DAN Blog – Decompression Sickness

https://www.scubadivermag.com/dan-blog-decompression-sickness/
Stephen Frink MFT Photo Tour to Tubbataha National Park aboard Philippines Siren. Dive site: Jessie Beazley, Part I (Jessie Beasley was expedition vessel that discovered Tubbataha)

This month the DAN Blog focuses on Decompression Sickness

One hour after diving, the room started spinning…

A DAN member experiences severe dizziness, tingling and impaired balance post-dive.

The Diver: Male, in good general health.

The Diver’s Experience: Advanced Open Water certified.

DAN Blog - Decompression Sickness

The Trip: Dive holiday in Anilao, Philippines.

The Dives: On the day of the incident, the diver had completed three dives on air. He went into deco on his final dive, so he performed a six-minute deco stop at 3m. Along with his Divemaster, he descended to 5m to complete a 15-minute safety stop.

The Profiles:

Dive 1: 25.3m for 59 minutes; surface interval of 1 hour.

Dive 2: 19.7m for 1 hour and 11 minutes; surface interval of 1 hour and 15 minutes.

Dive 3: 17.4m for 1 hour and 11 minutes.

Onset of Symptoms

Upon surfacing the diver had no apparent problems. However, one hour later while resting in his bed at the hotel, he started to feel as though the room was spinning. This was followed by an episode of vomiting. A few minutes later he developed a tingling sensation in both hands.

He informed the dive resort of his symptoms and was put on oxygen for 20 minutes via nasal canula with no relief, so was taken to a nearby hospital by road. Requiring further treatment, the diver was transferred to another hospital 90 minutes away (also by road) for higher level care, including further evaluation and management. (Note: A nasal canula provides insufficient oxygen for managing a diving accident. With a flow rate of only 1-6 litres per minute the percentage of oxygen inspired is quite low at 24-44%).

DAN Blog - Decompression Sickness

Treatment

On admission to the hospital the diver was given oxygen. While he was in the emergency department the doctor wanted him evaluated for a cerebrovascular accident (stroke) and referred him to a neurologist, who ordered a cranial CT scan. The stroke was ruled out, and the diver was treated for DCS Type II. It was found that while he could sit up on his own, he could not stand due to severe dizziness. It was also found that his tongue was deviated to the left.

He underwent a US Navy Table 6 treatment. After this treatment, the diver could stand but staggered when trying to walk, falling to one side, and he was still dizzy.

The decision was made for the diver to undergo a second Table 6 treatment. Although there was improvement after this treatment, he still had trouble with his balance.

The diver underwent a third and final recompression treatment (Table 9).

Diagnosis: Decompression Sickness Type II

Recovery

The diver was discharged the day after his final recompression treatment. While his balance had not fully recovered, he was in much better condition, and the dizziness has nearly fully resolved.

The treating doctor provided these recommendations:

  • No diving for 30 days after the last chamber treatment
  • No airline travel or driving to high altitude for a minimum of 96 hours after the last chamber treatment
  • Avoid strenuous activities
  • Follow up with a diving medical officer in 2 weeks

Costs

  • Hospital: US$3,441.28
  • Chamber: US$6,100.00

Total US$9,541.28

Fully covered by DAN

Analysis

Brain injury can result from external trauma (blunt injury, falls) or from interruptions in blood flow within the brain. The latter is known as a cerebral vascular accident (CVA) or stroke, which is what the doctors first suspected when the diver arrived at the hospital. The fact that this diver also had tongue deviation was another possible indicator that he had experienced a stroke. However, it is likely this doctor was not familiar with diving medicine.

After testing, stroke was ruled out and the diver was diagnosed with Type II Decompression Sickness.

Symptoms of Type II Decompression Sickness are serious. They typically fall into three categories: neurological, inner ear and cardiopulmonary. Neurological symptoms may include numbness; pins and needles or tingling (paraesthesia); muscle weakness; an impaired gait (difficulty walking); problems with physical coordination or bladder control; paralysis; or a change in mental status, such as confusion or lack of alertness.

