Greetings,
Saw this today & thought I'd share it in light of recent activity regarding CO poisoning & divers:
Carbon monoxide poisoning mimicking arterial gas embolism in a commercial diver.
Holt J, Weaver LK.
Source
Hyperbaric Medicine, LDS Hospital, Salt Lake City, Utah, USA. Julie.Holt@imail.org
Abstract
A 32-year-old male commercial diver was working at 7,000 feet of altitude in a municipal water tank, at a depth of 27 feet for two hours. While surfacing from a compressed-air surface-supplied dive, he exhibited loss of consciousness and neurological symptoms. He was presumptively diagnosed with arterial gas embolism, flown by pressurized aircraft to a regional medical center and treated with hyperbaric oxygen. During the U.S. Navy Treatment Table 6, new information suggested the patient's air supply had been contaminated by a continuously running engine and compressor. His admission blood was then assayed for carboxyhemoglobin (COHb), which measured 8.8% six hours after surfacing, including four hours of normobaric oxygen inhalation. His estimated COHb based on rough reported half-life calculations at the conclusion of the dive was approximately 45%. The patient's diagnosis was changed to carbon monoxide poisoning from contaminated breathing gas. Upon hospital discharge, he exhibited problems with balance and gait, nystagmus, word-finding limitations and slurred speech. Also, he had cardiac injury treated with carvedilol. When evaluating diving-related casualties, including in commercial divers, clinicians should consider carbon monoxide poisoning as a differential diagnosis.
45%!! I'd like to know how symptomatic this fellow was prior to surfacing, as he would have been on 2-way comms. with the surface Tender &/or Dive Supervisor, he would have undoubtedly been complaining of classic CO poisoning symptoms...
Best,
DSD
Saw this today & thought I'd share it in light of recent activity regarding CO poisoning & divers:
Carbon monoxide poisoning mimicking arterial gas embolism in a commercial diver.
Holt J, Weaver LK.
Source
Hyperbaric Medicine, LDS Hospital, Salt Lake City, Utah, USA. Julie.Holt@imail.org
Abstract
A 32-year-old male commercial diver was working at 7,000 feet of altitude in a municipal water tank, at a depth of 27 feet for two hours. While surfacing from a compressed-air surface-supplied dive, he exhibited loss of consciousness and neurological symptoms. He was presumptively diagnosed with arterial gas embolism, flown by pressurized aircraft to a regional medical center and treated with hyperbaric oxygen. During the U.S. Navy Treatment Table 6, new information suggested the patient's air supply had been contaminated by a continuously running engine and compressor. His admission blood was then assayed for carboxyhemoglobin (COHb), which measured 8.8% six hours after surfacing, including four hours of normobaric oxygen inhalation. His estimated COHb based on rough reported half-life calculations at the conclusion of the dive was approximately 45%. The patient's diagnosis was changed to carbon monoxide poisoning from contaminated breathing gas. Upon hospital discharge, he exhibited problems with balance and gait, nystagmus, word-finding limitations and slurred speech. Also, he had cardiac injury treated with carvedilol. When evaluating diving-related casualties, including in commercial divers, clinicians should consider carbon monoxide poisoning as a differential diagnosis.
45%!! I'd like to know how symptomatic this fellow was prior to surfacing, as he would have been on 2-way comms. with the surface Tender &/or Dive Supervisor, he would have undoubtedly been complaining of classic CO poisoning symptoms...
Best,
DSD