Dive med test Flashcards
P1 V1 = P2 V2 Or PV = K
Boyles Law
Charles Law
Charging
Boyles Law
pressure and POIS
Daltons Law
Mixed Gas
Henrys Law
Absorption and DCS
1.3
wet
2.4
dry
Vitamin E and HBOT
Decreases susceptibility to free radicals which reduces CNS O2 tox
RANKINE
459.67 or 460
absolute pressure during dive of 72 fsw
3.18
What’s the benefit of using air as gas?
dive deeper than you can with 100% O2
Which phase of O2 tox includes Edema, Intra-Alveolar Hemorrhage, and destruction of the capillaries?
Acute Exudative Phase
Reasons for TT6
DCS not relieved
AGE
skin marbling?
cutis mam
tx a type II
when tx co poisoning, how is O2 working?
Gas Washout
Why use saline in ET tube?
So it is non-compressible
Most common side effect of HBOT?
Ear pain eyes CROAC (central retinal artery occlusion)
What causes middle ear squeeze / otitis media
Eustachian tube dysfunction
Cause of Otitis Externa?
Wax impaction
Pathological response to formation of bubbles in the tissues?
DCS
Caloric Vertigo
Change in water temp
Sinus squeeze
mild redness in canal post diving, tx?
7 days no diving / re-assess
Alka-Seltzer’s cause what in diving?
GI / Abdominal squeeze
Decongestants can mimic?
spinal DCS sx
Can females take oral contraceptive and dive?
Yes, but it increases chance of stroke
Shooting pain in the belly?
Ridicular tx as type II
Sx of hypercapnia
RUDE-PHS
Dives requiring cardiac monitoring or EKG?
Any deeper than 2 ATA
Bilateral myringotomy prior to HBO to prevent perfs, what is the landmark?
Anterior - Inferior quadrant of the TM
prevents damage to the connection point of the malleus to the TM
Round window rupture is most often accompanied with…
Vertigo
Oval window rupture is less common due the protection from the?
stapes
Alternobaric facial palsy tx
toynbees maneuver
Pathology of round window rupture is the leakage of the…
cochlear aqua duct
High Doses of oral decongestants may cause?
Arrhythmia (palpitation / syncope)
THERE IS NO OFFICIAL APPROVED MEDICATIONS LIST
Are oral contraceptives safe for diving?
yes
Antihistamines and diving?
currently considered unsafe, but under some circumstances may be authorized
Anticholinergic effects include?
sedation, loss of judgement, and worsening of n2 narcosis sx. (contained in sea sickness patches)
Divers with latent TB
May be returned to Diving status in 8 weeks (provided they are stable and “A” symptomatic)
epinephrine is given at what dose
concentration of 1:1000
0.1-0.5mg
IM/Sub-cu
Diphenhydramine dose
25-50 mg Iv or IM
Solu/Medrol dose
125mg IV or IM
Immersion Dieresis
250-500cc of fluids per hour
Never use D5W
Fluids for all DCS PTs unless?
pulmonary (chokes)
LMWH should be used for all PTs w. inability to walk due to any degree of lower extremity paralysis from DCS/AGE
What’s the tx?
Enoxaparin 30 mg Subcutaneous
EVERY 12 HOURS
lidocaine not for DCS
What’s the lidocaine dose for therapeutic relief of AGE?
- IV 1mg/kg followed by 2-4mg/minute
- IM4-5mg 15 min after dose, lasting around 90 minutes
STEROIDS ARE NOT INDICATED
T2
Charles law
pressure gradient law
henrys
Which DCS is more susceptible to CNS ox tox
spinal
sx of pulmonary 02 tox
- end inspiratory discomfort
- substernal burning and severe pain on inspiration
- shortness of breath
- paroxysmal cough
- sx resolve spontaneously
When could it be indicated to modify tt and take pt off o2
when there is pain on inspiration
When a diver is successfully tx for DCS/AGE, how long until returned to diving duty?
30 days
Diver tx for type 1 DCS, returns?
