BAROTRAUMA & DYSBARISMS #8

ARTERAIL GAS EMBOLISM:  (AGE)Most serious of all dive injuries - frequently fatal.
Second only to drowning in fatalities in sport divers.
Ruptured airways allow air bubbles to enter the pulmonary circulation and go to the left side of the heart.
From the left ventricle may migrate to the coronary or cerebral circulation.
Resulting in:
ACUTE MYOCARDIAL INFARCTION (AMI)
CEREBROVASCULAR ACCIDENT (CVA)
AGE usually presents within 10 minutes of the “burst lung”.

SYMPTOMS: 
CVA = neurological symptoms:
change in mood or affect
visual disturbances
hemiplegia or hemiparesis
unconsciousness

AMI = apnea - dyspnea
chest pain - chest pressure
dysrhythmia s - asystole

SUDDEN LOSS OF CONSCIOUSNESS BEFORE SURFACING IS AGE UNTIL PROVEN OTHERWISE

TREATMENT:  RECOMPRESSION!!!
100% O2 while transporting
Transport supine & MONITOR AIRWAY

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BAROTRAUMA & DYSBARISMS #6

ASCENT INJURIES:  “REVERSE SQUEEZE”

ASCENT   = expansion of the gas.     
The volume of gas increases by 2, doubles, every 33 fsw.

This is why it is an absolute rule that people with asthma cannot SCUBA dive!
ASTHMA and SCUBA diving = death.
During ascent some of the air breathed at depth will get trapped in the alveoli and bronchioles, then during ascent that trapped air will expand and burst the alveoli and bronchioles, resulting in burst lungs and DEATH.

PULMONARY OVERINFLATION:
“Pulmonary Over Pressurization Syndrome” - POPS = “Burst Lung”
Usually occurs with a rapid ascent and breath holding.
Gas in the lung expands rapidly causing alveolar rupture.  (Boyle’s Law)
Alveolar rupture allows air to be forced into other tissues/spaces.
Resulting in escape of air under pressure into the:
Mediastinum = PNEUMOMEDIASTINUM/INTERSTITIAL EMPHYSEMA
Pleural Space = PNEUMOTHORAX
Pulmonary Venous System = ARTERIAL GAS EMBOLISM  (AGE)

This blog is powered by the Wilderness Medicine Newsletter, now celebrating 20 years of publication. The WMN is published and distributed online six times each year by TMC Books, and subscriptions cost as little as $10 per year. To find out more, or to subscribe online, click here.