Caisson diseases Affected diver care is an article that describes the medical procedures that must be performed under medical supervision, according to the US treatment methodology. It must first be determined caisson diseases the degree of urgency of injury treatment.
Perform an initial assessment at the diving site. Caisson disease or any of its symptoms described above appear within 24 hours of emerging from the surface of the water. The initial condition of the diver determines the order of actions to be performed and the degree of urgency.
Based on the classification used by the US Navy, a diver can be included in one of three categories:
- Critical condition
- Acute condition
- Timely condition
Table of Contents
1) Caisson disease in critical condition
(KESON'S DISEASE EMERGENCIES)
Symptoms are severe and appear quickly, about an hour after emergence. Unconsciousness may occur. Symptoms may progress. The diver may experience severe headaches, difficulty breathing or significant disturbances of consciousness. Obvious neurological disorders are altered states of consciousness, incorrect gait or weakness.
These divers are very ill and in critical condition. If necessary (eg if the diver is unconscious), initiate CPR and evacuate the diver immediately. Check the airways for foreign objects. If cardiac resuscitation is required, the injured diver should be supine while lying on his back. In this condition, vomiting is particularly dangerous; if this happens, the diver must be quickly turned to the side before the airways clear and return to life can continue by returning to a supine position.
If possible, use supplemental oxygen during breathing adjustment to provide an increased amount of oxygen to the injured diver. Even if the CPR is successful and the diver has regained consciousness, 100 percent oxygen must be delivered at all times until the diver arrives at the medical facility.
If trained caregivers are available, intravenous administration of an isotonic solution that does not contain dextrose should be initiated. An initial rapid administration of 1 liter after 30 minutes will prevent dehydration and reduce haemoconcentration. Once this is done, the rate can be reduced to 100-175cc / hour.
An additional 1 liter of fluid delivery device is needed to further correct the dehydration process and normalize blood pressure, but this should be done by trained personnel who will properly assess the situation. Otherwise, you may have problems with increased fluid in your body and a feeling of discomfort with urinary retention. If trained personnel are available, unconscious divers should be placed in a catheter, as well as those who are unable to urinate.
Call helpdesk or DAN
After the condition has returned to normal and evacuation measures have been taken, contact DAN. DAN medical experts will help if necessary to make a diagnosis and, if necessary, a course of treatment. Contact a specialist, even if breathing oxygen has improved the diver's condition. While awaiting evacuation, keep as detailed a medical history as possible and a description of the diver's neurological status. These facts will be helpful in getting the right medical equipment. If air traffic is used for evacuation, the internal pressure of the aircraft must be similar to the sea level pressure and must not exceed 800 ft / 244 meters altitude, unless this poses a problem to the safety of the aircraft.
Place the diver in a supine position, also known as the recovery position. Thus, the person is placed on one side (usually the left), the head is supported at a low angle and the upper leg is bent at the knee. If vomiting occurs, gravity helps keep the airways clean.
2) Caisson disease, acute condition.
(Category B - Acute conditions of Caeson's disease)
In this case, the main symptom is severe pain that does not go away or has progressed in the last few hours. Divers do not experience any particular distress other than pain, and the neurological signs and symptoms, without careful examination, are not obvious.
Immediately place the injured diver in 100 percent oxygen and inject fluid into the mouth. Do not try to relieve pain with any painkiller until instructed to do so by a healthcare professional. Continue to supply oxygen until you arrive at the treatment facility.
Contact DAN or your nearest medical facility to find out what transportation is needed and where the diver should be taken, even if the symptoms have disappeared due to oxygen. In all cases, air transport is not necessary at all.
While awaiting evacuation, take as detailed a history as possible and describe the diver's neurological status. This information will be useful for the staff of the medical institution. If air traffic is used for evacuation, the internal pressure of the aircraft must be similar to the sea level pressure and must not exceed 800 ft / 244 meters altitude, unless this poses a problem to the safety of the aircraft.
3. Timely condition of caisson disease
Category C- - Timely cases of KESON'S DISEASE
The symptoms are not obvious or their progression is slow within a few days. Usually, the main signs or symptoms include pain or strange feelings; in this case, the diagnosis of KESON'S DISEASE may be in question. Obtain as complete a history of the diving case as possible and perform a neurological evaluation. Then call DAN or the nearest medical facility, or go to the nearest medical facility for their evaluation.
