seaangel
Guest
This is a horrifiying topic that I witnessed while on my dive trip to Cozumel. As a diver it was scarey, and as a nurse it was another case of patients that live in denial of their diseases and are determined to act beyond their limitations. The following is an accounting of my witnessing "acute pulmonary edema on ascent".
My roomate and buddy developed severe acute pulmonary edema on ascent from our first wall dive on our second day in Cozumel. She is 67 years old and has been diving for a couple of years now. Our first dive the first day she aborted before we descended stating " It does not feel right, I want to go back to the boat!" At this time she seemed quite stressed and almost panick stricken. Another diver was having a hose problem, so they went back together and his buddy paired with me. Our next dive was made together and she had no problems, atleast none she told us of. Our boat consisted of 23 divers from our LDS that had travelled together, on board we were divided into three groups of 8-9 and each had a DM from the operator, plus DM's from home in each group as well.
My buddy was tired that first day, and took a nap in the afternoon on return to our room. She also went to sleep early that evening. I was not concerned since we had travelled the day before and it had been a long day at her age I thought this not a problem. She was taking medications, of which I did not know the kinds, I did notice that she had several pills loose in plastic baggies, not in prescription bottles. I carry mine all in their bottles with the labels, and I advise anyone on prescirbed medicaitons to do the same.
Second day first dive a wall dive, the dive plan was to go no more than 100 feet, stay together in group. This was a drift dive and we had a professional photographer with us to take photos during the dive. We were the first group to dive from the boat. I told my buddy that I would be taking pictures along the wall, this was my first wall dive and the deepest, I told her I did not plan to go below 90 feet, and if I did it would only be for a short time for a photo. I also, told her that due to wanting extended dive or bottom time I would stay shallower if possible since I am always first to hit the low air time in our group. She told me she had no problem with that plan and she was going to stay just a few feet over me as she did not want to be too deep either. We went on
down and began the dive gradually descending along the wall, I checked to see if she was ok and she responded ok. The photographer took my picture coming through a coral swim through, this was at about 80fsw. On the other side she had found a small sandy patch and had situated herself on that waiting, I again signaled the are you ok, she slowly signaled ok back. The DM called us to continue our dive. At 23 minutes I checked my computer, my depth was 88 feet, air 1200psi and time remaining was 13 minutes, buddy still over me about 6ft and ok on check. I continued along taking more pictures, when I noticed a tendency to lift alerting me that my al tank must have gone down to below 1000psi, I checked and I had 770psi, and 7minutes time remaining, my buddy still over me, I tapped the DM to let him know my air, we were then still at 88fsw. He pulled his octo out and shared his air, signalled to our group to begin a horizontal ascent toward the shallower water. At 30fsw he returned my regulator, gathered us into a group for a group ascent, my buddy still remained slightly over us. We began to ascend, to 15fsw, I maintained my stop but it required alot of concentration as I was very bouyant, being in a group is common for us and we all watch each other, however the current was strong, one of the other groups had a few divers join us that were low on air and my bouyancy was a struggle, I did not see that my buddy had gone on to the surface, I was the first to pop out and it was then that I saw a diver, no gear on towing someone toward our boat, I swam over and saw my buddy being towed, she was short of breath and very grey looking. On the boat one of our group, a physician was on board due to equipment problems. He helped her back on, the DM and our group DM all boarded next then I was helped back. She could not talk was very short of breath and grey. Oxygen was started immediately and she was placed on her left side. She was nauseated, and vomited some, but continued to remain grey. Her color did not return, she had audible rales and began coughing bloody fluid up. All divers back on the boat we began back to the nearest dock where an ambulance was waiting.
The DAN doctor cleared this as non-rapid ascent related. But diagnosed it as acute pulmonary edema, brought on by unstable
hypertension, and use of Sudafed pre dive. My buddy has been told she is to never dive again. She is a fortunate lady to still be alive. We cared for her appropriately and she continued the vacation staying at the hotel and resting while we dove. I assisted her during the surface time when needed. The doctor and I stayed with her the entire way home and helped her in the airports. She is a very determined and headstrong lady, that still is in some denial over the seriousness of her condition. We have since learned she was taking BP medications, what kind she did not even know. She also, had to go to the ER 5 hours after we got home with her BP 240/120, and she then told us her BP has always been difficult to control.
