Treatments

Question 1

What should you do if a patient develops CNS O2 toxicity while undergoing recompression?

1. Non convulsive
2. 2nd non convulsive or convulsive

Answer 1

1. remove O2. Once symptoms resolve, wait 15 minutes, replace O2 and resume table at point of interruption.
2. For 5,6,6A: remove mask, once symptoms resolve, ascend 10 fsw at 1f/s and begin breathing O2 at the shallower depth at point of interruption.
   For 4,7,8: remove mask, (c/s DMO)

Question 2

What is the DDx for CHEST PAIN after diving? (8)

Answer 2

The Chokes
Spinal Cord DCS (usually paresthsia/anesthesia with girdle–like chest pain)
Pulmonary O2 Tox
Pneumomediastinum
Pneumothorax
MI
Anxiety
Trauma

Question 3

What is the DDx for VERTIGO from diving? (5)

Answer 3

caloric vertigo (resolves when leaving water)
alternobaric vertigo (transient typically on ascent)
inner ear barotrauma (hx of trouble equalizing – more common descent)
inner ear DCS (more common on mixed gas, an no evidence of MEB)
AGE

Question 4

What do you do for recurrence of symptoms during treatment?1. <60 fsw
2. > 60fsw

Answer 4

1. descend to 60fsw, restart TT6

2. descent to DOR (165fsw) restart TT6A

Question 5

How long should a patient be observed after completing TT5?

Answer 5

2 hours at chamber facility

must remain within 1 hour of facility for 24 hours

Question 6

How long should a patient be observed after completing TT6 or greater?

Answer 6

6 hours at chamber facility

*can be changed by DMO – patient must be with personnel who can identify symptoms and return to facility within 30 mins

Question 7

What is the treatment for stinging/envenomation injuries?

Answer 7

MARCH
symptomatic care \nwound care (flush with SW/saline – NOT water)
HWI – 117 for 30–90 mins
CASEVAC
*antivenom if available

Question 8

What toxins are heat stable?

Answer 8

sea snakes venom
blue ringed octopus

*pufferfish and paralytic shellfish also

Question 9

When do you stop cooling a heat stroke patient??

Answer 9

101 RECTAL temp

Question 10

How do you treat a seasnake bite?

Answer 10

ACE wrap away from heart

antivenom if available

Question 11

What sea antivenoms are available?

Answer 11

box jellyfish (most deadly!!)
stone fish
sea snake

Question 12

what marine life venom causes respiratory depression?

Answer 12

cone shell

Question 13

Sea Bathers’ Eruption vs. Swimmers’ Itch

Answer 13

SBE: larvae from jellysfish, painful/itchy rash in bathing suit pattern.

SI: schistosome larva (lakes in midwest) PRURITIS

Question 14

How do you treat mediastinal and subcu emphysema?

Answer 14

100% for mild sx

5-10 fsw on 100% O2 for severe symptoms only record by DMO

Question 15

What is the ONLY Absolute Contraindication to Recompression Treatment?

Answer 15

Tension Pneumo