II. If possible, obtain a diving history, summarize and document all cases reminiscent of KESON'S DISEASES:
- Collect all information about what happened during the 48 hours before the injury, that is, information about all dives: depths / times, take-off modes, intervals between dives, breathing gases, description of problems or symptoms before, after or during the dive;
- ask about the appearance of symptoms and their progression after the last dive;
- summarize all first aid measures (including 100 per cent oxygenation) as well as the effectiveness of these first aid measures in preventing post-traumatic symptoms;
- to record the results of local neurological examination (described below);
- a description of any joint or other body muscle pain, specifying the location, intensity, as well as any changes that have occurred during the movement;
- obtain information on the appearance of any rash;
- provide a description of any injuries that occurred before, during or after diving.
III. Performing local neurological examination
Information on the neurological status of the injured diver will be useful for effective treatment by medical staff. The examination of the injured diver's central nervous system immediately after the accident will provide important information to the doctor in charge of treatment.
Local neurological examination is easy to learn and can be performed by individuals without medical training. Perform the examination as much as possible, but within the limits that it does not delay the evacuation to the medical institution. The description of the examination can be found on the DAN website, as well as in the DAN Diving and Travel Medical Guide.
IV. Take the injured diver to the nearest medical facility and call DAN
Call your local EMS first, then call DAN. Depending on the degree of depth of the injury (see above), take care of the diver's airway, respiratory and circulatory system and contact your local EMS. After contacting EMS, call DAN, medical staff is available 24 hours a day to provide emergency assistance.
What to do when calling the DAN Helpline:
1. By calling the Helpline, the calls go to the headquarters of Duke University Medical Center. Tell the operator that you are calling due to a diving emergency. The operator will connect you to DAN immediately or call you back as soon as possible.
2. A DAN staff member can give you immediate advice or call you back after consulting your local doctor or DAN Regional Coordinator.
3. A DAN employee or Regional Coordinator may ask you to wait on the phone while he / she makes a decision. This may take 30 minutes or more, so you will need several phone calls.
This delay must not endanger the diver's health. However, if the situation becomes life-threatening, take the diver immediately to the nearest medical facility to stabilize his or her health. Call the DAN Travel Help Center at 1-800-326-3822 (1-800-DAN EVAC) to consult your local medical provider.
Despite the facts about KESON'S DISEASES described above, you don't have to think that diving will always end in injury. In reality, KESON'S DISEASES are acquired in relatively rare cases, research shows that it is acquired only in 3-4 cases every 10,000 dives, about 1,000 such accidents occur annually. In most cases, KESON'S DISEASES accidents are not serious in nature and, if cured, do not affect further diving activities.
As with any sport, diving can cause injury, but knowing how to recognize KESON'S DISEASES will always work well. The DAN service is available at any time and provides worldwide expert advice on the diagnosis and treatment of KESONON'S DISEASE. There are few sports where such support is available.
However, DAN does not sleep on its laurels. We are still looking for ways to reduce the number of diving accidents in the future. The Diving Research project is working on these issues. These studies teach those interested how to recognize KESON'S DISEASES, and they collect various data and information about diving. The main goal of this project is to create a database, the resources of which will ensure safe diving. To learn more about this project, visit www.DiversAlertNetwork.org/medical/research/pde/.
Return to diving after KESON'S DISEASE
These Fleet Regulations are for diving professionals. The US Navy has established rules for returning to diving after a course of treatment. If KESONA DISEASE causes only pain, without the presence of neurological symptoms, divers may resume diving within 2 to 7 days after treatment, depending on the treatment schedule.
If neurological symptoms are present, the diver may resume diving within 2 to 4 weeks of treatment, depending on the severity of the symptom. In particularly severe cases, the diver must undergo an examination by a Diving Medical Officer three months after treatment.
Rules for diving sports amateurs
Those divers who do not make a living from diving need a more conservative approach to minimize the possibility of re-injury.
- In cases where there is only pain, in the absence of neurological symptoms, it is recommended to refrain from diving for at least 2 weeks.
- If minor neurological disorders are observed, it is recommended to refrain from diving for 6 weeks.
- In case of severe neurological symptoms or any residual symptoms, it is recommended to refrain from diving at all.
Even if the symptoms have not been severe and have been completely eliminated, a diver who has had KESON'S DISEASES on several occasions must keep a record. If KESON'S DISEASE is acquired at a location where other divers with the same diving profile, KESON'S DISEASE have not been detected, then it is possible that the diver has an increased susceptibility to KESON'S DISEASE. In these cases, consult a Diving Medical Officer to find out if it is safe to resume diving.
Remember that you need good health for a lifetime.
Article on Caisson diseases affected diver care uses information from DAN (diversalertnetwork.org)
