Scuba diving emergencies: Difference between revisions

Revision as of 23:14, 10 February 2015

Occurs when air is not added to facemask during descent resulting in:
- Facial bruising
- Conjunctival Injection/hemorrhage
- Retrobulbar hemorrhage if severe

Occurs when diver breathing compressed air ascends too rapidly
Symptoms occur minutes to hours after surfacing
- Can occur without rapid ascent in pts w/ obstructive lung disease
Lung rupture can lead to pneumomediastinum, pneumothorax, or air embolism
- Pneumomediastinum and pneumothorax do not require recompression

Spinal cord involvement
- Ascending paralysis
- Signs often cannot be traced to single location in the cord (may have skip lesions)
Vestibular ("staggers") involvment
- Vertigo, hearing loss, tinnitus
  - Differentiated from inner ear barotrauma which usually occurs on descent
Pulmonary "chokes"
- Cough, hemoptysis, dyspnea, substernal chest pain

Results from pulmonary barotrauma (most common) and decompression sickness
Symptoms develop during ascent or immediately upon surfacing
Causes variety of stroke syndromes depending on part of brain affected
- Immediate death, loss of consciousness, seizure, blindness, hemiplegia

Tintinalli

Authors:

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 ==Barotrauma of Descent==
 ===[[Otic barotrauma]] ("ear squeeze")===
-====Middle Ear====
-*Results from inability to equalize middle ear pressure
-*Pain, fullness, vertigo, conductive hearing loss, TM rupture
-:;Treatment
-#decongestants
-#consider abx if TM ruptured
-====Inner Ear====
-*Results from forceful Valsalva against an occluded eustachian tube
-**Pressure difference between middle ear and inner ear can rupture oval or round window
-*Sudden onset of sensorineural hearing loss, tinnitus, severe vertigo
-:;Treatment
-#Head of bed up
-#no nose blowing
-#antivertigo medications
-#ENT consult
 ===[[Sinus barotrauma]] ("sinus squeeze")===
 *Pain over affected sinus, possible bleeding from nare