scubadoc Ten Foot Stop

April 26, 2006

DAN and SSS Issue Joint Press Release

Filed under: Uncategorizedscubadoc @ 4:05 pm


We received an email from Dan Orr, President of DAN concerning a joint news release from DAN and SSS located on DAN’s web site. This is a most welcome note indicating that the impasse between the two entities has been resolved and settled. Here is the note from DAN:

“Divers Alert Network (DAN) and SSS Network of Recompression Chambers (SSS) Joint Press Release

Divers Alert Network (DAN America) and clinic members of the SSS Network of Recompression Chambers (SSS) announce that they have reached a settlement in the recent legal action. Representatives of SSS announce that DAN America insurance is once again accepted as a result of the resolution of the outstanding claims that were the basis for the lawsuit. The terms of the settlement remain confidential. The SSS Network of Recompression Chambers and DAN America pledge to work closely together to ensure that injured divers will receive the most appropriate and effective medical care.”

Decompression illness presenting as breast pain.

Filed under: Uncategorizedscubadoc @ 3:00 pm


There is an interesting article in the Undersea and Hyperbaric Medical Journal relating two reports of decompression illness presenting as painful breasts. This is in Volume 33, #2 by A.J. Trevett, C. Sheehan, Y. Forbes.

They present two cases of decompression illness in women in whom the initial symptom causing distress after completion of the dives was breast pain. Both women were also subsequently found to have a patent foramen ovale. They postulate that breast pain may be an unusual under-recognized manifestation of decompression illness.

This is more interesting because of a discussion that took place on our Scuba Clinic Forum back last year concerning several women divers with similar complaints and responses provided by consultants and other divers. Two of these divers anecdotally had PFOs. This thread can be seen on our forum at this location: http://snipurl.com/ppk0

More about women divers at http://www.scuba-doc.com/womdiv.html

2nd Congress of the Alps-Adria Working Community on Maritime, Undersea, and Hyperbaric Medicine

Filed under: Uncategorizedscubadoc @ 2:16 pm

The Croatian Maritime, Undersea, and Hyperbaric Medical Society Naval Medical Institute is sponsoring a meeting to be held at Zadar from 18th to 21st October 2006. Capt. Nadan Petri writes requesting that we post information about this meeting, the 2nd such held since 2001.

Dear Dr. Campbell,
please be so kind and put the web site

www.marmed.hr

as a link on scubadoc portal.

It is the official web site of the 2nd Congress of the Alps-Adria Working Community on Maritime, Undersea, and Hyperbaric Medicine.

You might remember that you did the same for us in 2000/2001, on the occasion of the 1st Congress, held in April 2001.

Hope your visitors might be also interested in knowing the info about our Congress.

Thank you so much for your concern in this matter and your most kind support.

Best wishes,

CAPT Nadan M.Petri, MD, PhD
President of the Croatian Maritime, Undersea, and Hyperbaric Medical Society
Naval Medical Institute

21000 Split, p/o box 196
Croatia

00385-21-381-711
fax 00385-21-381-716

MedWatch Warning: Risk of Oxygen Regulator Fires from Poor Gasket Use

Filed under: Uncategorizedscubadoc @ 1:38 pm

April 25, 2006 — Healthcare professionals and the public have been warned by The US Food and Drug Administration (FDA) and the National Institute for Occupational Safety and Health (NIOSH) of the risk for fires from the cylinder valves and regulators of oxygen tanks.

MedWatch, the FDA’s safety information and adverse event reporting program reports today that fires have been linked to the incorrect use of CGA 870 seals.

The FDA has received 12 reports in which the regulators burned or exploded, in some cases during emergency medical or routine equipment use. Although there may have been other contributing factors, improper use of the nylon crush gasket variety of CGA 870 seals is believed to have played a major role in both fire ignition and severity.

The FDA notes that these single-use gaskets require higher torque than the elastomeric multiple-use sealing washers, and they require more torque with each successive use to seal the cylinder valve/regulator interface. Wrenches or other hand tools used to achieve this torque can deform the crush gasket and damage the cylinder valve and regulator, resulting in oxygen leaking across the gasket. This apparently causes “flow friction” from O2 leaking across the gasket surface and producing thermal energy igniting the nylon material.

The FDA and NIOSH advise against reuse of plastic crush gaskets. Other recommended precautions include “cracking” cylinder valves to allow expulsion of foreign matter from the foreign port prior to regulator attachment; use of manufacturer-recommended sealing gaskets; and visually verifying that the regulator and seal are in good condition prior to connecting the valve.

