dive stuff Flashcards

1
Q

During a dive a diver’s blood and tissues absorb additional ________ from the lungs when at depth.

A

nitrogen/helium

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2
Q

What happens if a diver ascends too fast

A

excess gas will separate from solution and form
bubbles, produce mechanical and biochemical effects that lead to a condition known as decompression sickness.

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3
Q

What type of decompression sickness involves the skin, lymphatic system, muscles, and joints. It is not life threatening.

A

Type I decompression sickness

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4
Q

What issue/Tx?
Hx of ascending too quickly from a dive
(a) Joint Pain – outside of the thorax, knees, ankle, elbow and wrist. Pain is typically a dull achy pain that is unable to be pinpointed.
(b) Skin Symptoms – itching and Cutis Marmorata. Cutis Marmorata is characterized by a marbled bright red, purplish or even bluish pattern on the skin.

A

Type I Decompression Sickness
Treatment of DCS Type I
(a) Complete a full neurological exam to rule out AGE or DCS Type II
(b) 100% Surface Oxygen via non rebreather mask
(c) Transport to the nearest Recompression Chamber
-NOTE: If transport by helicopter maintain an altitude less than 1000ft

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5
Q

If transporting a DCS via AIR patient what is the altitude limit?

A

1000Ft

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6
Q

What type of DCS is a serious & possibly life threatening illness symptoms are divided into three categories (Neurological, Inner Ear & Cardio Pulmonary)

A

Type II DCS

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7
Q

What issue
Hx of ascending too quickly from a dive
(a) Neurological
-1) Numbness
-2) Paresthesia’s
-3) Muscle weakness
-4) Mental status changes
-5) Impaired urinary function
(b) Inner Ear
-1) Tinnitus
-2) Hearing Loss
-3) Vertigo
-4) Dizziness
-5) Nausea
-6) Vomiting
(c) Cardiopulmonary
-1) Chest pain
-2) Painful inspiration
-3) Irritating Cough
-4) Tachypnea
-5) Lung congestion
-6) Complete circulatory collapse

A

DCS Type II
Treatment
(a) Complete a full neurological exam to rule out AGE (Arterial gas embolism)
NOTE: Treatment for DCS Type II and AGE are the same.
(b) 100% Surface Oxygen via non rebreather mask
(c) Transport to the nearest Recompression Chamber
NOTE: If transport by helicopter maintain an Altitude less than 1000ft.

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8
Q

WHAT occurs when gas is forced through torn lung tissue into the loose mediastinal tissues in the middle of the chest surrounding the heart, trachea, and major vessels

A

Pulmonary Over Inflation Syndrome (POIS)

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9
Q

What issue/Tx?
1) Mild to moderate pain under the breastbone
2) Pain that radiates to the shoulder or back.
3) Fullness around the neck and difficulty swallowing
4) Voice
5) Palpation of the skin near the trachea may result in crepitus (cracking or crunching sound)

A

Mediastinal/substernal emphysema
Treatment
(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

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10
Q

This defines what?
Caused by air leaking from the tissues of the lungs into the space between the
lungs and chest wall.

A

Pneumothorax

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11
Q

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

A

Pneumothorax
Tx
(a) Heart/lung exam
(b) 100% O2
(c) Needle-decompression or chest tube as warranted

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12
Q

What issue?
Damage to body tissues from the mechanical effects of pressure, results when
pressure differentials between body cavites

A

Barotrauma

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13
Q

What are the different types of Barotrauma

A

(1) Ear squeezes
(2) Sinus squeeze
(3) Tooth squeeze

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14
Q

The __________ enables a diver to equalize pressure in the Middle ear.

A

Eustacian tube

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15
Q

What issue/Tx?
Hx: the diver couldn’t equalize the pressure in the Middle ear
Symptoms
(a) Sharp pain in the ear
(b) Rupture of the tympanic membrane
(c) Vertigo
(d) Tinnitus
(e) Hearing Loss
(f) Nausea/Vomiting

A

Ear squeeze
Tx
(a) HEENT exam
(b) Decongestants
(c) Pain medication
NOTE: If a ruptured eardrum is suspected do not administer medication directly into the ear canal without consultation of a ear, nose & throat Specialist.

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16
Q

What are complications for Ear squeeze?

A

-tympanic membrane rupture,
-tissue damage,
-possible injury to the Coclea/vestibular apparatus

17
Q

The affinity of carbon monoxide for hemoglobin is ____ times that of Oxygen

A

210

18
Q

A diver’s air supply can be contaminated by carbon monoxide when…….

