DIVE MEDICINE Flashcards
WHAT IS HYPOXIA?
abnormal deficiency of o2 in the arterial blood.
WHAT ARE THE CAUSES OF HYPOXIA? (5)
1- improper line up 2- blockage of airway 3- breathholding 4- collapse lung (pneumothorax) 5- co poisoning
WHAT ARE THE SYMPTOMS OF HYPOXIA? (5)
1- CYANOSIS 2- loss of judgment/ concentration 3- drowsiness and weakness 4- aggitation and euphoria 5- unconsciousness
WHAT IS THE TREATMENT FOR HYPOXIA? (3)
1- 100% o2
2- switch to secondary air source
3- seek medical assistance
WHAT IS HYPERCAPNIA?
abnormal high carbon dioxide in the blood and tissue
WHAT ARE THE CAUSES OF HYPERCAPNIA? (2)
1- skip breathing
2- inadequate ventilation
WHAT ARE THE SYMPTOMS OF HYPERCAPNIA? (8)
heavy work load, shortness of breath
confusion, headache, nausea
dizziness, loss of concentration and convulsions
WHAT IS THE TREATMENT FOR HYPERCAPNIA? (3)
1- 100% O2
2- VENTILATE
3- switch to secondary air source
WHAT IS IMERSION PULMONARY EDEMA?
imersion in water causing a leakage in the circulatory system and accumulate first in the interstitial tissues of the lungs.
WHAT ARE THE CAUSES OF IPE?
immersion in cold water, negative pressure breathing, over hydration.
WHAT ARE THE SYMPTOMS OF IPE? (3)
coughing, shortness of breath.
WHAT IS THE TREATMENT FOR IPE? (3)
100%o2
transport medical facility
24hr observation
WHAT IS CO POISONING?
abnormal high levels of carbon monoxide in blood caused by bad gas absorption. Co blocks hemoglobin ability to delivery o2 to the cells, causing cellular hypoxia. CAUSES : from compressor intake/ overhaul- suspect bad gas.
WHAT ARE THE SYMPTOMS OF CO POISONING? (5)
1- tightness across the forehead 2- headache 3- nausea 4- bad taste in mouth 5- inability to concentrate
WHAT IS THE TREATMENT FOR CO POISONING? (3)
1- 100 o2
2- seek medical (hyperbaric treatment) or TT5
3- TT6 severe
WHAT’S THE PRE REC FOR BAROTRAUMA?
GRAVE
WHAT ARE THE SIGNS AND SYMPTOMS/ TREATMENT FOR A MIDDLE EAR SQUEEZE? (5)
1- SHARP pain in ear
2- vertigo, fullness in ear
3- hearing loss, bloody nose
TREATMENT:
ENT
WHAT ARE THE SIGNS/ SYMPTOMS/ TREATMENT FOR IEB?
1- NYSTAGMUS 2- persistent vertigo, hearing loss 3- tinnitus, nausea, vommitting 4- bubbling in ear, loss of balance/ concentration 5- painful w/ head position- PRESSURE.
CAUSES: mostly on descent/ surge/ surf
TREATMENT: ENT
- when in doubt to rule out AGE/ DCS, recompress SLOWLY w/ head position in upright, no BIBBS
WHAT ARE THE SIGNS/ SYMPTOMS AND TREATMENT FOR STAGGERS (INNER EAR DCS)?
1- NO NYSTAGMUS
2- difficulty walking, vomit, nausea
3- hearing loss, tinnitus, vertigo, dizziness
CAUSES: mostly on HE/O2 DIVES
WHAT ARE MEDIAL STINAL AND SUBCUTANEOUS EMPHYSEMA?
causes are from coughing or breath holding in ascent, or a blow to the chest.
SYMPTOMS:
1- MILD/ MODERATE CHEST pain behind breast bone.
2- DULL ache, coughing, tightness
3- RADIATE SHOULDER AND BACK
4- pain may increase upon inspiration
5- fullness around neck, voice change
TREATMENT:
100% O2
recompress only by discretion of DMO when ruled out PNEUMOTHORAX.
WHAT IS PNEUMOTHORAX?
SYMPTOMS: 1- SHARP/ SUDDEN PAIN 2- shortness of breath 3- laboured breathing 4- weak pulse/ anxiety 5- guarded. 6- CYANOSIS
2 TYPES:
SIMPLE (one time leakage)
TENSION: trapped in plural space (most serious)
TREATMENT:
100% O2
if AGE/DCS is suspect, may recompress tip depth of relief until thoracic cavity can be properly vented.
WHAT IS CNS O2 TOXICITY?
VENTID C
TREATMENT:
ascend, off o2, switch to secondary air source
What is DCS? TYPE 1: (not life threatning)
• usually on deeper or shallow- longer dives
• gradual or suden onset >:10
• most often diving w/o appropriate stop.
• SYMPTOMS:
o Shoulder, elbow, wrist, hand, knee, ankle (joints)
o Pain, marbling, swelling
o May worsen when movement
o Can not pin point
• TREATMENT:
o 100% O2
o TT5 (if not severe)
What is DCS TYPE II?
