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Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society

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https://www.readbyqxmd.com/read/29557102/pre-hospital-management-of-decompression-illness-expert-review-of-key-principles-and-controversies
#1
Simon J Mitchell, Michael H Bennett, Phillip Bryson, Frank K Butler, David J Doolette, James R Holm, Jacek Kot, Pierre Lafère
Guidelines for the pre-hospital management of decompression illness (DCI) had not been formally revised since the 2004 Divers Alert Network/Undersea and Hyperbaric Medical Society workshop held in Sydney, entitled "Management of mild or marginal decompression illness in remote locations". A contemporary review was initiated by the Diver's Alert Network and undertaken by a multinational committee with members from Australasia, the USA and Europe. The process began with literature reviews by designated committee members on: the diagnosis of DCI; first aid strategies for DCI; remote triage of possible DCI victims by diving medicine experts; evacuation of DCI victims; effect of delay to recompression in DCI; pitfalls in management when DCI victims present at hospitals without diving medicine expertise and in-water recompression...
March 31, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29557101/immersion-pulmonary-oedema-in-a-healthy-diver-not-exposed-to-cold-or-strenuous-exercise
#2
Olivier Castagna, Sébastien de Maistre, Bruno Schmid, Delphine Caudal, Jacques Regnard
In healthy divers, the occurrence of immersion pulmonary oedema (IPE) is commonly caused by contributory factors including strenuous exercise, cold water and negative-pressure breathing. Contrary to this established paradigm, this case reports on a 26-year-old, well-trained combat swimmer who succumbed to acute IPE during static immersion in temperate (21°C) water, while using a front-mounted counterlung rebreather. The incident occurred during repeated depth-controlled ascent practice at the French military diving school...
March 31, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29557100/vomiting-and-aspiration-of-gastric-contents-a-possible-life-threatening-combination-in-underwater-diving
#3
František Novomeský, Martin Janík, Michal Hájek, Jozef Krajčovič, Lubomír Straka
Vomiting and aspiration of gastric contents into the airways and lungs is a common and well-known clinicopathological entity. This phenomenon might also occur in underwater diving, where it can lead to life-threatening or fatal situations. This article presents two incidents involving diving-related vomiting with associated aspiration of gastric contents. One case, a 39-year-old commercial diver using a full-face diving mask, was fatal and the other was a 33-year-old, female recreational scuba diver in whom underwater vomiting was complicated by pulmonary aspiration of a solid foreign body (a peanut) into the right lower lobe bronchus...
March 31, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29557099/hyperbaric-oxygen-treatment-in-thromboangiitis-obliterans-a-retrospective-clinical-audit
#4
Dogus Hemsinli, Gokalp Altun, Safiye Tuba Kaplan, Furkan Yildirim, Gamze Cebi
INTRODUCTION: Wounds refractory to standard treatment in patients with thromboangiitis obliterans (TAO, Buerger's disease) are associated with amputation, other morbidity and mortality. The purpose of this study was to investigate the effect of hyperbaric oxygen treatment (HBOT) in patients with TAO. MATERIALS AND METHODS: Ninety-seven patients with TAO with ischaemic wounds treated between January 2007 and July 2016 were included in this dual-centre, non-randomised, retrospective study...
March 31, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29557098/challenges-in-profiling-australian-scuba-divers-through-surveys
#5
John Lippmann, David McD Taylor, Christopher Stevenson, Joanne W Williams
INTRODUCTION: This study aimed to compare the results from three Australian scuba diver surveys. As the surveys differed in recruitment methods, the expectation was that respondents would differ in some important characteristics. METHODOLOGY: Anonymous, online, cross-sectional surveys of the demographics, health, diving practices and outcomes were distributed to: (1) Divers Alert Network Asia-Pacific (DAN AP) members; (2) Professional Association of Diving Instructors (PADI) Asia-Pacific members; and (3) divers who had received any PADI non-leadership certification within the previous four years...
March 31, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29557097/modern-assessment-of-pulmonary-function-in-divers-cannot-rely-on-old-reference-values
#6
Thijs T Wingelaar, Paul Clarijs, Pieter-Jan Am van Ooij, Dave Aa Koch, Rob A van Hulst
INTRODUCTION: Pulmonary function testing (PFT) is an important part of dive medical examinations. Depending on the standard used to assess fitness to dive, different reference sets and fixed cut-off points are used. Reference values are part of an ongoing debate regarding the validity and accuracy related to different age groups, sex and ethnic backgrounds. The Global Lung Initiative (GLI) has provided an all-age reference set which corrects for sex and ethnicity (GLI-2012); this has had substantial impact on pulmonary medicine...
