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KIN 424 - Medical Aspects of Sport > Module 3 - Physiology and Medicine of Diving and Immersion > Flashcards

Module 3 - Physiology and Medicine of Diving and Immersion Flashcards

1
Q

What are the types of Hyperbaric Exposures?

A
  • SCUBA diving
  • Rebreathers
  • Umbilical (surface supply) device
  • Hyperbaric Chamber Exposure
  • Breathhold/Free Diving: Pearl Divers; Syncro Swimmers
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2
Q

Describe SCUBA Diving

A

Breath air or gas from a tank and it goes to the environment
- Open Circuit
- Expired Gases Released
- Bubbles

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3
Q

Describe Rebreathers

A

Uses Same gas, more than once, good for stealth
- Apparatus
- Closed Circuit
- No Bubbles Exhausted
- Rarely used by Civilians

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4
Q

Describe Umbilical/Surface Supply diving

A

old-timey diving
- connection from diver and ship
- air pumped from above water
- exclusively used by commercial divers
- long duration

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5
Q

Describe a JIM suit

A

Mix between exoskeleton and personal submarine
- surface rigid
- pressure inside different from pressure outside
- Dexterity and mobility reduced

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6
Q

Describe Free Diving

A
  • Single Breath
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7
Q

When is Free Diving used?

A
  • Competition: athletes
  • Commercial: spear fishers, pearl divers
  • Recreational
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8
Q

Describe Boyle’s Law

A
  • Pressure of given mass of ideal gas is inversely proportional to its volume at constant temperature
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9
Q

How does Boyle’s Law relate to diving?

A
  • Deeper dive = increased pressure = decreased volume
  • every 10m of depth increased in pressure by 1atm, volume decrease by 1/2
  • on the way up, it is reverse
  • Density of gas remains the same
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10
Q

What is Shallow Water Blackout?

A
  • Passing out in water and drowning
  • Results due to low O2
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11
Q

How does Shallow Water Blackout Occur?

A

O2 decreases below the threshold for consciousness before CO2 increases above the threshold for the urge to breathe
- Hyperventilation before diving: Reduces CO2 in blood
- Diving deep: increases pressure, increases O2 in blood
- On the way up Pressure decreases, O2 decreases and you pass out

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12
Q

How do you avoid blackout?

A
  • Never Swim Alone
  • Never ignore urge to breathe
  • Certified lifeguard on duty
  • Do not attempt long or competitive kicks for any reason
  • Only perform underwater training activities with proper supervision
  • Never compete with other swimmers to see who can swim the farthest underwater
  • Never play breath holding games
  • Never hyperventilate before performing underwater swim or kick
  • Proper buffer time between training
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13
Q

What is the common term ‘squeezes’ referring to?

A
  • Hyperbaric Trauma
  • Pressure Injury
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14
Q

Describe a Mask Squeeze

A
  • pressure difference between Scooba Mask and ambient pressure
  • Blood squeezes outside of blood vessels in the eye, white part
  • Does not affect vision or long-term vison
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15
Q

Describe Ear Squeeze

A
  • Pressure difference between the middle and outer ear
  • Outside tympanic membrane: ambient pressure
  • Inside tympanic membrane: different pressure
  • Eustachian tube: allows for pressure equalization
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16
Q

What are the risk factors of Ear Squeeze?

A
  • Upper respiratory infection
  • Difficulty clearing ears
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17
Q

What is the main symptom of Ear Squeeze?

A
  • Pain
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18
Q

Describe a Sinus Squeeze

A
  • Poor communication to nose
  • Congestion, edema, bleeding
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19
Q

When does a Sinus Squeeze occur?

A
  • Infection; edema; or swelling
  • Interference in communication with sinus and nasal pharynx
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20
Q

Describe Skin Squeeze

A
  • Dry suit seals to wrist, neck and ankles
  • Volume decreases with depth
  • Suit presses against the skin
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21
Q

When is a dry suit used while diving?

