[abstract] TYPE III DECOMPRESSION ILLNESS COMPLICATED BY PROLONGED DEHYDRATIONAL SHOCK.

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[abstract] TYPE III DECOMPRESSION ILLNESS COMPLICATED BY PROLONGED DEHYDRATIONAL SHOCK.

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Title: [abstract] TYPE III DECOMPRESSION ILLNESS COMPLICATED BY PROLONGED DEHYDRATIONAL SHOCK.
Author: Jones, K; Hardy, S; LeGros, T; Murphy–Lavoie, H; Harch, P; Van Meter, K
Abstract: BACKGROUND: AGE is one of the most serious injuries associated with diving. AGE compounded by depletion of intravascular volume is an even greater challenge. We report a case of a novice commercial diver who was successfully resuscitated at depth with a USNTT6A, saturation decompression, and IV hydration after suffering an air embolism (indicated by a sudden loss of consciousness upon surfacing), and complications of prolonged dehydrational shock. CASE REPORT: A 31 year old male commercial diver completing an air surface supplied working dive to 137fsw had dizziness on surfacing. After deck decompression, he had immediate loss of consciousness. He was recompressed on a USNTT 6, then a Table 6A on Nitrox 60/40. Due to persistent depressed mental status, he was then converted to a Modified Royal Navy 71. His profuse sweating, retching, and bloody diarrhea resulted in a deterioration of vital signs, delirium, and shock (tachypneic – rate of 40, diaphoretic, pulseless, and circumoral cyanosis). A physician locked-in to obtain intravenous access. At this point gut ischemia secondary to decompression sickness was the working diagnosis. Elevated ambient temperature, failed communication systems, and environmental contaminants contributed additional challenges. RESULTS: The patient incurred a significant oxygen debt which was ultimately resolved by prolonged intense hyperbaric oxygen therapy during 56 hours of saturation decompression and aggressive IV hydration. He exited the chamber lucid, with dry skin, bounding pulses, and normal respirations. During hospitalization, he underwent four low pressure tailing treatments. On discharge he had only minimal residual symptoms (two small areas of hypesthesia below each nipple). CONCLUSION: A case of air embolism complicated by dehydrational shock was successfully treated, despite the seemingly insurmountable odds of shock, oxygen debt, and extreme environmental conditions. Saturation decompression, physician ‘rescue’, and fluid resuscitation overcame the odds. The diver finished treatment neurologically intact and essentially asymptomatic.
Description: Abstract of the Undersea & Hyperbaric Medical Society 2008 Annual Scientific Meeting June 26-28, 2008 Salt Lake City Marriott Downtown, Salt Lake City, Utah.
URI: http://archive.rubicon-foundation.org/7916
Date: 2008

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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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