Pulmonary Overinflation Syndrome

Question 1

At a constant temperature, a gases pressure is inversely proportional to the volume.

Answer 1

Boyles Law

Question 2

(1) Results from gas that is forced through damaged lung tissue into the arterial system causing an air embolism to the brain (most commonly affected), heart, and other major organs.
(2) Blockage from bubble in the arterial system causes ischemia and inflammatory cascade most commonly leading to stroke like symptoms,
arrythmias, and in some cases heart attack.

Answer 2

Arterial Gas Embolism

Question 3

Sx:
(a) Gross neurological deficits occur (rapidly) within 10 minutes of injury or surfacing from a dive.
1) Unconsciousness
2) Paralysis
3) Numbness
4) Weakness
5) Fatigue
6) Behavioral Changes

Answer 3

Arterial Gas Embolism

Question 4

Treatment of Arterial Gas Embolism

Answer 4

(a) Basic first aid
1) Cardiac arrest requires CPR, AED, and transport to the nearest Emergency Department for advanced lifesaving modalities.
2) If diver regains consciousness continue transportation to Emergency Dept.
(b) 100% oxygen
(c) Immediate re-compression in a hyperbaric chamber

Question 5

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

Answer 5

Mediastinal/ Subcutaneous emphysema

Question 6

Symptoms:
(a) Mild to moderate pain under the breastbone
(b) Pain that radiates to the shoulder or back.
(c) Fullness around the neck and difficulty swallowing
(d) Voice change
(e) Palpation of the skin near the trachea may result in crepitus (cracking or crunching sensation/sound)

Answer 6

Mediastinal/ Subcutaneous emphysema

Question 7

Treatment of Mediastinal/ Subcutaneous emphysema

Answer 7

(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

Question 8

Occurs when gas is forced throught damaged lung tissue into the pleural space between the lungs and chest wall.

Answer 8

Pneumothorax

Question 9

Types of pneumothorax

Answer 9

(a) A simple pneumothorax is a one time escape of gas.
(b) A tension pneumothorax is caused when air continues to escape and collapses the lung which compromises cardiac function.

Question 10

Symptoms:
(a) Sudden, sharp chest pain
(b) Shortness of breath
(c) Labored breathing
(d) Rapid heart rate
(e) Weak pulse
(f) Anxiety (impending doom)

Answer 10

Pneumothorax

Question 11

Treatment of Pneumothorax

Answer 11

(a) Heart/lung exam
(b) 100% O2
(c) Needle-decompression
(d) Chest tube as warranted