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39 Cards in this Set
- Front
- Back
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U.S Navy DMO Requirements
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Graduate of NDSTC
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Requirements of DMO to modify treatment tables?
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Must have subspecialty code of 16U0 or 16U1
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A diver who surfaces unconscious and then recovers shall receive _____ to rule out ____ and then _____ for _____
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Nuero
AGE evaluated by DMO Pulmonary Aspiration |
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SX of AGE (18)
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- Blow to chest (hallmark)
Dizziness, Parathesis Paralysis, Vision trouble, Weakness, Convulsion, Personality change, Unconsciousness, Extreme fatigue, Can't think clearly, Vertigo, Nausea/Vomiting, Hearing Abnormalities, Bloody Sputum, Loss of bodily functions, Tremors, Loss of coordination, Numbness, Death |
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Rules on resuscitation and recompressing a pulseless diver?
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-Start CPR / ACLS
-If AED can be attained w/in :10, stay on surface and use ACLS/AED - If ACLS / AED cannot be obtained within :10 press to 60' - If ACLS / AED becomes available w/in :20 bring PX back to surface and start ACLS. - Do not press pulseless diver after defibrilation has been tried |
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Most common SX of DCS is?
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Joint pain
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Describe joint pain DCS
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usually in joints
-begins gradually -difficult to localize -may increase in intensity - deep, dull, ache - always present at rest - usually unaffected by movement |
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SX of Type I DCS
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PMS
Pain in joints (extremities only) Marbling of Skin Swelling of lymph nodes --Skin rash and Itching are Type I also, but usually not treated unless it's Cutis Mamorata |
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What types of Type I DCS does not require recompression?
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Itching and Skin rash
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Recompression provides relief of ____ on lymphatic obstruction but _____ may still occur
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-relief of pain
- swelling may still be present |
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No resolution or change after ____ on Type I Pain might be _____ ?
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Two O2 periods
- Orthopedic (mechanical) rather than DCS. |
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If pain is determined to be mechanical rather than Type I DCS what is procedure ?
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No change/resolution after two O2 periods.
- Call DMO - Review PX history - DMO determines its mechanical, complete TT-5 ----If DMO cannot be reached, TT-6 shall be used. |
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___% of DCS occurs after 24 hours from surfacing?
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98%
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____% of DCS occurs after 1 hour from surfacing?
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42%
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Most common skin manifestation of decom (pression sickness is ?
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Itching
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Three types of Type II DCS
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Neurological
Inner Ear (Staggers) Cardiopulmonary (Chokes) |
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SX of Inner Ear DCS
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Tinnitus (ringing in ears)
Hearing Loss Vertigo, dizziness, nausea, vomiting. |
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When are you most likely to see Inner Ear DCS?
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HeO2 diving during decompression when diver switches from HeO2 to Air.
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_____ is not present in Inner Ear DCS?
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Nystagmus (rapid involuntary eye movement) - which is hallmark for Inner Ear Barotrauma
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SX of "Chokes" Cardiopulmonary DCS?
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Chest pain - hallmark - aggravated by inspiration w/ irritating cough
- Increased breathing rate - circulatory collapse - loss of consciousness / death |
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To limit recurrence, Severe Type II DCS SX's require ____ ?
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Full extensions at 60 fsw even if SXs resolve during the first O2 period.
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TX for Symptomatic Omitted Decompression ?
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Press to 60' make rapid assesement and TX or go deeper if needed.
TT-5 NOT an appropriate table |
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Course of Action : Symptomatic Omitted Decompression if diver surfaced 50' or shallower ?
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Compress to 60', TT-6
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Course of Action : Symptomatic Omitted Decompression deeper than 50' ?
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Compress to 60' or depth where SX are Signifigantly Improved
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Course of Action : Symptomatic Omitted Decompression,,Uncontrolled Ascent deeper than 165' ?
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Compress to depth of relief not to exceed 225'. TT-8
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Altitude DCS: What is the most common SX
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Simple Pain
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Altitude DCS: TX for joint pain ?
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If only joint pain was present and resolved before reaching 1 ata, then TX with 2 hours of 100% O2 on surface followed by 24 hrs of observation.
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Altitude DCS: TX for any SX after arriving 1 ATA (on ground)
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100% O2 in transit.
-Press to 60' and TX accordingly by SX/s present. |
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Primary objectives of Recompression Treatments ?
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- Compress the Bubble restore blood flow
- Allow time for bubble re-absorption - Increase blood O2 content and O2 delivery to injured tissues. |
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Descent rate for all Treatment Tables ?
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20 fpm
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TT-1A is used for what?
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Pain only when pain is relieved at depth less than 66 fsw.
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TT-2A is used for what?
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Pain only when relieved at depths greater than 66 fsw.
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TT-3A is used for what ?
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All other SX's other than Pain.
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What is TX depth for TT-1A, TT-2A, TT-3A ?
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1A- 100 fsw
2A- 165 fsw 3A- 165 fsw |
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If SX are not relieved w/in :30 at 165 fsw on TT-3A, what is Course of Action ?
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Call DMO and switch to TT-4
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Transporting stricken diver procedures ?
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Kept lying supine(horizontal)
kept warm, TX for shock Monitor ABC's 100% O2 Hydrate or give I/V if indicated. |
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In Water recompression should be considered as ________ ?
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Option of last resort! When no chance of reaching recompression chamber w/in 12-24 hrs and PX does not have severe SX.
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What procedure would you perform prior to starting In-Water Recompression ?
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- Begin 100% O2 breathing 1st for :30. If SX's stabilize or improve then remain on surface and continue O2 breathing unless SX return with same or greater severity.
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In-Water Recompression procedures ?
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Using Air - full face mask or UBA, maintain comms, keep diver with PX, plan for more air/cylinders.
Goto deepest depth attainable NTE 100' Remain at TX depth for :30, Follow TT-1A. Using 100%O2: Descend to 30' for :60 for Type 1 DCS or :90 for Type II DCS, Ascend to 20' and 10' for :60. After surfacing continue O2 breathing for 3 hours, arrange for transport regardless of delay. |