• NEUROLOGICAL/ INNER EAR (STAGGERS)/ CARDIO PULMONARY (CHOKES)
• SYMPTOMS:
o NEURO: numbness, tingling, prickling, PINS AND NEEDLES, creeping, electric sensation, paralysis, muscle weakness, mental status change, bizarre behavior
o STAGGERS: tinnitus, hearing loss, vomiting, nausea, NO NYSTAGMUS
o CHOKES: burning sensation in the chest upon deep inhalation.
• TREATMENT:
o 100% O2
o TT6/ TT6A – severe/ unchanged or worsen
• note:
o upon receiving treatment, no diving until after 30 days having no neurological deficit. If showing any signs after 30 days, patient needs a BUMED waiver.
What are CHOKES?
- chest pain aggravated and irritated by inhalation.
* Careful examination for signs of pneumothorax should be performed presenting shortness of breath.
AFTER CARE - how many days FOR DCS AND AGE:
- 7 days (DCS TYPE 1)
- 30 days (DCS/ AGE) w/ dmo discretion
- lidocaine for AGE, but not DCS
What is HYPOGLYCEMIA?
- low blood sugar, confusion, not coordinated, anxiety, loss of consciousness,
- excessive sweating, HUNGRY, numbness, chills and trembling.
What are the signs and symptoms for SHOCK?
- respiration low, eyes vacant, dialated,
- CYANOSIS
- Skin pale/ cold, blood pressure drop
- Vomiting, thirsty
- Pulse weak, rapid
- TREATMENT:
o GIVE NOTHING BY MOUTH!!!
o Maintain breathing open airway
o Control bleeding, administer 100 o2
o Elevate (not head/ chest injuries)
o Keep warm, laying down
What is the normal respitory cycle rate?
• 12-18 breathes per min.
What is normal blood pressure?
• 120/80 systolic/diastolic
What is the normal body temperature?
• 98.6 degrees
How many liters of blood does the body carry?
• 5 liters
At what temperature will a diver start to become chill?
• 72 degrees
Warm water temperature is?
- 88 degrees
* Diving in water temp greater than 99 degrees should not be attempted after first contact NAVSEA OOC.
what do you do for a PULSE LESS DIVER?
1- if no AED or DMO around, compress diver to 60’ in chamber.
2- if AED arrives w/in :20, bring diver up 30fpm and attempt to revive diver. If can not revive, DO NOT RECOMPRESS.
what do you do for TREATMENT OF REOCCURRENCE?
1- if reoccurrence occurred 60fw, contact DMO and compress depth of relief NTE 165’ w/ patient off of o2, remain at depth :30. If more time needed consult DMO TT4.
3- if no need for more time, recompress TT6A
what do you do when you have a bottom excess of table?
1- contact NEDU
2- DIVE MAN algorithm to compute
3- read deepest depth until depth is found that has a schedule equal or longer bottom schedules at various depths.
example: diver trapped
155/ :100
because 160’ table longest bt is :80, go to 170/:120
what do you do when you have contaminated air?
1- check line up on console
2- re ventilate divers ::20
3- continue w/ decompression
what do you do when you have DCS IN THE WATER?
1- predominant symptom are joint pain, more serious are numbness, weakness, hearing loss and vertigo.
- appear on shallower stops
- occur also during ascent to first stop or shortly after
- DMO should be sought whenever possible.
2- dispatch stby to assist
3- continue deco the other diver according to original schedule.
4- have diver descend 10’ down if significant relief is not obtained, descend another 10’ down.
5- remain at treatment depth :30 resume deco from treatment depth by multiplying subsequent air stop times by 1.5.
5- if recompression went deeper than first stop, insert intervening stops in 10’ increments betw/ treatment depths and original first stop equal to 1.5 times original first stop time.
6- if diver is undergoing treatment at 40’, return to surface by multiplying 30 and 20’ stop times by 1.5. if it doesn’t call for 30’ insert a 30’ stop time equal to 20 stop time.
7- if at 30’ return surface by x 20’ stop time by 1.5.
8- if diver surface symptoms free, place on o2, transport and TT5. (this maybe waived if in remote location)
9- if not symptom free, transport TT6.
10- if chamber is immediately available on dive station, dive sup may elect to forego treatment w/ in water recompression and surface diver for treatment in chamber. or treat diver in water for :30 to relieve symptoms, then surface diver for further treatment in chamber.
11- in either case, SI should be w/in :05, diver consider to be DCS Type II even if it’s type I.
12- after completion of treatment, observe for 6hrs, if reoccur treat as reoccurrence type II symptoms.
if DIVER W/ DCS in water cannot remain in water?
1- surface diver @ 30fpm
2- if level 1 chamber available, recompress diver in chamber
3- if chamber not available, transport to nearest recompression chamber, treat as such TT6/ TT6A
ALTITUDE DCS- JOINT PAIN
1- if only pain was present, but resolved BEFORE reaching 1 ATA from altitude, maybe treated w/ 2 hours of 100% o2 breathing at surface followed by 24hr observation.
2- After return of 1 ATA, other symptoms or joint pain- transport to chamber even if symptoms resolved during transport. 100% o2.
FIRST AID BLEEDING:
1- apply direct pressure/ elevate
2- pressure points for :15