7 days with DMO concurrence
What will a pt experience prior to subcutaneous emphysema?
mediastinal
What must be ruled out prior to HBOT?
pneumothorax
altitude at which helo must stay when transporting pt
1000 ft
Non Emergent HBOT tx gets approved by who?
BUMED M95
what portion of the ear feels the pressure?
external surface
Vascular penetration
expand, leak, burst
In middle ear O2 absorption syndrome what does the O2 create?
negative vacuum
How does barotrauma occur in the inner ear?
fluid shifts
what is the anatomical landmark that exhibits the narrow passage and transmits CFS?
cochlear aqueduct
What bone attaches to the oval window?
stapes
hole / perforation
fistula
If a diver experiences vertigo lasting for 1 minute or less
considered transient, continue dive
What is the landmark for alternobaric verigo?
inner ear
caloric vertigo
change in water temp
frontal maxillary squeeze, often confuse with?
barodontalgia
relief of intestinal squeeze
flatulence
What is the concern with decongestants?
cardiac concerns, arrhythmias
oral decongestants have minimal effect when compared with?
topical
NSAIDS are not recommended with?
type II DCS
what is recommended to reduce free radicals (oxidation) in HBOT?
400 mg Vitamin E
What is recommended with paralysis?
enoxaprin at 30mg (lovinox)
Antihistamine are correlated with?
drowsiness / N2 narcosis
when you enter water and HR drops?
Hyper-vagotonic syndrome
tx carotid massage
What should be prescribed for deep marine life puncture?
antibiotics
How long are you NPQ from INH?
8 weeks (stable and A symptomatic)
All divers must have minimum corrected vision of what?
20/25
What is the inst for pregnant divers
BUMEDINST 6200.15A
ADVANTAGE OF DIVING WITH AIR?
YOU CAN DIVE DEEPER
WHAT IS THE GREATEST DANGER OF CNS O2 TOX IN THE CHAMBER?
CONVULSIONS
SUB ACUTE SX
INTERSTITIAL FIBROSIS
ACUTE EXODATIVE SX
EDEMA
SX NOT RELIEVED COMPLETELY W/IN 10 MINUTES?
TT6
MOST COMMON SX OF O2 TOX?
EAR PAIN
EXTERNAL EAR SQUEEZE STEMS FROM?
WAX IMPACTION
MIDDLE EAR SQUEEZE STEMS FROM?
EUSTACHIAN TUBE DYSFUNCTION
VERTIGO IS A SX OF WHAT RUPTURING?
ROUND WINDOW RUPTURE
WHICH BAROTRAUMA IS NOT DUE TO PRESSURE IMBALANCES
OUTER EAR CANAL
SX OF FACIAL PALSY
CANNOT CLOSE EYE ON THE EFFECTED SIDE
WHAT IS THE CONCERN WITH DECONGESTANTS?
ARYTHMIA
SPHINCTER CONTRACTION
CAN YOU TAKE VITAMINS AND DIVE?
YES
CAN YOU TAKE ANTIBIOTICS AND DIVE?
MUST INVESTIGATE CONTRAINDICATIONS FIRST
WHAT MEDICATION COMES WITH A LAUNDRY LIST OF SIDE EFFECTS FOR DIVING?
ANTIHISTAMINES
CAN YOU DIVE WHEN TAKING HCTZ WHICH IS A HYPER TENSIVE RX?
YES, AS LONG AS IT IS THE ONLY MED YOURE TAKING FOR BP
WHAT SX OF PYSCHOTROPICS ARE NOT DISQUALIFYING FOR DIVING?
MIGRAINS
NEVER USE WHAT FLUID FOR DIVING?
D5W
WHAT IS THE TIMELINE FOR DIVING AFTER HERNIA REPAIR?
APPLY FOR INTERIM WAIVER AFTER 90 DAYS / 3 MONTHS, THIS WILL BE GOOD FOR A TOTAL OF 6 MONTHS, PERMENANT WAIVER MUST BE COMPLETED BY 1 YEAR MARK.
HOW LONG MUST YOU WAIT POST NATAL?