Hand-tightening the T-handle is also advised to reduce the risk for damage associated with wrenches and other hand tools. The post valve should then be opened slowly while maintaining a grip on the valve wrench to allow rapid closure if gas escapes at the junction.

Additional information regarding the proper use of CGA 870 seals may be obtained by contacting April Stubbs-Smith, Office of Surveillance and Biometrics (HFZ-510), 1350 Piccard Drive, Rockville, Maryland 20850. Questions may also be submitted by fax to 1-301-594-2968 or by e-mail at phann@cdrh.fda.gov, and voicemail messages left at 1-301-594-0650 will be returned as soon as possible.

Healthcare professionals are encouraged to report adverse events related to use of CGA 870 seals to the FDA’s MedWatch reporting program by phone at 1-800-FDA-1088, by fax at 1-800-FDA-0178, online at http://www.fda.gov/medwatch, or by mail to 5600 Fishers Lane, Rockville, MD 20852-9787.

University of Auckland Graduates First Physician as a Specialist in the field of Diving and Hyperbaric medicine.

Filed under: Uncategorizedscubadoc @ 9:38 am

Dr Dives To Medical History


University of Auckland, from Tower

The newspaper ‘Scoop’ reports from the University of Auckland that it has graduated it’s first physician as a specialist in the field of Diving and Hyperbaric medicine.

Christchurch emergency physician Dr Sandy Inglis will make New Zealand medical history on April 27th when he becomes the first doctor to graduate with a Postgraduate Diploma in Diving and Hyperbaric Medicine from The University of Auckland.

The diploma programme and a Master of Science specialisation in the field are run by Associate Professor Michael Davis, Medical Director of Christchurch Hospital’s Hyperbaric Medicine Unit, which is one of only two units in the country equipped to treat scuba divers suffering from “the bends”.

Professor Des Gorman, Head of the School of Medicine at Auckland’s Faculty of Medical and Health Sciences, congratulated Dr Inglis on becoming the first to graduate from the programme, which was introduced in 2004.

See the entire article at this web site.
http://snipurl.com/pp2n

More about New Zealand dive accident facilities at this site: http://www.scuba-doc.com/divnz.htm

April 25, 2006

DDRC Investigates HBOT Effect on QoL on Diabetic Neuropathy

Filed under: Uncategorizedscubadoc @ 9:41 am


The DDRC (Diving Diseases Research Center), always in the forefront studying hyperbarics, is investigating the long term effect of HBOT on the quality of life of patients with diabetic neuropathy. The condition can be devastating, causing loss of use as well as incapacitating pain. Read about this study (and others) at this site:

DDRC - investigation into the impact of Hyperbaric Oxygen Therapy (HBO2)
on Quality of Life (QoL) in patients with Diabetic Neuropathy
http://snipurl.com/pniv

5th International Symposium for Hyperbaric Oxygenation and the Recoverable Brain

Filed under: Uncategorizedscubadoc @ 9:38 am

Please remind your readers that we are fast approaching the deadline for early bird reduced rate for delegates – May 1st.

www.hbo2006.com

Thanks very much.

Regards.
Sharon Phillips

April 22, 2006

UK Coast Guard Diving Accidents

Filed under: Uncategorizedscubadoc @ 10:16 am

UK Diving fatalities down, but accidents up (From the bymnews.com)

The 2005 figures for open water diving accidents reported by HM Coastguard reveal that while fatalities are down from 2004, the overall number of accidents has risen slightly. During 2005, HM Coastguard Maritime Rescue Coordination Centres reported a total of 254 open water diving related accidents, and these incidents ranged from cases of decompression illness and medical emergencies to broken down vessels.

Thirteen fatalities have been recorded, with one case reported ‘previously missing’ (body found of a previously missing person). The greatest single incident category remains decompression illness (DCI) which accounts for 70 incidents alone, with a further 45 attributed to rapid ascent, which may have developed into DCI. Medical emergencies also accounted for 27 which may not have been diving related but arose from a pre-supposing medical conditions.

These statistics relate to only those in which HM Coastguard coordinated Search & Rescue or was involved. National Diving statistics including both open water and inland diving together with detailed analysis, are available from the BSAC (www.bsac.org) who is the National Governing body for UK Sport Diving.

The south coast of the UK again saw the highest number of accidents reported reflecting its popularity and accessibility as one of the premier diving areas in the country.

