dive stuff Flashcards
During a dive a diver’s blood and tissues absorb additional ________ from the lungs when at depth.
nitrogen/helium
What happens if a diver ascends too fast
excess gas will separate from solution and form
bubbles, produce mechanical and biochemical effects that lead to a condition known as decompression sickness.
What type of decompression sickness involves the skin, lymphatic system, muscles, and joints. It is not life threatening.
Type I decompression sickness
What issue/Tx?
Hx of ascending too quickly from a dive
(a) Joint Pain – outside of the thorax, knees, ankle, elbow and wrist. Pain is typically a dull achy pain that is unable to be pinpointed.
(b) Skin Symptoms – itching and Cutis Marmorata. Cutis Marmorata is characterized by a marbled bright red, purplish or even bluish pattern on the skin.
Type I Decompression Sickness
Treatment of DCS Type I
(a) Complete a full neurological exam to rule out AGE or DCS Type II
(b) 100% Surface Oxygen via non rebreather mask
(c) Transport to the nearest Recompression Chamber
-NOTE: If transport by helicopter maintain an altitude less than 1000ft
If transporting a DCS via AIR patient what is the altitude limit?
1000Ft
What type of DCS is a serious & possibly life threatening illness symptoms are divided into three categories (Neurological, Inner Ear & Cardio Pulmonary)
Type II DCS
What issue
Hx of ascending too quickly from a dive
(a) Neurological
-1) Numbness
-2) Paresthesia’s
-3) Muscle weakness
-4) Mental status changes
-5) Impaired urinary function
(b) Inner Ear
-1) Tinnitus
-2) Hearing Loss
-3) Vertigo
-4) Dizziness
-5) Nausea
-6) Vomiting
(c) Cardiopulmonary
-1) Chest pain
-2) Painful inspiration
-3) Irritating Cough
-4) Tachypnea
-5) Lung congestion
-6) Complete circulatory collapse
DCS Type II
Treatment
(a) Complete a full neurological exam to rule out AGE (Arterial gas embolism)
NOTE: Treatment for DCS Type II and AGE are the same.
(b) 100% Surface Oxygen via non rebreather mask
(c) Transport to the nearest Recompression Chamber
NOTE: If transport by helicopter maintain an Altitude less than 1000ft.
WHAT occurs when gas is forced through torn lung tissue into the loose mediastinal tissues in the middle of the chest surrounding the heart, trachea, and major vessels
Pulmonary Over Inflation Syndrome (POIS)
What issue/Tx?
1) Mild to moderate pain under the breastbone
2) Pain that radiates to the shoulder or back.
3) Fullness around the neck and difficulty swallowing
4) Voice
5) Palpation of the skin near the trachea may result in crepitus (cracking or crunching sound)
Mediastinal/substernal emphysema
Treatment
(a) Neuro to rule out AGE
(b) Cardio/Lung exam to rule out pnuemothorax
(c) 100% surface oxygen
(d) Shallow recompression to 5-10FSW may be warranted until symptoms resolve
This defines what?
Caused by air leaking from the tissues of the lungs into the space between the
lungs and chest wall.
Pneumothorax
What issue/Tx
Symptoms
(a) Sudden, sharp chest pain
(b) Shortness of breath
(c) Labored breathing
(d) Rapid heart rate
(e) Weak pulse
(f) Anxiety (impending doom)
Pneumothorax
Tx
(a) Heart/lung exam
(b) 100% O2
(c) Needle-decompression or chest tube as warranted
What issue?
Damage to body tissues from the mechanical effects of pressure, results when
pressure differentials between body cavites
Barotrauma
What are the different types of Barotrauma
(1) Ear squeezes
(2) Sinus squeeze
(3) Tooth squeeze
The __________ enables a diver to equalize pressure in the Middle ear.
Eustacian tube
What issue/Tx?
Hx: the diver couldn’t equalize the pressure in the Middle ear
Symptoms
(a) Sharp pain in the ear
(b) Rupture of the tympanic membrane
(c) Vertigo
(d) Tinnitus
(e) Hearing Loss
(f) Nausea/Vomiting
Ear squeeze
Tx
(a) HEENT exam
(b) Decongestants
(c) Pain medication
NOTE: If a ruptured eardrum is suspected do not administer medication directly into the ear canal without consultation of a ear, nose & throat Specialist.