62
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SPRING 2014
RESEARCH, EDUCATION & MEDICINE
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F R O M T H E M E D I C A L L I N E
Q:
My doctor recently put me on Coumadin.
Could diving while taking this medication
cause me any problems?
A:
There is a well-recognized risk for
uncontrolled bleeding in people who are
being treated with anticoagulant medications
such as Coumadin. However, many people who take
anticoagulants — including divers — have carefully
adjusted their prothrombin times and with appropriate
behaviors may not be at undue risk. Some physicians
believe diving is an unnecessary risk for their patients
who are taking anticoagulants and will advise against
diving, but DAN is unaware of any data indicating that
sport divers face an increased risk of complications.
Some physicians trained in dive medicine may
be willing to endorse recreational diving for these
patients provided:
• the underlying disorder or need for anticoagulants
does not put the patient at increased risk of an
accident, illness or injury while diving.
• the patient understands the risks and modifies
his or her dive practices to reduce the risk of ear,
sinus and lung barotrauma as well as physical
injury. This includes avoiding forceful equalization
— equalization must come easily for these people.
• the patient dives conservatively, planning
short, shallow profiles to reduce the risk of
decompression illness, which can involve bleeding
in the inner ear or spinal cord.
• the patient avoids diving in circumstances in which
access to appropriate medical care is limited.
DAN medics are available for consultation with you
or your doctor; don’t hesitate to give us a call.
— Dan Nord, EMT-P, DMT
Q:
When trying to provide
rescue breaths in the
water to an injured
diver, why can’t I use my spare
regulator’s purge button? That
seems easier to me than trying to
manage a pocket mask.
A:
Using the purge button of
a second-stage regulator
has been proposed many
times, but any advantage it may
seem to offer does not outweigh the
potential risks and complications.
If the regulator mouthpiece is
not already in the unconscious
diver’s mouth, trying to replace
it can be difficult and time
consuming. Without a good seal
and a means to occlude the diver’s
nostrils, any attempts to ventilate
will be unsuccessful. Even if the
mouthpiece can be successfully
placed in the diver’s mouth there
is a risk of it pushing the relaxed
tongue to the back of the throat and
blocking the airway.
REEFS
•
WRECKS
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CAVES
•
SHARKS
•
DOLPHINS
•
FRIENDLY STAFF
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1
ST
CLASS FACILITY
Call 1 800 992-DIVE
or
(242) 373-1244
DIVE WITH THE BEST!
Grand Bahama Island, Bahamas
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