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WINTER 2012
RESEARCH, EDUCATION & MEDICINE
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I N C I D E N T I N S I G H T
Diver No. 1
The diver was a 45-year-old, healthy female with reasonably
good physical fitness. She had been certified for five years and
had done 15 dives in the previous year. She had no problems
on the first day of her Caribbean dive vacation but reported
minor difficulties with her rental BCD. On the following day
she dived to 88 feet for 30 minutes and 30 feet for 30 minutes,
using normal air and spending 90 minutes on the surface
between dives. During the second dive, she attempted to
vent air from her BCD but mistakenly depressed the inflator
mechanism and made an uncontrolled ascent. She later
reported feeling weak and unable to move her legs during the
ascent. Upon reaching the surface she lost consciousness.
The crew immediately brought her onboard the boat and
administered oxygen with a demand mask. They recalled the
divers who remained in the water and quickly proceeded to
the dock. A local ambulance service had been contacted by
radio and was waiting when they arrived. Upon arrival at the
local hospital, the treating physician diagnosed arterial gas
embolism (AGE), and the diver was taken into the hyperbaric
chamber. The elapsed time from the onset of symptoms to
entering the chamber was one hour, during which the diver’s
supply of 100 percent oxygen was interrupted only twice and
for less than five minutes each time.
The diver was treated with a U.S. Navy Treatment Table 6
(TT6). Within the first 20 minutes in the chamber, at 60 feet,
she regained consciousness. The treatment was extended by
three oxygen periods (about five hours), but her symptoms
improved only slightly. Despite the treatment, she was unable
to urinate on her own and needed a catheter. The next
morning she was treated again with another extended TT6.
Motor function in her legs did not return but sensation did. She
still required a urinary catheter. In consultation with DAN®,
the decision was made to evacuate her to the U.S. in an air
ambulance at sea-level pressure for further treatment. Upon
arrival in the U.S., she was treated aggressively with multiple
hyperbaric treatments totaling 57 hours. Ultimately, she was
discharged with residual weakness and numbness in her legs.
After three months she was able to urinate on her own, but she
reported persistent sexual dysfunction. After a year of following
this diver’s progress, it was determined that the weakness,
numbness and sexual dysfunction were likely permanent.
Diver No. 2
The diver was a 50-year-old male who had been diving
actively for 20 years. He was traveling on a liveaboard in a
remote area. On the fourth day of his trip he made two dives,
the first to 133 feet for 37 minutes and the second to 88 feet
for 47 minutes. He used normal air on both dives and spent
two hours on the surface between them. During the second
dive the sea conditions changed. The waves became larger,
causing the divers to move up and down vigorously during
their 15-foot safety stop. Within five minutes of boarding the
boat the diver began to complain of severe right shoulder
pain that quickly progressed to numbness and weakness. He
became unable to stand or walk normally. The crew helped
him find a seat and began to evaluate him. He had impaired
sensation and motor function in both legs and diminished
strength and reduced sensation in his right arm. The crew
provided oxygen via demand mask. The boat had a two-hour
supply of oxygen, and it would take eight hours to get to the
closest medical facility.
Time and Recovery
B y M a R T y M c c a f f E R T y
R A D I U S I MA G E S / CORB I S
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