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Diving accident case study

Published on July 22nd, 2016 by Dr. Jennifer Nardella and Dr. Meghan Haggarty

A 37 year old female came to the Nardella Clinic with the chief complaint of a severe headache and decreased sensation in her right arm and thigh following repetitive dives in Bahamas, when she experienced an unexpected ascent to the surface due to a fault in her gear in the last dive. Immediately after the dive, she felt dizzy but thought it was due to the effect of sea sickness. The next day, she started having shoulder pain before she flew back to Canada. Upon arrival, the pain had gotten worse and was accompanied by paresthesia on her right body side. Physical examination upon arrival was remarkable for sever right shoulder pain and hypoesthesia on the right arm, hand and trunk. On top of that, she had lymphedema in the right thigh combined with knee jerk hyporeflexia. She was diagnosed with type II decompression sickness and the patient underwent standard recompression therapy. The patient experienced near-complete resolution of her symptoms, her only residual complaint being that of shoulder pain with hyperextension movement. The naturopathic doctors decided to give her another two sessions of HBOT recompression therapy where she showed complete recovery and disappearance of all symptoms.

Discussion

Scuba diving involves breathing compressed airs under pressure. Divers usually take a compressed air supply tank when they dive to allow them to breathe.  The compressed air is taken in by our bodies. Unfortunately, our bodies aren’t used to the pressurized air (because we take in air that is under normal atmospheric conditions). With higher air pressure, the nitrogen component of air gets dissolved in blood. When divers want to emerge from the water, they have to make sure they don’t ascend to the surface level too fast because of the risk of having decompression illness due to creating numerous bubbles from blood-soluble air (Particularly nitrogen). When nitrogen (N2) gas forms bubbles, it accumulates and saturates the muscles and blood, causing pain. Called the Bends, this condition can also cause injuries involving the nervous system and in some cases might be life threatening and ends by death.

In the Hyperbaric center at the Nardella Clinic, we have a well-trained hyperbaric team to manage such incidences as soon as it presents. Like any other emergency condition, the sooner we administer HBOT, the better the outcome will be.


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