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Scuba diving, decompression illness, barotraumas,

P D Nijk, T P van Rees Vellinga, J M van Lieshout, M I Gaakeer
BACKGROUND: During scuba diving, nitrogen dissolves into the body tissues due to elevated pressure under water. During a sudden drop in pressure due to a rapid return to the water surface, arterial gas embolism can arise from pulmonary barotrauma. In a later phase, nitrogen bubbles can also arise in the venous circulation (decompression sickness). Arterial bubbles can incur vascular damage, obstruction, hypoxia and infarction. CASE DESCRIPTION: A 53-year-old healthy sport diver presented at the emergency department in a hypovolemic shock with progressive paresis of all the extremities...
2017: Nederlands Tijdschrift Voor Geneeskunde
Devon M Livingstone, Kristine A Smith, Beth Lange
Scuba diving is a popular recreational and professional activity with inherent risks. Complications related to barotrauma and decompression illness can pose significant morbidity to a diver's hearing and balance systems. The majority of dive-related injuries affect the head and neck, particularly the outer, middle and inner ear. Given the high incidence of otologic complications from diving, an evidence-based approach to the diagnosis and treatment of otic pathology is a necessity. We performed a systematic and comprehensive literature review including the pathophysiology, diagnosis, and treatment of otologic pathology related to diving...
June 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
Lars Eichhorn, Dieter Leyk
BACKGROUND: Diving is a popular sport, and some recreational divers have medical risk factors. Their health can be endangered by high extracorporeal (ambient) pressure and its many systemic effects. METHODS: We review relevant publications on free (breath-hold) diving, scuba diving, medical evaluation for diving, barotrauma, decompression sickness, and diving with medical risk factors, which were retrieved by a selective search of PubMed. RESULTS: Free diving or scuba diving, even at seemingly innocuous depths, puts considerable stress on the cardio - vascular system, ears, and lungs...
February 27, 2015: Deutsches Ärzteblatt International
Lucy Ashken, Andrew Ross-Parker, Tamer Shalaby
Physicians should consider barotrauma and decompression illness (DCI) in any patient presenting after a recent scuba dive, even apparently shallow dives. If and when DCI is suspected, clinicians should act without delay to transfer the patient to a recompression facility, even if diagnostic certainty has not been attained. We present a case of hyperbaric injury in an asthmatic woman who had an atypical presentation in view of the depth of dive.
February 2015: Clinical Medicine: Journal of the Royal College of Physicians of London
Jennifer Hall
Decompression Illness includes both Decompression Sickness (DCS) and Pulmonary Overinflation Syndrome (POIS), subsets of diving-related injury related to scuba diving. DCS is a condition in which gas bubbles that form while diving do not have adequate time to be resorbed or "off-gassed," resulting in entrapment in specific regions of the body. POIS is due to an overly rapid ascent to the surface resulting in the rupture of alveoli and subsequent extravasation of air bubbles into tissue planes or even the cerebral circulation...
November 2014: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
A Gonnermann, J Dreyhaupt, M Praetorius, I Baumann, P K Plinkert, C Klingmann
BACKGROUND: Due to the increasing number of scuba divers in Germany, the otorhinolaryngologist has to face rising numbers of diving-associated ENT disorders. However, data about the lifetime prevalence of these disorders are insufficient. The aim of this study was to determine the frequency of ENT disorders in scuba divers correlated with their diving history. METHODS: The study design was a non-randomized, retrospective, cross-sectional study based on questionnaires...
May 2008: HNO
Massimo Chessa, Francesco Clai, Carlo Vigna, Gianfranco Butera, Diana Gabriela Negura, Alessandro Giamberti, Edoardo Bossone, Mario Carminati
Scuba diving (diving with a self-contained underwater breathing apparatus) has become a popular sport. Decompression illness may be due to the formation of gas bubbles in various body tissues at an increased ambient pressure. The gas can pass from the systemic venous circulation into the arterial circulation as a result of either pulmonary barotrauma or intravascular shunting. Gas emboli may be the cause of an increased prevalence of brain lesions in sport divers. The management of scuba divers (professionals and amateurs) with a patent foramen ovale is not clear...
January 2005: Italian Heart Journal: Official Journal of the Italian Federation of Cardiology
C Klingmann
BACKGROUND: There has been a steady in-crease of recreational scuba divers in the last years. The majority of diving associated diseases involve otorhinolaryngology, the most important of which are cochleovestibular dysfunctions as these can lead to permanent inner ear failure. MATERIAL AND METHODS: We discuss the origin and clinical symptoms, as well as the therapy, of both inner ear barotrauma and inner ear decompression illness. Our own experiences are considered together with a review of the literature from the last decade...
October 2004: HNO
S Schröder, H Lier, S Wiese
Decompression injuries are potentially life-threatening incidents mainly due to a rapid decline in ambient pressure. Decompression illness (DCI) results from the presence of gas bubbles in the blood and tissue. DCI may be classified as decompression sickness (DCS) generated from the liberation of gas bubbles following an oversaturation of tissues with inert gas and arterial gas embolism (AGE) mainly due to pulmonary barotrauma. People working under hyperbaric pressure, e.g. in a caisson for general construction under water, and scuba divers are exposed to certain risks...