March 31, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29557096/long-term-changes-in-spirometry-in-occupational-divers-a-10-25-year-audit
#7
Christopher Sames, Desmond F Gorman, Simon J Mitchell, Lifeng Zhou
AIM: To determine whether long-term engagement in occupational diving causes significant changes in spirometric measurements. METHOD: All divers with adequate spirometric records spanning at least 10 years were identified from the New Zealand occupational diver database. Changes in lung function over time were compared with normative values derived using published prediction equations. Any significant changes were tested for correlation with age, duration of occupational diving, gender, smoking history and body mass index (BMI)...
March 31, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29557095/transcutaneous-oximetry-variability-in-normal-values-for-the-upper-and-lower-limb
#8
Denise F Blake, Derelle A Young, Lawrence H Brown
INTRODUCTION: Published normal transcutaneous oxygen partial pressures (Ptc O2 ) for the chest and lower limb have defined tissue hypoxia as a value of < 40 mmHg (< 30 mmHg in some patients, < 50 mmHg in others). AIM: To determine 'normal' Ptc O2 for the upper and lower limb in healthy, non-smoking adults using the Radiometer® TCM400 with tc Sensor E5250. METHOD: Thirty-two volunteers had transcutaneous oxygen measurements (TCOM) performed on the chest, upper and lower limbs breathing air, with leg then arm elevated and whilst breathing 100% oxygen...
March 31, 2018: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29241238/hyperbaric-oxygen-associated-seizure-leading-to-stroke
#9
Jordan M Warchol, Jeffrey S Cooper, Thomas S Diesing
Oxygen toxicity seizures are a well-known complication of hyperbaric oxygen treatment (HBOT). Until now, there have not been any reported cases of an acute ischaemic event (stroke) as the result of a HBOT-associated oxygen toxicity seizure. We report an event in which a seizure and stroke occurred together and consider that the stroke may have been caused by seizure-induced demand ischaemia. This challenges the generally held view that oxygen toxicity seizures in the clinical hyperbaric setting are benign. A discussion of the literature on the subject of seizure-induced brain injury is included...
December 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29241237/delayed-hyperbaric-intervention-in-life-threatening-decompression-illness
#10
Michael Fm Perez, Janet V Ongkeko Perez, April R Serrano, Maravic P Andal, Maria Cc Aldover
Arterial gas embolism is a catastrophic event. Bubbles in the arterial circulation may lodge in the brain and cause infarction in the affected area and/or in a coronary vessel causing acute myocardial ischaemia. There is no well-defined window of time beyond which a response to hyperbaric oxygen is not expected. Major improvement may occur if the patient is treated as soon as possible, but is less likely in divers with severe decompression illness who have delayed intervention. We report on a 51-year-old, male rebreather diver who suffered loss of consciousness and cardiovascular collapse within minutes of a 30-metre deep dive at a remote Micronesian dive site...
December 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29241236/diving-and-antidepressants
#11
REVIEW
Abraham L Querido
Psychoactive drugs pose a risk to both the diver and his or her buddy. Little is known about the safety of diving with antidepressants. Amongst the potential interactions with the diving environment are: somnolence; convulsions; a bleeding tendency (potentially worsening decompression illness, DCI), alterations to glucose metabolism and psychiatric side effects. Fluoxetine may potentially reduce the inflammatory process associated with DCI. This article presents guidelines for recreational diving in combination with antidepressants...
December 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29241235/personality-and-behavioural-outcomes-in-diving-current-status-and-recommendations-for-future-research
#12
REVIEW
Charles H van Wijk
This paper provides a brief overview of the shift from studies describing the personality profiles of divers to studies exploring associations between personality variables and diving performance in terms of behavioural outcomes. The personality associations that were investigated include performance during training, panic proneness, diving injuries, susceptibility to inert gas narcosis, and the behaviour of tourist divers. The paper concludes with a number of suggested directions for further research on personality and diving that may provide tangible benefits in terms of both enhanced safety and improved performance underwater...
December 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29241234/lost-at-sea-the-medicine-physiology-and-psychology-of-prolonged-immersion
#13
REVIEW
Heather Massey, John Leach, Michael Davis, Vicki Vertongen
In most countries, immersion represents the second most common cause of accidental death in children and the third in adults. Between 2010 and 2013, 561 deaths worldwide involving recreational divers were recorded by the Divers Alert Network. Consequently, there is no room for complacency when diving. Being lost at sea is a diver's worst nightmare. In 2006, a diver was lost at sea off the coast of New Zealand for 75 hours. It is unprecedented that, after such a long time immersed in temperate (16-17°C) waters, he was found and survived...
December 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29241233/hyperbaric-oxygen-in-the-treatment-of-acute-retinal-artery-occlusion
#14
Mark J Elder, John A Rawstron, Michael Davis
INTRODUCTION: Acute retinal artery occlusion (ARAO) is a major cause of sudden, painless visual loss, often leaving no useful vision in the affected eye. Its incidence is cited at 0.85 per 100,000 persons per year but may be higher because of under-reporting. The natural history is difficult to study, but a spontaneous resolution rate of < 1-8% for acute, non-arteritic ARAO has been cited. Occurrence in an only eye is devastating for the patient. There is currently no consensus regarding management of ARAO and little evidence to support any treatment modality...
