Chambers/TT
Thermometers allowed in a chamber?
Electronic
Bimetallic
Alcohol
Liquid Crystal
Primary Objectives of Recompression treatments?
Compress gas bubbles to a small volume, thus relieving local pressure and restarting blood flow.
Allow sufficient time for bubble resorption.
Increase blood oxygen content and thus oxygen delivery to injured tissues.
What are the six parts of a neurological exam?
Mental Status
Coordination
Motor Skills
Cranial Nerves
Sensory
Deep Tendon Reflex
How many pressure points are there?
11 Pressure points
When Can you eat, sleep and drink in the chamber?
Sleeping: Patient should be kept awake deeper than 30fsw on 100% O2
Food: May be taken at anytime.
Fluids: Should be maintained.
(IT should monitor vitals of sleeping patient)
Ideal chamber side positions?
Diving Officer
Master Diver
Chamber Supervisor
UMO
IT/DMT
Log Keeper
OT
Three symptoms of type 2 DCS?
Neurological Symptoms
Inner Ear DCS
Cardiopulmonary Symptoms
Test the person to your lefts coordination.
Heal-to-toe
Romberg
Finger to nose
Heal shin slide
Rapid alternating movement test
What is a nystagmus?
Rapid jerking movement of the eyes.
Tenders should allow for a surface interval of how long between TT?
TT 1A,2A,3,5,6 & 6A: 18 hours (Tender may repeat TT 5,6,6A if oxygen requirements are met at 30fsw)
TT 4,7,8: 48 hours
How much water, juice or non-carbonated drink should a patient have for adequate hydration over the course of a TT 5 or 6?
1 to 2 liters
CNS O2 toxicity occurs whenever PPO2 increase exceeds what wet and dry?
In a Wet Diver: 1.3 ata
In a Dry Diver: 2.4 ata
Extremity Strength Scale 0-5?
0 - Paralysis
1 - Profound Weakness
2 - Severe Weakness
3 - Moderate Weakness
4 - Mild Weakness
5 - Normal
Bones of the middle ear?
Malleus
Incus
Stapes
Tender Oxygen Breathing Requirements?
TT5 Without Extension - 0
TT5 With Extesnion - 0
TT6 1 Extension - 30
TT6 More Than 1 - 60
TT6A 1 Extension - 60
TT6A More Than 1 - 90
Oxygen gas mixtures in the chamber for treatment?
0-60: 100%
61-165: 50/50 HeO2
166-225: 64/36 HeO2
POIS Tree
Pulmonary Overinflation
Rupture of the Alveolar Lining
Interstitial Emphysema
Mediastinal Emphysema -> AGE -> Pneumothorax
Subcutaneous Emphysema
What are the 12 cranial nerves?
Olfactory
Optic
Oculomotor
Trochlear
Abducens
Trigeminal
Facial
Acoustic
Glossopharyngeal
Vagus
Spinal Accessory
HypoglossalRespiration Phases?
1. Ventilation of the lungs
2. Exchange of gasses between blood and air in lungs
3. Transport of gases by blood
4. Exchange of gases between blood and tissue fluids
5. Exchange of gases between tissue fluids and cells
6. Use and production of gases by the cell
Responsibilities of IT?
Releasing the door latches (dogs) after a seal is made.
Communicating with outside personnel.
Providing first aid as required by the patient.
Monitoring the patients vital signs.
Administering treatment gas to the patient at treatment depth.
Monitoring the patient for signs of oxygen toxicity. (CNS and Pulmonary)
Ensuring that sound attenuators for ear protection are worn during compression and ventilation portions of recompression treatments.
Ensuring that the patient is lying down and positioned to permit free blood circulation to all extremities.
Ascent rate for TT7?
58-49 3ft/m
40-20 2ft/m
20-4 1ft/m
How do you treat shock?
1. Ensure adequate breathing.
2. Control Bleeding.
3. Oxygen.
4. Elevate Lower Extremities
5. Avoid Rough Handling.
6. Prevent loss of body heat.
7. Keep patient lying down.
8. Give nothing by mouth.
Initial Assessment of Diving Injuries Questions In Order?
What is the problem/symptoms?
Has the patient made any dives recently?
What was the dive profile?
How many dives has the patient made in the last 24 hours?
When were the symptoms first noticed?
If noticed during the dive was the diver ascending, descending or on bottom.
Has the symptoms increase or decreased since first noticed?
Have any additional symptoms developed since first noticed?
Has the patient had ever similar symptoms?
Has the patient ever suffered from AGE/DCS before?
Does the patient have any concurrent medical conditions that could explain these symptoms?
What’s Immersion Pulmonary Edema?
Immersion in water can cause fluid to leak out of the circulation system and accu mulate first in the interstitial tissues of the lungs then in the alveoli themselves.
immersion in cold water, negative pressure breathing, and overhy dration predive, all of which enhance the increase in central blood volume with immersion. Heavy exercise is also a contributor.
What are good vital signs?
Pulse: 60100 BPM
BP: 120/80
Breath: 12-16/m
Pulse Oximeter: 95-100%
Temperature: 98.6F