November 2004: Der Anaesthesist
Peter Lindholm, Mikael Gennser
Breath-hold diving as a recreational and competitive sports activity is on the increase. In this review physiological limitations and medical risks associated with breath-hold diving are discussed. Specific topics include hypoxia, ascent blackout, hyperventilation, squeeze or barotrauma of descent including effects on the pulmonary system, glossopharyngeal breathing, and decompression illness. It is also concluded that the health requirements for competitive breath-hold diving should follow essentially the same standards as used for SCUBA-diving...
February 26, 2004: Läkartidningen
Antonio DeGorordo, Federico Vallejo-Manzur, Katia Chanin, Joseph Varon
Self-Contained Underwater Breathing Apparatus (SCUBA) diving popularity is increasing tremendously, reaching a total of 9 million people in the US during 2001, and 50,000 in the UK in 1985. Over the past 10 years, new advances, equipment improvements, and improved diver education have made SCUBA diving safer and more enjoyable. Most diving injuries are related to the behaviour of the gases and pressure changes during descent and ascent. The four main pathologies in diving medicine include: barotrauma (sinus, otic, and pulmonary); decompression illness (DCI); pulmonary edema and pharmacological; and toxic effects of increased partial pressures of gases...
November 2003: Resuscitation
Michael Koehle, Rob Lloyd-Smith, Don McKenzie, Jack Taunton
Asthma has traditionally been a contraindication to recreational self-contained underwater breathing apparatus (SCUBA) diving, although large numbers of patients with asthma partake in diving. The purpose of this paper is to review all the research relevant to the issue of the safety of asthma in divers. MEDLINE and MDConsult were searched for papers between 1980-2002. Keywords used for the search were 'asthma', 'SCUBA' and 'diving'. Additional references were reviewed from the bibliographies of received articles...
2003: Sports Medicine
C A Gnadinger, C B Colwell, A L Knaut
SCUBA diving-induced pulmonary edema is a rare syndrome that has been previously reported to occur in cold water. We present a case of SCUBA diving-induced pulmonary edema in a 52-year-old man diving in a warm swimming pool. The pathophysiology of this syndrome is unclear, but it is unrelated to either barotrauma or decompression illness. This patient developed frank pulmonary edema while submerged, which resolved after surfacing. As with other patients who have had this syndrome, he did not have any cardiorespiratory disease...
November 2001: Journal of Emergency Medicine
M Schwerzmann, C Seiler
Scuba diving has become a popular leisure time activity with distinct risks to health owing to its physical characteristics. Knowledge of the behaviour of any mixture of breathable gases under increased ambient pressure is crucial for safe diving and gives clues as to the pathophysiology of compression or decompression related disorders. Immersion in cold water augments cardiac pre- and afterload due to an increase of intrathoracic blood volume and peripheral vasoconstriction. In very rare cases, the vasoconstrictor response can lead to pulmonary oedema...
June 30, 2001: Swiss Medical Weekly
W Beuster, U van Laak
The term "decompression illness (DCI)" is a disorder which arises from the presence of ectopic gas bubbles following decompression. Scuba diving poses the risk of two typically clinical syndromes: decompression sickness (DCS) and arterial gas embolism (AGE). DCS results from the formation of gas bubbles in the tissues of the body and in the blood due to rapid reduction of the environmental pressure. AGE is caused by pulmonary overinflation if the breathing gas cannot be exhaled adequately during the ascent...
1999: Wiener Medizinische Wochenschrift
J Wilks, M Coory
OBJECTIVE: To determine the number of overseas visitors admitted to Queensland hospitals for water-related injuries over three years, the causes of their injuries, the resulting conditions treated, and the type of hospitals to which they were admitted. DESIGN: Retrospective analysis of admissions of overseas visitors to Queensland hospitals over the three financial years 1995/96, 1996/97 and 1997/98. PATIENTS: 296 overseas visitors admitted for water-related injuries, identified from hospital records by their usual place of residence...
September 2000: Medical Journal of Australia
A Spira
Diving is a high-risk sport. There are approximately between 1 to 3 million recreational scuba divers in the USA (with over a quarter-million learning scuba annually); there are about 1 million in Europe and over 50,000 in the United Kingdom. In this population 3-9 deaths/100,000 occur annually in the US alone, and those surviving diving injuries far exceeds this. Diving morbidity can be from near-drowning, from gas bubbles, from barotrauma or from environmental hazards. In reality, the most common cause of death in divers is drowning (60%), followed by pulmonary-related illnesses...
September 1999: Journal of Travel Medicine
M Moser, G Wolf
The popularity of scuba diving among the general public and the great increase in air travel are increasingly associated with health problems. In the ENT sector, such problems mainly take the form of barotrauma that can arise from changes in the volume of gases enclosed within body cavities, due to fluctuations in pressure during diving and air travel. More rarely, decompression illness can occur when the required time for decompression is ignored by a diver coming up to the surface, or when a sudden loss of pressure occurs in the cabin of a plane, leading to the liberation of nitrogen dissolved in body fluids...
August 30, 1990: Fortschritte der Medizin
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