6 MONTHS
FORM FOR DOCUMENTING AN UP / DOWN DIVER?
6150/2
WHAT HX QUESTION IS MOST IMPORTANT TO ASK?
HAVE YOU HAD AGE / DCS BEFORE?
IF SO, DIVER IS MORE LIKELY TO GET IT AGAIN
WHAT CRAINIAL NERVE AND NUMBER GOVERNS THE VOICE?
VAGUS #10
WHAT IS THE TERM FOR IMPAIRED STRENGTH?
PARESIS
WHAT IS THE TERM FOR IMPAIRED STRENGTH?
PARESIS
WHAT IS THE TERM FOR IMPAIRED STRENGTH?
PARESIS
WHAT IS THE TERM FOR IMPAIRED STRENGTH?
PARESIS
WHAT DERMATONE LABELS THE SENSATION OF THE KNEE?
L3/L4
WHAT DERMATONE LABELS THE SENSATION OF THE KNEE?
L3/L4
BURNING SENSATION RUNNING FROM THE ARM DOWN TO THE HAND IS WHAT FORM OF DCS?
SPINAL
TYPE II
SCANARIO WHERE THE PT FEELS PAIN LIKE SX OF ROCK FALLINIG ON THE FOOT, EFFECTING WHAT NERVOUSE SYSTEM
PERIPHERAL
PNS
SHOOTING PAIN AROUND THE RIBS?
RIDICULAR
TYPE II
WHAT DO THESE SX EFFECT: MUFFLED HEARING SENSATION, LOSS OF SENSATION, DECREASED FACIAL SENSATION, DECREASED VISION…
BRAIN STEM
DIFFICULTY WITH FINGER TO NOSE TEST / BALANCE, EFFECTS WHAT PORTION OF THE BRAIN?
CEREBELLUM
IF PT EXPERIENCES LEG WEAKNESS / NUMBNESS POST DIVE, WHAT PORTION OF THE BRAIN IS EFFECTED?
CEREBRUM
AUCTHONOMOUS SENSORY / REFFERED TO AS THE AUTOMATOR FOR THE BODY?
CEREBRUM
HOW MANY RCC TX OBJECTIVES ARE THERE?
3
ALTERNOBARIC VERTIGO EFFECTS WHAT PART OF THE EAR?
INNER EAR
WHAT IS THE PRIMARY CONCERN WITH ASCENT INJURIES?
HOLDING BREATH OR PASSED OUT ON THE WAY UP TO THE SURFACE CAUSING POIS
CEREBRAL DCS SX EFFECT
MOTOR DEFICIT
WHAT TYPE OF THERAPY IS NECROTIZING SOFT TISSUE TX
ADJUNCTIVE THERAPY
WET SUITE HOODY CAUSES WHAT TYPE OF SQUEEZE?
MIDDLE EAR
PRESSURE ON THE WAY DOWN IMPACTS WHAT PORTION OF THE EAR?
TM
MIDDLE EAR / PRESSURE IMBALANCE RUPTURES WHAT?
OVAL WINDOW
WHAT AGE REQUIRES ANNUAL EXAMS
60
PAIN FROM THE THIGH DOWN TO THE FEET, STEMS FROM?
LOWER SPINAL CORD
BUMED 1300.2
SUITABILITY
1754
EFMP
WHOS RESPONSIBILITY IS IT TO ASSURE THE FM?
COMMANDS
6200.15 SERIES
PREGNANCY
WHO APPROVES MATERNITY/CONVELESCENT LEAVE?
CO
UP TO WHAT WEEK CAN PREGANT FEMALE FLY OR TRAVEL OVERSEAS?
28 WEEK
WHOS RESPONSIBILTY TO WORK WITHIN LIMITATIONS OF PREGNENCY INST?
MEMBER
AUTHORIZES 1 OR MORE AREA OF BURIAL FOR NOK?
RETURN OF REMAINS PROGRAM
DECEDENT AFFAIRS PROGRAM
HIGH STANDARDS OF UNIFORMITY