More about UK Dive Accident Facilities and contacts at http://www.scuba-doc.com/divuk.htm

April 21, 2006

Are There Risks for Diving while on Dialysis?

Filed under: Uncategorizedscubadoc @ 5:51 pm

Dialysis and diving


Hemodialysis being done

A recent question prompted an effort to find the risks of scuba diving while on renal dialysis.

I am a librarian in a French hospital and I am looking for articles or other documents about diving and dialysis. I have found the following link on your website : http://www.scuba-doc.com/kidprbs.htm but I can’t find anything else.

Could you help me ?

There are no studies or references to dialysis and diving, that I can find. Of course, I have had several questions over the years from persons with renal failure who want to dive, have dived or who have questions or comments about the problem. The material below summarizes my recommendations to a question from a diver.

Main problems seem to be associated with immersion effects, dehydration and/or diving “wet” (in the case of peritoneal dialysis, with an abdomen full of fluid or diving just before the need to dialyze.). The study linked below indicates some of the cardiovascular changes that can occur.

Renal disease can cause changes in the sensorium due to obtundation from elevations in byproducts of metabolism (BUN, creatinine). Whether or not this is additive to the effects of elevated partial pressures of nitrogen at depth is not known but should be assumed. In addition, there might be some cerebral alteration in the response to stress and decision-making abilities from accumulations of blood nitrogen (metabolic, as well as gaseous).

There would be no problems related to the depth/pressure changes that take place in air-containing body cavities and there probably would not be any increased risk from a decompression accident due to the renal disease, unless there was associated dehydration. Peritoneal access sites should be well healed or sealed due to the possibility of marine infection and there should be no air containing equipment on the diver. The diver should not dive while “wet” - that is with a fluid load of the dialysate intra abdominal.

Simple immersion causes a central shift in the body fluids, which would increase the GFR (glomerular filtration rate) in the normal individual. This factor, plus the decrease in the anti-diuretic hormone, causes normal kidneys to excrete more urine (pee factor with diving). If the kidneys could not manage this increased load, there would be the possibility of increased cardiac pre-load with the possibility of heart failure and pulmonary edema.

If there are no secondary changes associated with the renal failure (eye, heart, brain), one can be certified as fit to dive. However, there are other factors that must be taken into consideration - one of which is the anemia that is usually associated with renal failure. Diving should not be done if the Hgb is below 12 Gm/dl. This is usually managed by using Procrit (Erythropoitin) injections and oral iron replacement. The patient can also be on many other medications which might be inimical to scuba diving, such as anticoagulants, sedatives, blood pressure medications and antihistamines.

The person on dialysis walks a fine line between diving dehydrated, right after a treatment and diving wet, just before a treatment. Each of these situations has it’s risks.
——————————————————————————-
Here is a citation in Medline about cardiovascular changes in dialysates during diving.

Evaluation of cardiovascular autonomic function tests in dialysis patients.
Chu TS, Tsai TJ, Lee SH, Yen TS.
J Formos Med Assoc. 1993 Mar;92(3):237-40.

http://snipurl.com/pf04
——————————————————————————-

Standard Diving Medicine textbooks do not discuss diving and dialysis, nor is it addressed by the UKSDMC or DAN.

scubadoc

Cuba Moves Ahead in Hyperbaric Medicine

Filed under: Uncategorizedscubadoc @ 5:28 pm

Cuba Moves Ahead in Hyperbaric Medicine
http://snipurl.com/picl

There is a conference about hyperbaric medicine that is going on in Cuba at this time. In the province of Sancti Spiritus the Cuban Society of Hyperbaric Medicine and Undersea Activities (SCMHBAS)is closing a meeting today (April 21, 2006) attended by experts from Spain, Costa Rica, Panama, Mexico and Peru.

Every hospital on the island is provided with hyperbaric oxygen services. In several of these facilities, hyperbaric chambers are indeed multipurpose units in which patients in critical conditions have been treated.

Participants in the conference are analyzing the use of hyperbaric techniques in the treatment of ulcers, graftings, diabetes, herpes zoster, chronic arterial deficiency and other illnesses.

Cuba is well supplied with hyperbaric facilities - there being a chamber in every hospital in the country.

Information about Cuban chambers can be seen on our web site at http://www.scuba-doc.com/divcuba.htm .

Reactivated and Maintained by Centrum Nurkowe Aquanaut Diving