[abstract] CARBON MONOXIDE POISONING IN RECREATIONAL DIVING: AN UNCOMMON BUT POTENTIALLY FATAL PROBLEM.

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[abstract] CARBON MONOXIDE POISONING IN RECREATIONAL DIVING: AN UNCOMMON BUT POTENTIALLY FATAL PROBLEM.

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Title: [abstract] CARBON MONOXIDE POISONING IN RECREATIONAL DIVING: AN UNCOMMON BUT POTENTIALLY FATAL PROBLEM.
Author: Caruso, JL; Hobgood, JA; Uguccioni, DM; Dovenbarger, JA
Abstract: BACKGROUND: Carbon monoxide (CO) is a colorless, testeless, non-irritating gas that is produced by the incomplete combustion of hydrocarbons. It is the most common cause of death by poisoning in the United States. Extremely low levels of carbon monoxide are normally present in the atmosphere, but great care is usually taken to avoid abnormally hugh amounts being introduced into scuba tanks. Increased levels of carbon monoxide in the breathing gas of a diver can result in a potentially catastophic outcome. METHODS: The Divers Alert Network (DAN) attempts to collect all available information on recreational diving fatalities that occur in the United States or those that involve U.S. citizens diving abroad. When possible, DAN acquires the autopsy report and toxicology studies related to the fatality. A total of 451 fatalities in the DAN database, occuring during the years 1993-1997, were reviewed to search for potential deaths related to carbon monoxide poisoning. Particular attention was paid to dive profile, the circumstances surrounding the fatality, autopsy findings, and postmortem carboxyhemoglobin (COHb) levels. RESULTS: Of the 451 diving fatalities, COHb levels were known to have been measured in 67 (15percent) cases. In 33 of these fatalities, the COHb levels were reported to be negative. In all of the remaining cases except two, the reported COHb levels ranged from 1-10percent. COHb levels of less than 10percent are not considered significant and may be found in asymptomatic individuals. There was a 1994 fatality for which the COHb level was found to be 32percent at autopsy. Since CO poisoning was not suspected at the time of the mishap, the gas remaining in the tank was not analyzed. In a fatality that occured in 1997, the COHb level wa also 32percent and an evaluation of the decedent's tank, as well as the tanks of others in that dive group, showed elevated levels of carbon monoxide. An additional fatality, not included in this review, occured in 1990 and involved a diver who mixed his own enriched air. The postmortem COHb level in that case was reported as 18percent. CONCLUSIONS: Despite the fact that CO poisoning is the most common cause of death due to poisoning, diving fatalities attributed to the effects of carbon monoxide are fortunately rare. Postmortem toxicology is to measure the COHb level, however, is seldom performed in the fatal diving mishaps. It is possible that some diving fatalities associated with CO toxicity are being missed. With an increased number of divers mixing their own breathing gas, carbon monoxide poisoning may become more of a significant problem. Routine toxicology, including a COHb level, should be performed for most diving fatalities. This is especially true when the mishap is unwitnessed, or when there is any possibility that toxic substances may have impaired the diver's performance in the water.
Description: Undersea and Hyperbaric Medical Society, Inc. (http://www.uhms.org )
URI: http://archive.rubicon-foundation.org/734
Date: 1998

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  • UHMS Meeting Abstracts
    This is a collection of the published abstracts from the Undersea and Hyperbaric Medical Society (UHMS) annual meetings.

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