It is common for divers to be assessed by a neurologist before being treated for DCI to rule out CVA.
Type II Decompression Sickness symptoms can develop at different speeds. A slow build-up can obscure the seriousness of the situation by allowing denial to persist. Less common symptoms such as difficulty walking, urinating, hearing or seeing — especially if their onset is quick — can prompt faster recognition and action.

Fortunately, the diver in this case acted fast and requested help at the first onset of symptoms, so he was able to receive prompt treatment, and ultimately he recovered well.

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The information in this video is not intended nor implied to be a substitute for professional SCUBA Training or recommendations for every manufacturer. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace training from a qualified Dive Instructor or specific requirements from equipment manufacturers.

YouTube Video UEw2X2VCMS1KYWdWbXFQSGV1YW84WVRHb2pFNkl3WlRSZS43RkJGOTAwRDhCOEQ1RjIy

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@sennacher 
#askmark Hi there, regarding DSMBs. I’m no expert whatsoever and normally I deploy it correctly. This weekend we dove on very strong current and I almost lose my breath while deploying it (mouth inflate) as it tangled a bit on my reg. It scared the sh&t out of me so. Is there any “little cylinder” kind of thing in order to keep my reg in my mouth to deploy it safer?  I haven’t tried to do it with my LPI… but asume it would tangle also.
Thanks
Please visit our website for more Scuba news, underwater photography, hints & advice, and travel reports: https://divernet.com/ 

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#askmark Hi there, regarding DSMBs. I’m no expert whatsoever and normally I deploy it correctly. This weekend we dove on very strong current and I almost lose my breath while deploying it (mouth inflate) as it tangled a bit on my reg. It scared the sh&t out of me so. Is there any “little cylinder” kind of thing in order to keep my reg in my mouth to deploy it safer? I haven’t tried to do it with my LPI… but asume it would tangle also.
Thanks
Please visit our website for more Scuba news, underwater photography, hints & advice, and travel reports: https://divernet.com/

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For Business inquiries, please use the contact information below:

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How Twinset Valves Work In Scuba Diving | Shutdown Drills And Isolator Tips Explained #scubadiving #askmark #twinset

Confused about how to use twinset valves or perform a proper valve shutdown drill? You’re not alone.

In this AskMark episode, Mark explains how valves work on twin cylinders, including how to safely open and close them, how isolator valves function, and why valve drills (also known as shutdown drills or V-Drills) are critical for diagnosing leaks during technical and recreational dives. Please visit our website for more Scuba news, underwater photography, hints & advice, and travel reports: https://divernet.com/ 

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Let us know in the comments how your instructor taught valve drills and don’t forget to leave your questions using #AskMark to get featured in a future video. 

@mostafametwally1

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Disclaimer: The information in this video is not intended nor implied to be a substitute for professional SCUBA Training. This video's content, including text, graphics, images, and information, is for general information purposes only and does not replace training from a qualified Dive Instructor.

🔎 Related Phrases:

How Twinset Valves Work In Scuba Diving, Shutdown Drills And Isolator Tips Explained, How Twinset Valves Work In Diving, Scuba Valve Drill Tutorial, Shutdown Drill For Twin Cylinders, How To Use Twinset Isolator Valve, Twinset Manifold Explained, Best Way To Close Dive Valves, V-Drill For Scuba Divers, Twin Cylinder Gas Management Tips, Scuba Regulator Shutdown Steps, How To Practice Twinset Valve Drills, Muscle Memory For Valve Shutdowns

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How Do Valves Work on Twin Cylinders? #askmark
@mostafametwally1
#askmark hi Mark. Could you do a video on how to deal with the valves and manifold on twin cylinders. It’s confusing to remember which way to open the valves and it’s easy to get wrong particularly in emergencies. Thanks
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The information in this video is not intended nor implied to be a substitute for professional SCUBA Training or recommendations for every manufacturer. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace training from a qualified Dive Instructor or specific requirements from equipment manufacturers.

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