A
  • in Cold Water
  • To keep you dry
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22
Q

How can Skin Squeeze be reduced?

A
  • Better technique
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23
Q

What is pulmonary Barotrauma?

A
  • Pressure injury in the lung
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24
Q

What are the two types of Pulmonary Barotrauma?

A
  • Pneumothorax
  • Arterial Gas Embolism
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25
What happens when you go up to fast in the water when diving?
- Air expands and can burst lung
26
Where can air expand and damage the lung when rising to fast when diving?
Alveolus - Into Capillary: Arterial Gas Embolism - Into Mediastinum or Pleural Cavity: Pneumothorax
27
What is a Pneumothorax?
- Collapsed Lung
28
What is an Arterial Gas Embolism?
- Air Bubbles in the blood
29
What is a Pulmonary Embolism?
- Clot that gets lodged
30
What can happen with Gas trapping? What can it lead to?
Pulmonary Barotrauma - No gas exchange: hypoxic
31
Describe the facts of Arterial Gas Embolism
- Sometimes called Air Embolism - Kills 5% of divers immediately - 50% will completely recover - Symptoms depend on tissue affected - Extremely Variable
32
How does Arterial Gas Embolism occur?
- Bubbles of air leave alveoli - Enters Arterial Side - Travels throughout body causing blockages to blood flow
33
How do 5% of divers die immediately when they get an Arterial Gas Embolism?
- Cardiac Arrest
34
What are the different types of symptoms for Arterial Gas Embolism?
- Cerebral: Numbness; weakness; altered consciousness; poor cognition - Cardiac: Cardiac Arrest; Myocardial Infraction - Other Organs: Aspiration; Altered Laboratory Enzymes
35
What are the prehospital treatments of an arterial gas embolism?
- emergency evacuation - Oxygen: increase temporary oxygen can lessen hypoxia - Positioning Trendelenburg: Position head down, bubbles against gravity - Treat near-drowning if necessary - Fluids (IV if possible): improve blood flow
36
What is the treatment for an Arterial Gas Embolism at the hospital?
- Use Recompression Chamber - Increase pressure to allow bubbles to decrease in volume
37
What are the parameters for the recompression chamber?
- Typically 2.8-6atm of pressure - 100% O2 - Resolubilizes the bubbles - Variety of different protocols
38
What are the causes of decompression sickness?
- Formation of bubbles of inert gases in the bloodstream - Occurs upon ascent/depressurization
39
How does Decompression Sickness happen?
When diving - Nitrogen dissolves in blood at high pressure (deep depths) When Returning to the Surface - Very small bubbles that come out of solution - Get lodged in small vessels in the bloodstream
40
What is similar between Pulmonary Barotrauma and Decompression Sickness? What is different?
Both - Bubbles end up in the bloodstream - Dangerous Pulmonary Barotrauma - Bubbles come from lungs Decompression Sickness - Bubbles dissolve out of solution (bloodstream)
41
What is Henry's Law?
- The amount of gas that will dissolve in the liquid relates directly to the pressure of the gas
42
What are the symptoms and signs of Musculoskeletal Decompression Sickness?
Symptoms - Joint Pain - Tingling - Numbness - Swelling Signs - Tenderness - Pain with joint motion
43
What are the symptoms and signs of Neurological Decompression Sickness?
Symptoms - Back Pain - Abdominal Pain - Weakness or Paralysis - Urine Retention - Incontinence Signs - Decreased Sensation - Weakness
44
What are the symptoms and signs of Brain Decompression Sickness?
Symptoms - Visual Loss - Headache - Confusion Signs - Disorientation - Abnormal Visual Field Testing
45
What are the symptoms and signs of Cutaneous Decompression Sickness?
Symptoms - Pruritis (itchiness) Signs - Mottled Skin
46
What are the symptoms and signs of the Chokes?
Symptoms - Dyspnoea - Cough - Chest Pain Signs - Cyanosis - Tachycardia - Tachypnoea
