > Flashcards

Diagnosis/COA Flashcards

1
Q

Steps to follow for SYMPTOMATIC omitted D?

A

Press to 60fsw.
TT5 is NOT authorized.
Surfaced from 50fsw or shallower? Recommend TT6.
Surfaced from greater depth?
Continue to depth where symptom significantly improves, dont exceed 165fsw, recommend TT6A.

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2
Q

Symptoms of Type I DCS?

A

Joint pain.
Symptoms involving skin.
Swelling/pain in the lymph nodes.

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3
Q

Symptoms of DCS Type II?

A

Neurological.
Inner ear (staggers)
Cardiopulmonary (chokes)

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4
Q

3 reasons to withhold recompression?

A

Major trauma.
Paralysis w/ inability to breath.
Near-drowning.

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5
Q

Pneumothorax treatment?

A

Mild? 100% O2. Recompression not recommended if not combined with DCS/AGE.
Severe? Recompress to depth of relief. Call UMO.

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6
Q

Missed 30’ Deco stop. Surface Interval 5 min. No Chamber Available.

A

Return to 30fsw. Multiply stop times by 1.5. Conduct Neuro. Notify Chain of Command.

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7
Q

Missed 40’ Deco stop. Surface Interval 3min. Asymptomatic. No chamber available.

A

Descend to deepest stop. Continue deco to 30’ stop. Multiple 30/20’ stop times by 1.5. Conduct Neuro. Notify Chain of command.

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8
Q

Missed 20fsw Deco stop. Surface Interval: 9min. Chamber is available. What TT are you recommending?

A

TT5 if 2 or fewer O2 periods.
TT6 if greater than 2 O2 periods.

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9
Q

Missed 30fsw deco stop. Surface Interval 6min. Chamber is available.

A

Initial compression to 50fsw.
Increase O2 period from 15min to 30min.
Continue with SurD02.

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10
Q

12 Cranial Nerves

A

Optic, Olfactory, Occulomotor, Trochlear, Abducens, Trigeminal, Facial, Acoustic, Glosopharengeal, Vagus, Spinal Accessory, Hypoglossal.

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11
Q

What is the treatment for AGE and DCS Type II?

A

Initial compression to 60fsw.
If symptoms IMPROVE within first O2 period recommend treatment continue on a TT6.
For DCS Type II, If severe symptoms are UNCHANGED OR WORSENING within 20min, compress to depth of relief not to exceed 165fsw recommend treatment on a TT6A.

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12
Q

What are the symptoms of AGE?

A

Near immediate onset of altered consciousness. Dizziness, paralysis, weakness, abnormal sensation vision or hearing, convulsion, personality changes. blow of the chest on ascent. Unconsciousness, fatigue, difficulty thinking, vertigo, nausea/vomiting, bloody sputum, loss of bodily functions, tremors, loss of coordination and numbness.

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13
Q

If either diver experiences difficulty in clearing on descent?

A

Both divers stop. Ascend until the situation is resolved. If the problem persists or if the problem is sinus related the dive shall be aborted.

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14
Q

Treatment of a near drowning?

A

Move victim to a stable platform.
Place patient in supine/recovery position. Utilize ABC method of resuscitation. Immediately place the patient in 100% O2.
Turn the patient on their side, suction the airway.
Immediate treatment is required. Transport the patient to hospital for treatment of cardiac/respiratory arrest.

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15
Q

A drop in ppO2 below ____ causes the onset of hypoxic symptoms.

A

.16ata

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16
Q

What causes “The Chokes?”

A

DCS Type II symptom: Excessive accumulation of venous gas bubbles in the lung during decompression. Can also cause Hypoxia.

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17
Q

What is the treatment for Hypoxia?

A

Treat with basic first aid and 100% O2.

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18
Q

Symptoms of Hypercapnia usually become apparent when divers attempt heavy work at depths deeper than ____fsw on air.

A

120fsw

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19
Q

Treatment of Hypercapnia?

A

Decrease the level of exertion to reduce CO2 production.
Increase helmet and lung ventilation to wash out excess CO2.
Shift to an alternate breathing source, or abort the dive if defective equipment is the cause.

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20
Q

What are the symptoms of a Near Drowning?

A

Unconsciousness.
Increased respiratory rate.
Shortness of breath.
Coughing with frothy and/or blood-tinged sputum.
Cyanosis.
Distress.

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21
Q

What is the treatment for an unconscious drowning victim?

A

In-water phase: OPEN AND MAINTAIN THE AIRWAY. Check for breathing. Provide 5 rescue breaths. Provide in-water rescue breath while transiting victim to stable platform.
Out-of-water phase: Place patient in a supine position, maintain an open airway, give 2 rescue breaths, check for pulse, initiate CPR. Get AED. Package victim for Immediate transportation to Hospital.

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22
Q

What is the treatment for Carbon Monoxide Poisoning?

A

Get the diver to fresh air.
Place diver on 100% O2
Seek medical attention.
Hyperbaric oxygen therapy is the definitive treatment of choice. Recommend TT6 for severe symptoms.

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23
Q

What are the prerequisites for a squeeze?

A

Gas filled space, rigid walls, ambient change in pressure, vascular penetration, enclosed space.

24
Q

What is the most common type of barotrauma?

A

Middle Ear Squeeze

25
Q

Symptoms AND treatment of a middle ear squeeze?

