Re the pressure of diving and its influence on subcutaneous emphysema, good question. The difference between the subq emphysema that you've seen in the ED and an event that occurs while diving is the reduction in ambient pressure on ascent, which will cause any pockets of subcutaneous air to...
Hi @SeaMarie ,
Subcutaneous emphysema from diving would have most likely arisen from some kind of pulmonary barotrauma. How experienced a diver are you? What were the diving conditions like? Depth? Sea conditions/waves? Do you recall holding your breath at any point in the dive?
Small...
PFO is associated with sudden-onset severe neurological DCS, inner ear DCS and cutis marmorata (skin marbling). Given the OP's description of symptoms and onset time, a PFO test would not be indicated.
Best regards,
DDM
Hi David,
High-pressure cylinders can be extremely dangerous and are not something to experiment with if you don't know exactly what you're doing. There are a lot of great scuba shops in San Diego that I'm sure would be happy to help you verify that they're empty.
Best regards,
DDM
Some fine detail points to add to this. First, this is a strictly theoretical discussion. For all practical purposes, divers will not have O2 bubbles in their blood. However, should a diver manage to survive breathing O2 at a high enough partial pressure to potentially produce bubbles on...
Thanks @rjack321 for the photo. This is similar to the hoods we use. We also have Scott aviator double-hose O2 masks for the rare claustrophobic patient who doesn't tolerate the hood.
Best regards,
DDM
Thanks for that callout. Mechanical damage is probably a bit of an oversimplification. The damage is subtle - the lining of the blood vessels is disturbed by the bubble to the point that the inflammatory cascade mentioned by @Dr Simon Mitchell is activated. This can lead to capillary leakage...
I think you're getting at arterial oxygen content, which is a function of hemoglobin level, O2 saturation (percentage of hemoglobin taken up by O2, normally 95-100%), and arterial partial pressure of O2. The answer to the question I think you're asking is, in a healthy individual, arterial...
That's a big if as noted above. A more likely scenario might be a combat diver on a 100% O2 CCR who experiences a gas embolism. An oxygen bubble would resolve much faster, but depending on size and duration, could also cause an inflammatory reaction that could in turn lead to neurological...
As noted above, most oxygen is carried by hemoglobin in red blood cells at sea level, where the inspired partial pressure of oxygen is .21 ATA. Still, there is a small amount of oxygen dissolved in the plasma at this pressure; a normal arterial pO2 value is 85-100 mmHg.
Divers breathe O2 at...
Hi @ljwillia ,
What was the indication for the coronary calcium score test?
Given the information you've provided, it looks like your husband has multiple risk factors for a cardiac event and I'd strongly recommend he be evaluated by a diving physician. Richmond isn't far from Durham, we're...
That's a really interesting insight. It seems like you're recognizing the possibility of becoming complacent, which could lead to drift from a good safety mindset and safe diving procedures. And, I basically just said the same thing that @crofrog wrote while I was typing this :wink:
Any empiric study of significant omitted decompression on humans would be unethical. There are animal models that purposely omit large amounts of decompression, but those studies are mostly to examine the pathophysiology of DCS. And, some of those animals don't get bent despite the...
Lymphatic DCS causes generalized swelling in the area drained by the affected lymph vessels. Swelling can be a symptom of extreme dehydration, but in a young, otherwise healthy person that seems unlikely. As noted by @arkstorm above, dehydration is not the lurking villain that some people make...
You may never be able to pin down an exact cause of this DCS event, assuming it's DCS. Decompression algorithms are not iso-risk, that is, the probability of DCS for any given decompression algorithm increases with increasing depth and bottom time. Specific to this dive, heavy work and cold on...
Great question. Frank ischemia with a very large bubble load, possibly. The more common mechanism of injury of DCS is a relatively short period of reduced blood flow followed by an inflammatory reaction at the capillary level. This is harder to detect on MRI.
Best regards,
DDM
Just a point of clarification on this. The mechanism of injury in pulmonary embolism is that the clot breaks loose, usually from an extremity, travels through the venous circulation and the right side of the heart, then to the pulmonary arteries. The clot then may obstruct blood flow through...
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