47
What are the symptoms and signs of Decompression Shock?
Symptoms - Weakness - Sweating - Unconsciousness Signs - Hypotension - Tachycardia - Pallor - Decreased Urination
48
What is the prehospital treatment for Decompression Sickness?
- Emergent Evacuation - Give Oxygen - Treat near-drowning if necessary - Fluids (IV if possible)
49
What is the Hospital Treatment for Decompression Sickness?
- Use Recompression Chamber
50
What are the outcomes of Decompression Sickness Treatment?
Most patients do well - 75% of patients become completely asymptomatic - 16% will have residual symptoms at 3 months
51
What's the best way to avoid Decompression Sickness?
- Dive Tables: estimate nitrogen build-up - Dive Computers: Track Diving Data (shows nitrogen build-up)
52
What are the greatest risk factors of decompression sickness?
- Exceeding depth-time exposure limits - Rapid Ascent - Dehydration - Residual Deficits from previous decompression Sickness - Obesity - Lung Disease - Intracardiac Septal Defects
53
Is it safe to fly after diving?
- Not for 12 hours
54
Why might Asthma be a problem for scuba divers?
- Asthma causes airway obstruction - Gas Trapping, can lead to pulmonary barotrauma
55
What are the current Guidelines for Asthmatics and Diving from the British Thoracic Society?
Do not dive if: - Wheeze precipitated by cold, exercise, or emotion Dive if (without medication): - Free of Asthma Symptoms - Normal lung Function Tests - Normal Exercise Tests
56
What should asthmatics who wish to dive do?
Monitor Asthma with: - Twice Daily peak flow tests - Refrain from diving if symptomatic - Refrain from diving if Peak Flow rates < 90% normal
57
What is common about all the epidemiological evidence for the risk of asthma during diving?
- low quality - potential for bias
58
What is Immersion Platypnea?
- Combination of upright status, immersion and exertion - Platypnea = shortness of breath, relieved when lying down
59
What is Immersion Pulmonary Edema thought to be caused by?
- Exercise and immersion-induced increase in pulmonary artery pressure - overpressure and leakage
60
What is thought to exacerbate Immersion Pulmonary Edema? why?
- Cold water - Immersion - Exercise Why? - Raise in Pulmonary Artery Pressure
61
What are the Symptoms of Immersion Pulmonary Edema?
- Cough - Dyspnea - Haemoptysis - Hypoxemia - Loss of Consciousness - Death
62
Why does immersion impact pulmonary edema?
- Blood pools in core - Increases pulmonary artery pressure
63
What are the Risk factors of Immersion Pulmonary Edema?
- Heavy Exertion - Cold Water - Immersion
64
Who gets Immersion Pulmonary Edema?
- Healthy Divers - Swimmers - Some Special Forces
65
What conditions can lead to immersion pulmonary edema?
- Short to prolonged exposure - Cold to thermoneutral temperature
66
What are some Facts about Immersion Pulmonary Edema?
- 197 cases now reported in literature - SCUBA divers, breathhold divers, military swimmers and triathletes - Surface to 72m depth, all temperature ranges (2-25Degrees)
67
What is the treatment for immersion pulmonary edema?
- Nifedipine reduces La threshold and peak power in athletes - Dexamethasone - prohibited substance - Salmeterol (LABA): potential for alveolar fluid clearance - Sildenafil (Viagra): shown reduce in PAP in IPE susceptibles - All proposed treatments
68
What's the difference between Decompression Illness and Decompression Sickness?
Decompression Illness - Overarching term that covers both decompression sickness and arterial gas embolism
69
How can you prevent Decompression Illness and other conditions?
- Follow dive tables - Avoid Rapid Ascents - Decompression stops on all dives: go up slowly, take stops - Never hold breath will diving: like an expanding balloon - No Flying after Diving

KIN 424 - Medical Aspects of Sport (11 decks)

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