A

Pain, fullness in the ear, hearing loss, or mild vertigo. Diver may also have a bloody nose.
Treatment: Decongestants, pain meds, and cessation of diving until the damage is healed. Refer to an ENT specialist.

26
Q

What are the primary symptoms of inner ear barotrauma?

A

Persistent vertigo and hearing loss.

27
Q

If pain in the ear occurs during ASCENT…

A

Do NOT perform Valsalva.
Descend a few feet to relieve symptoms and continue ascent at a slower rate. If symptoms develop into hearing loss or vertigo, and you can’t ascertain if it’s IEB or AEG immediately move to recompression.

28
Q

Symptoms of a REVERSE sinus squeeze?

A

When gas is trapped in the sinus cavity, the blood supply to the infraorbital nerve may be reduced leading to numbness of the eyelid, upper lip, side if nose, or face. Numbness will resolve itself.

29
Q

What cranial nerves controls eye movement? How are they tested?

A

Ocular motor, trochlear, abducen.
Test all 3 with quadrant test, move point of focus to 4 corners and back in toward patient’s nose.

30
Q

What cranial nerve controls the gag reflex?

A

Glossopharyngeal. (Not usually tested.)

31
Q

What cranial nerve controls vocal cords and roof of the mouth?

A

Vagus.

32
Q

How do we test the hypoglossal cranial nerve?

A

Muscle activity of the tongue, have the patient stick their tongue out and say “Ahh!”

33
Q

How is extremity strength rated?

A

0- Paralysis
1- Profound Weakness
2- Severe Weakness
3- Moderate Weakness
4- Mild Weakness
5- Normal

34
Q

On the Neuro scale of extremity strength, define a (1).

A

Profound weakness: A flicker or trace of muscle contraction.

35
Q

On the Neuro scale of extremity strength, define a (2).

A

Severe Weakness: Able to contract muscle but cannot move joint against gravity.

36
Q

On the Neuro scale of extremity strength, define a (3).

A

Moderate weakness: Able to overcome the force of gravity but not the resistance of the examiner.

37
Q

What are the parts of a Neurological Exam?

A

Mental Status.
Coordination.
Motor.
Cranial Nerves.
Sensory.
Deep tendon reflexes.

38
Q

How do we test (cerebellar/inner ear function) during a neurological exam?

A

Heel-to-toe test.
Romberg test.
Finger-to-nose test.
Heel-shin slide test.
Rapid alternating movement test.

39
Q

Any pain occurring in _______ and _____ areas, including the ______, should be considered as symptoms arising from spinal cord involvement and treated as Type II DCS.

A

Abdominal and thoracic areas, including the hips.

40
Q

Never interrupt chest compressions foe longer than ____.

A

10 seconds.

41
Q

When Type I DCS is suspected, but a full neurological exam cannot be completed before compression, what is your response?

A

Treat as Type II DCS.

42
Q

What is the treatment for DCS Type I?

A

Initial recompression to 60fsw.
If the patient experience COMPLETE RELIEF during the first 10 min, recommend completing a TT5.
If the patient does NOT experience COMPLETE RELIEF in the first 10 minutes, recommend a TT5.

43
Q

What are the primary objectives of recompression treatment?

A

Compress gas bubbles, relieving local pressure and restarting blood flow.
Allow sufficient time for bubble resorption.
Increase blood O2 content and improve oxygen delivery to injured tissues.

44
Q

If a patient suffering from AGE/DCS is to be transported by helicopter…

A

the aircraft should be flown as low as safely possible, preferably less than 1000 feet.

45
Q

What are the symptoms of CNS O2 Toxicity?

A

VENTID-C
Vision, Ears, Nausea, Twitching/Tingling, Irritability, Dizziness, Convulsions.

46
Q

What is considered a normal respiratory rate?

A

12-16 breaths per minute.

47
Q

A sudden sharp pain in the chest, followed by shortness of breath/labored breathing, rapid heart rate, weak pulse, and anxiety indicates what?

A

Pneumothorax.

48
Q

Running out of air is a common cause if ____ during SCUBA Diving?

A

Asphyxia.

49
Q

SCUBA operations produce a comparatively high incidence of what type of accidents?

A

Embolism, specifically AGE.

50
Q

The depth of each decompression stop should be calculated so that the diver’s ______ is never brought above the depth prescribed for the stop.

A

Chest

51
Q

______ is a prerequisite for subcutaneous emphysema.

A

Mediastinal Emphysema.

52
Q

Treatment for shock?

A

Ensure adequate breathing.
Control bleeding.
Administer Oxygen.
Lay Down and Elevate legs.
Avoid rough handling.
Keep warm.
Give nothing by mouth.

53
Q

Vitals

A

BP 120/80
Pulse 60-100bpm
Respirations 12-16 breaths per minute. (Ventilate for less than 8)
Core temp: 98.6F

54
Q

Do not initiate ______ with severe cases of hypothermia

A

Active rewarming.

55
Q

The hallmark of middle ear squeeze is _____ caused by _______.

A

Sharp pain caused by stretching of the ear drum.

56
Q

______ should not be initiated on a severely hypothermic divers, unless it can be determined that the heart has stopped or is in ventricular fibrillation

A

CPR

57
Q

Immersion Pulminary Edema

A

Coughing, shortness of breath, blood tinged mucus. Chest pain is noticeably absent.

SCUBA Sup (7 decks)

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