A

the compressor intake is placed to close to the compressor’s engine exhaust

19
Q

What issue?
Symptoms
(1) Headache
(2) Dizziness
(3) Confusion
(4) Nausea
(5) Vomiting
(6) Tightness across the forehead

A

Carbon Monoxide Poisoning
Treatment
(1) Getting the diver to fresh air
(2) 100% surface oxygen
(3) Transport to hyperbaric or medical treatment facility.
definitive treatment of choice

20
Q

______ is an abnormally high level of carbon dioxide in the blood and body tissues.

A

Hypercapnia

21
Q

In diving operations, hypercapnia is generally the result of what?

A

a buildup of carbon dioxide in the breathing supply or an inadequate respiratory minute volume

22
Q

What issue/Tx?
Hx: buildup of carbon
dioxide in the breathing supply or an inadequate respiratory minute volume
(1) Increased breathing rate
(2) Shortness of breath
(3) Confusion or feelings of euphoria
(4) Inability to concentrate
(5) Increased sweating
(6) Drowsiness
(7) Headache
(8) Loss of consciousness
(9) Convulsions

A

Hypercapnia
Treatment
(1) Decreasing the level of exertion to reduce CO2 production
(2) Increasing helmet and lung ventilation to wash out excess CO2
(3) Shifting to alternate breathing source of aborting the dive if defective equipment is
the cause.

23
Q

True/False
Exposure to a partial pressure of oxygen above that encountered in normal daily living may be toxic to the body.

A

True

24
Q

The two areas of the body
affected by Oxygen toxicity are….

A

Central Nervous System and the Pulmonary System

25
Q

The extent of the oxygen toxicity is dependent upon both
the _______ and _______

A

oxygen partial pressure and the exposure time

26
Q

What issue/ TX?
Hx: Exposure to a partial pressure of oxygen above that encountered in normal daily
living
(1) Tunnel vision, decreased peripheral vision, and other visual symptoms
(2) Tinnitus
(3) Confusion/Euphoria
(4) Inability to concentrate
(5) Increased sweating
(6) Drowsiness
(7) Headache
(8) Loss of consciousness
(9) Convulsions

A

CNS Oxygen Toxicity
Treatment
(1) Immediately ascend
(2) Shift to a breathing mixture with lower oxygen percentage.
(3) In a recompression chamber, remove oxygen mask and follow emergency procedures.

27
Q

___________ sometimes called low pressure oxygen poisoning, can occur whenever the oxygen partial pressure exceeds 0.5ata.

A

Pulmonary oxygen toxicity

28
Q

Pulmonary oxygen toxicity
-A __ hour exposure to a partial pressure of 1ata will produce mild symptoms and measurable decreases in lung function

A

12

29
Q

What issue/Tx?
Hx
(1) oxygen partial pressure exceeded 0.5ata
or
(2) 12 hour exposure to a partial pressure of 1ata
Symptoms
(1) Burning sensation during inspiration
(2) Pain during inspiration
(3) Cough
(4) Decreased pulmonary function

A

Pulmonary Oxygen Toxicity
Treatment
(1) If the patient cannot continue with respiratory discomfort, remove the patient from O2
(2) Consult DMO (Diving Medical Officer) to modify treatments, increasing air time of air breaks between oxygen periods.

30
Q

The biggest risk of shallow water black out is _______

A

subsequent drowning

31
Q

Shallow Water Blackout
-While conducting breath hold operations, oxygen PPO2 is (higher/lower) at depth.

A

Higher

32
Q

Shallow Water Blackout
During ascent the PPO2 decreases and increases the risk of what?

A

hypoxia and unconsciousness.

33
Q

What issue/tx?
Symptoms
(1) Unconsciousness close to the surface or subsurface
(2) Hypoxia
(3) Subsequent drowning
(4) Cardiac/Respiratory arrest

A

Shallow Water Blackout
Treatment
(1) In water: Ventilation only, open airway, check breathing, provide 5 rescue breaths
(2) Do not attempt compressions in the water
(3) Rule out cardiac arrest once on the boat/shore
(4) If the patient is pulseless continue CPR utilizing ABCs (Airway, Breathing, Circulation)
(5) Transport to the nearest emergency department

34
Q

True/False
You can attempt chest compressions in the water

A

false

35
Q

What issue/Tx
Hx
(1) Young individual with no
predisposing conditions.
(2) Exertion, immersion in cold water and overhydrating
Symptoms
(1) Dull to sharp substernal chest pain
(2) Hemoptysis (coughing up blood)
(3) Shortness of breath
(4) Frothy sputum
(5) Shortness of breath

A

Swimmer Induced Pulmonary Edema (SIPE)
Treatment
(1) Remove patient from the wet/cold environment
(2) Supplemental oxygen
(3) Complete heart/lung exam
(4) EKG
(5) X-ray within 2 hours
(6) For critical patients, follow BLS/ACLS algorithms and transport to Emergency Department