December 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29241232/thromboelastographic-assessment-of-the-impact-of-mexiletine-on-coagulation-abnormalities-induced-by-air-or-normal-saline-intravenous-injections-in-conscious-rats
#15
Joseph L Nates, Davide Cattano, Fernanda S Costa, Jacques E Chelly, Marie-Francoise Doursout
BACKGROUND: Thromboelastography (TEG) in venous air embolism (VAE) has been poorly studied. We induced coagulation abnormalities by VAE in a rat model, assessed by TEG with and without mexiletine, a lidocaine analogue local anesthetic. METHODS: Twenty-three Sprague Dawley rats instrumented under isoflurane anesthesia and allowed to recover five days prior to the experiments were randomized into three experimental groups: 1) VAE (n = 6); 2) VAE and mexiletine (n = 9); and 3) normal saline (NS) alone (control group, n = 8)...
December 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29241231/influence-of-repetitive-diving-in-freshwater-on-pressure-equalization-and-eustachian-tube-function-in-recreational-scuba-divers
#16
Stefanie Jansen, Manuela Boor, Moritz F Meyer, Eberhard D Pracht, Ruth Volland, Heinz D Klünter, Karl-Bernd Hüttenbrink, Dirk Beutner, Maria Grosheva
INTRODUCTION: We investigated the effect of repetitive pressure exposure during freshwater dives on Eustachian tube function and the middle ear, assessed by the Eustachian tube function test (ETFT). METHODS: This prospective observational cohort study included 23 divers over three consecutive days of diving in freshwater lakes in Nordhausen, Germany. Participants underwent otoscopy and ETFT before the first dive, between each dive and after the last dive. ETFT included regular tympanometry (R-tymp), tympanometry after Valsalva (V-tymp) and after swallowing (S-tymp)...
December 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29241230/influence-of-repetitive-diving-in-saltwater-on-pressure-equalization-and-eustachian-tube-function-in-recreational-scuba-divers
#17
Moritz F Meyer, Manuela Boor, Stefanie Jansen, Eberhard D Pracht, Moritz Felsch, Heinz D Klünter, Karl-Bernd Hüttenbrink, Dirk Beutner, Maria Grosheva
INTRODUCTION: We investigated in a prospective, observational trial the feasibility of using the Eustachian tube function test (ETFT) to measure the effect of repetitive pressure exposure during open seawater dives on Eustachian tube function. METHODS: The study included 28 adult divers during six consecutive days of diving in the Red Sea. Participants underwent otoscopy and ETFT before the first dive, between each dive and after the last dive. ETFT included regular tympanometry (R-tymp), tympanometry after Valsalva (V-tymp) and after swallowing (S-tymp)...
December 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/29241229/back-to-the-future-occupational-diver-training-in-australia
#18
EDITORIAL
David Smart
The Australian Diver Accreditation Scheme (ADAS) had its genesis in the 1990s in response to a need to produce occupational divers who were trained to international standards with the necessary skills to safely undertake complex work in high-risk environments. Well-trained dive teams who are 'fit-for-purpose' can be regarded as the highest level of risk control in preventing accidents and workplace morbidity. Without such training, work site risks are not detected, with potentially disastrous consequences. In September 2017, the only civilian ADAS level 3 and 4 training facility in Australia, The Underwater Centre Tasmania (TUCT), closed its doors...
December 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/28868603/proliferative-retinopathy-during-hyperbaric-oxygen-treatment
#19
REVIEW
Viet Tran, David Smart
A 43-year-old male with type 2 diabetes mellitus, treated with insulin for 28 years and with an HbA1c of 7.9% six months prior, suffered from bilateral plantar ulcers refractory to specialised wound care. He underwent a planned 40 sessions of hyperbaric oxygen treatment (HBOT) at 243 kPa for 90 minutes. Consent was given for this report. The patient's ophthalmic history included bilateral proliferative diabetic retinopathy (PDR) identified on routine diabetic eye screening three years previously. This was treated with pan-retinal photocoagulation (PRP)...
September 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/28868602/ruptured-tympanic-membrane-from-underwater-impact-with-an-atlantic-salmon-salmo-salar
#20
David Smart
An unusual case of tympanic membrane rupture in a diver due to impact from an Atlantic salmon, Salmo salar is described. The diver was treated conservatively and the injury fully healed by eight weeks after which the diver successfully returned to diving. The author contends that the appearances of such traumatic perforations differ from barotrauma in divers secondary to ear clearing problems on descent.
September 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
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