raffles
Guest
Here's a question for the Doc's out there. An actual case Hx.
Male Diver in his early 40's began a diving day after no previous diving this trip. He reports that apart from a slightly "queasy" belly he was well rested and looking forward to diving.
The first dive of the day was a two level dive, 60ft for 20mins moving up to 30 feet for another 20 mins. This was followed by an ascent to 15 feet for a 3min safety stop.
At this point, apart from the slight "queasiness" changing to a more marked "fullness" in the umbilical area the Diver felt well and did not consider drawing this matter to the DM"s attention.
After a surface interval of 1hour and 10mins the diver re-entered the water for his second dive. The discomfort increased upon descent but only to the point that a trip to the head was planned on surfacing. At no point the Diver says was it so uncomfortable that he thought he should abort the dive. The second profile was 60feet for 20mins coming up to 25feet for another 20 mins, ascent to 15feet for safety stop of 3 mins. Upon ascent the symptoms resided to their previuos feeling of fullness. Again he did not report his symptoms to the DM.
About 30mins into this surface interval he began to feel bloated and nauseous but ascribed to motion sickness as the waves had increased in size and strength, after a total surface interval of 1hour 20 mins the third dive started. At this point the Diver reported his increasing discomfort to the DM who agreed to Buddy up to ensure no problems on the last dive of the day, they entered the water.
At this point the DM reports that it was obvious that the Diver was in distress as soon as the descent began. Increased respirations a degree of unco-ordination using the down line and at 30 feet the Diver clutched the line, his stomach and began taking huge gulps of air the DM aborted the Dive at this point and began a slow controlled ascent to the surface pausing at 15feet for about 6mins as the divers distress had obviously eased.
Exiting the water the Diver reported that his symptoms on descent had been, increasing abdominal pain, radiating from the umbilical area to the flanks. At 30feet nausea had increased to the point of almost vomiting. Immediately upon ascending the symptoms started to fade.
At this point the DM decided to treat for DCS. The Diver changed into dry clothes, was placed in the modified Trendellenberg and given O2 using a D cylinder with non rebreather mask the boat returned to shore. On the return trip the symptoms returned with increasing severity until the Diver was assisted ashore and back to his room. At this point it was too late in the evening to evacuate to the Recompression Facility although they were contacted. They suggested, continued use of O2, administration of Tyelenol 1G Q 4hrs, or PRN if not required that frequently and encouraging drinking of fluids. Plus monitoring divers vital signs (available if required)
At this point the Diver was in acute pain and the pain was exacerbated when prone, the only comfortable position was found to be sitting up with legs extended. In this position the pain gradually subsided until it finally went away at aproximately 2200 local. At this point the Diver experienced a sharp abdominal cramp followed by the expulsion of a really impressive amount of flatus. After he had been to the bathroom he stated that he had passed nothing with the flatus.
The Diver felt much better and tried to lie down to sleep which he managed to do without further incident. In the morning the Diver refused further Medical Attention but discontinued his diving activities at the suggestion of the DM. Waited a suggested 48hours then flew home.
The question is was this a DCS case which was how it was treated or was it some sort of Barotrauma.
Male Diver in his early 40's began a diving day after no previous diving this trip. He reports that apart from a slightly "queasy" belly he was well rested and looking forward to diving.
The first dive of the day was a two level dive, 60ft for 20mins moving up to 30 feet for another 20 mins. This was followed by an ascent to 15 feet for a 3min safety stop.
At this point, apart from the slight "queasiness" changing to a more marked "fullness" in the umbilical area the Diver felt well and did not consider drawing this matter to the DM"s attention.
After a surface interval of 1hour and 10mins the diver re-entered the water for his second dive. The discomfort increased upon descent but only to the point that a trip to the head was planned on surfacing. At no point the Diver says was it so uncomfortable that he thought he should abort the dive. The second profile was 60feet for 20mins coming up to 25feet for another 20 mins, ascent to 15feet for safety stop of 3 mins. Upon ascent the symptoms resided to their previuos feeling of fullness. Again he did not report his symptoms to the DM.
About 30mins into this surface interval he began to feel bloated and nauseous but ascribed to motion sickness as the waves had increased in size and strength, after a total surface interval of 1hour 20 mins the third dive started. At this point the Diver reported his increasing discomfort to the DM who agreed to Buddy up to ensure no problems on the last dive of the day, they entered the water.
At this point the DM reports that it was obvious that the Diver was in distress as soon as the descent began. Increased respirations a degree of unco-ordination using the down line and at 30 feet the Diver clutched the line, his stomach and began taking huge gulps of air the DM aborted the Dive at this point and began a slow controlled ascent to the surface pausing at 15feet for about 6mins as the divers distress had obviously eased.
Exiting the water the Diver reported that his symptoms on descent had been, increasing abdominal pain, radiating from the umbilical area to the flanks. At 30feet nausea had increased to the point of almost vomiting. Immediately upon ascending the symptoms started to fade.
At this point the DM decided to treat for DCS. The Diver changed into dry clothes, was placed in the modified Trendellenberg and given O2 using a D cylinder with non rebreather mask the boat returned to shore. On the return trip the symptoms returned with increasing severity until the Diver was assisted ashore and back to his room. At this point it was too late in the evening to evacuate to the Recompression Facility although they were contacted. They suggested, continued use of O2, administration of Tyelenol 1G Q 4hrs, or PRN if not required that frequently and encouraging drinking of fluids. Plus monitoring divers vital signs (available if required)
At this point the Diver was in acute pain and the pain was exacerbated when prone, the only comfortable position was found to be sitting up with legs extended. In this position the pain gradually subsided until it finally went away at aproximately 2200 local. At this point the Diver experienced a sharp abdominal cramp followed by the expulsion of a really impressive amount of flatus. After he had been to the bathroom he stated that he had passed nothing with the flatus.
The Diver felt much better and tried to lie down to sleep which he managed to do without further incident. In the morning the Diver refused further Medical Attention but discontinued his diving activities at the suggestion of the DM. Waited a suggested 48hours then flew home.
The question is was this a DCS case which was how it was treated or was it some sort of Barotrauma.
