air embolism - Information on?

[Dr Deco]

Dear Barb:

Frankly, this does not sound like a case of arterial gas embolization. There have been cases where individuals had a heart attack. Because it occurred while diving, the initial response was that this was a diving related problem. There are times when the body is recovered and the blood vessels contain gas. This can occur when you ascend from depth to surface in the absence of any circulation. The coroner will list it as decompression sickness , although this is not right.

We may never know, even if the body is recovered.

Dr Deco :doctor:

 

[barb]

This makes more sense. I was a little concerned although I don't hear of divers dying that often from AGE.

 

[devilfish]

Originally posted by barb
I reread the information on the Tobermory death and according to the divers buddy - They went from 110' to 93' together. The diver that died was using her octo so he would have been breathing fine. According to her he was looking her in the face when he suddently started to descend again - took her down to 139' before she had to push him away as she only had 500 psi left. So now tell me how could this diver have an embolism going form 110' to 93' ?

If it was AGE, it might have been what is common called "deep water embolism". In such a cases a diver might have perforated a lung while attempting to valsalva at the begining of the dive. During the dive more gas entered the arteries and expanded on the ascent. In those cases divers passed out before reaching the surface such as in classic AGE.

 

[The Iceni]

I find this story and the related posts quite interesting as it raises the question of just how accurate the reports of all diving related deaths actually are. I apologise if this post is quite gruesome but I think it needs saying.

In my humble opinion the following factors mitigate against accurate reports.

1) It takes a very brave buddy indeed to admit that "I had to push my buddy away" as in this case. So often we hear that the diver simply lost sight of his buddy.

2) Certificated medical cause of death - artefactual injuries.

If a diver's body is recovered it will not be decompressed so will inevitably contain air bubbles in the circulation and possibly in the tissues as well. (This is not found in the bodies of those who have simply drowned.) So easy to conclude DCI was the cause of death.

I am not certain of this, but is seems to me that the very act of recovery may also cause barotrauma artefact. For example, the diver is hardly exhaling during the ascent, so there is the risk of a burst lung (pneumothorax) being produced post mortem during the ascent. Again this differs from simple drowning. (I have always been told that an unconcious casualty in respiratory arrest has a closed glottis, perhaps not?)

Diving medicine is a pretty specialised field. Most pathologists (medical examiners?) are not experienced in diving medicine and may not be aware that these findings may - or may not - be artefactual.

In any case I do not envy their job as I think it must be almost impossible to determine the actual cause of death in diver fatalities for these reasons alone.

I have to emphasise that I am not a pathologist and have no idea of how they go about their jobs and this is not intended as a criticism of their branch of the profession.

Perhaps a Canadian reader could ask the pathologist how he concluded the cause of death was AGE as this sounds more and more unlikely to me.

One posibility, and it is only conjecture, is simple cardiac arrest due to ventricular fibrillation caused by the stress and biochemical imbalances. This would leave no post mortem evidence whatsoever. Is there anyone from DAN on the forum to advise?

:doctor: