Diving Injuries Flashcards
What is DCS
Decompressions sickness
How many types of DCS are there
Type I - not life threatening
Type II - serious and possibly life-threatening
What are the symptoms of DCS Type I
Joint pain - commonly to knees, ankle, elbow and wrist (think outside of the thorax)
Skin symptoms - itching and marbling such as cutis marmorata
Lymph node symptoms - painful lymph nodes and swelling
What is the treatment for DCS type I
Full neuro exam to rule out AGE or DCS Type II
Oxygen and transport to nearest recompression chamber
What are the symptoms of DCS Type II
Neurological DCS - (think brain and spine) numbness, muscle weakness, mental status changes, incontinence
Inner ear DCS - (Staggers) tinnitus, hearing loss, vertigo, dizziness, nausea, vomiting
Cardiopulmonary DCS - (Chokes) chest pain, painful inspiration, irritating cough, tachypnea, lung congestion
What is the treatment for DCS Type II
Full neuro exam to rule out AGE
Oxygen and recompression chamber
What is POIS
Pulmonary over inflation syndrome
When does POIS occur
When gas is forced through damage lung tissue into the arterial system, and/or tissues in the middle of the chest surrounding the lungs, heart, trachea, and major vessels
What s AGE
Arterial gas embolism
AGE can commonly lead to what
Stroke like symptoms, arrhythmias, and in some cases heart attack
What is the treatment for AGE
Basic first aid - cardiac arrest requires CPR, AED, and transport to the nearest ED
Oxygen and recompression chamber
What is mediastinal/subcutaneous emphysema
Occurs when gas is forced through damaged lung tissue into the loose mediastinal tissues in the middle of the chest surrounding the heart, trachea and major vessels
What are the symptoms of mediastinal/subcutaneous emphysema
Mild-moderate pain under the breastbone
Pain that radiates to the shoulder or back
Fullness around the neck and difficulty swallowing
Voice change
Palpitation of the skin near the trachea may result in crepitus
What is the treatment for mediastinal/subcutaneous emphysema
Neuro to rule out AGE
Cardio/lung exam
Oxygen and shallow recompression to 5-10 feet
What is a simple pneumothorax
A one time escape of gas
What is a tension pneumothorax
When air continues to escape and collapses the lung which compromises cardiac function
What are the symptoms of pneumothorax
Sudden, sharp chest pain
Shortness of breath
Labored breathing
Rapid heart rate
Weak pulse
Anxiety (impending doom)
What is the treatment of a pneumothorax
Heart/lung exam
100% O2
Needle - d
Chest tube as warranted - definitive treatment
What is barotrauma
Damage caused by vascular penetration as a result of ambient pressure change to enclosed gas-filled spaces that are surrounded by rigid walls
What are the types of barotrauma
Ear squeezes
Sinus squeeze
Tooth squeeze
What is ear squeeze caused by
Injury to tissues within the ear as a result of an obstruction or inability to equalized pressure to the inside, or outside the areas of the tympanic membrane (TM)
What are the symptoms of ear squeeze
Sharp pain in the ear
Rupture of the TM
Vertigo
Tinnitus
Hearing loss
Nausea/vomiting
What is the treatment of ear squeeze
HEENT exam
Decongestants
Pain medication
If a ruptured TM is suspected, DO NOT administer medication directly into the ear canal
How can carbon monoxide poisoning occur in a diver
Their air supply can be contaminated by carbon monoxide when the compressor intake is placed too close to the compressors engine exhaust
What are the symptoms of carbon monoxide poisoning
Headaches
Dizziness
Confusion
Nausea
Vomiting
Tightness across the forehead (band-like pressure)
What is the treatment for carbon monoxide poisoning
Getting diver to fresh air
Oxygen and transport to hyperbaric or MTF
What is hypercapnia
An abnormally high level of carbon dioxide in the blood and body tissues
What are the symptoms of hypercapnia
Increased breathing rate
Shortness of breath
Confusion or feelings of euphoria
Inability to concentrate
Increased sweating
Drowsiness
Headache
Loss of consciousness
Convulsions
What is the treatment for hypercapnia
Decreasing the level of exertion to reduce CO2 production
BASICALLY…. It’s prevention or fix the problem
What is CNS oxygen toxicity
BASICALLY… the extent of the toxicity is dependent upon both the oxygen partial pressure and the exposure time
What are the symptoms of CNS oxygen toxicity
VENTIDC
Vision - is tunneled, decreased periphery, and ther
Tinnitus
Nausea
Eyes twitching and facial muscles
Irritability
Dizziness
Convulsions
What is the treatment of CNS oxygen toxicity
Shift to a breathing mixture with lower oxygen percentage
Immediately ascend
What is pulmonary oxygen toxicity
A 12 hour exposure to a partial pressure of 1 ata that will produce mild symptoms and measurable decreases in lung function
What are symptoms of pulmonary oxygen toxicity
Burning sensation during inspiration
Pain during inspiration
Cough
Decreased pulmonary function
What is the treatment of pulmonary oxygen toxicity
Remove the patient from O2 if respiratory discomfort is present
Consult DMO
What is shallow water blackout
Oxygen PPO2 is higher at depth and during ascent the PPO2 decreases and increases the risk of hypoxia and unconsciousness
What is the biggest risk of shallow water blackout
Subsequent drowning
What are the symptoms of shallow water blackout
Unconsciousness close to the surface or subsurface
Hypoxia
Subsequent drowning
Cardiac/respiratory arrest
What is the treatment for shallow water blackout
In water: ventilation only, open airway, check breathing, provide 5 rescue breaths
If the patient is pulseless, continue CPR utilizing ABCs
What is SIPE
Swimming induced pulmonary edema
When does SIPE occur
During swimming or diving operations; often in young individuals with no predisposing conditions and believed to be related to exertion, immersion in cold water and overhydrating
What are the symptoms of SIPE
Dull to sharp substernal chest pain
Hemoptysis
SOB
Frothy sputum
What is the treatment for SIPE
Remove patient from wet/cold environment
Supplemental oxygen
Complete heart/lung exam
EKG
X-ray within 24 hours