How did she get medical clearance??? I don't know, I suspect that she made light of this and possibly did not document all facts.
I know the waiver we completed for the boat operator did not reflect this. One last thing she did not have DAN insurance. Did not understand the importance of this.
Lessons learned:
1- Be honest about your health.
2-Never dive beyond your capabilities.
3-Always have DAN coverage.
4-If Sudafed is necessary pre dive, don't dive.
5- I will always carry my BP cuff and stethoscope on these trips.
I know this is long but I hope it will help others.
My roomate and buddy developed severe acute pulmonary edema on ascent from our first wall dive on our second day in Cozumel. She is 67 years old and has been diving for a couple of years now. Our first dive the first day she aborted before we descended stating " It does not feel right, I want to go back to the boat!" At this time she seemed quite stressed and almost panick stricken. Another diver was having a hose problem, so they went back together and his buddy paired with me. Our next dive was made together and she had no problems, atleast none she told us of. Our boat consisted of 23 divers from our LDS that had travelled together, on board we were divided into three groups of 8-9 and each had a DM from the operator, plus DM's from home in each group as well.
My buddy was tired that first day, and took a nap in the afternoon on return to our room. She also went to sleep early that evening. I was not concerned since we had travelled the day before and it had been a long day at her age I thought this not a problem. She was taking medications, of which I did not know the kinds, I did notice that she had several pills loose in plastic baggies, not in prescription bottles. I carry mine all in their bottles with the labels, and I advise anyone on prescirbed medicaitons to do the same.
Second day first dive a wall dive, the dive plan was to go no more than 100 feet, stay together in group. This was a drift dive and we had a professional photographer with us to take photos during the dive. We were the first group to dive from the boat. I told my buddy that I would be taking pictures along the wall, this was my first wall dive and the deepest, I told her I did not plan to go below 90 feet, and if I did it would only be for a short time for a photo. I also, told her that due to wanting extended dive or bottom time I would stay shallower if possible since I am always first to hit the low air time in our group. She told me she had no problem with that plan and she was going to stay just a few feet over me as she did not want to be too deep either. We went on
down and began the dive gradually descending along the wall, I checked to see if she was ok and she responded ok. The photographer took my picture coming through a coral swim through, this was at about 80fsw. On the other side she had found a small sandy patch and had situated herself on that waiting, I again signaled the are you ok, she slowly signaled ok back. The DM called us to continue our dive. At 23 minutes I checked my computer, my depth was 88 feet, air 1200psi and time remaining was 13 minutes, buddy still over me about 6ft and ok on check. I continued along taking more pictures, when I noticed a tendency to lift alerting me that my al tank must have gone down to below 1000psi, I checked and I had 770psi, and 7minutes time remaining, my buddy still over me, I tapped the DM to let him know my air, we were then still at 88fsw. He pulled his octo out and shared his air, signalled to our group to begin a horizontal ascent toward the shallower water. At 30fsw he returned my regulator, gathered us into a group for a group ascent, my buddy still remained slightly over us. We began to ascend, to 15fsw, I maintained my stop but it required alot of concentration as I was very bouyant, being in a group is common for us and we all watch each other, however the current was strong, one of the other groups had a few divers join us that were low on air and my bouyancy was a struggle, I did not see that my buddy had gone on to the surface, I was the first to pop out and it was then that I saw a diver, no gear on towing someone toward our boat, I swam over and saw my buddy being towed, she was short of breath and very grey looking. On the boat one of our group, a physician was on board due to equipment problems. He helped her back on, the DM and our group DM all boarded next then I was helped back. She could not talk was very short of breath and grey. Oxygen was started immediately and she was placed on her left side. She was nauseated, and vomited some, but continued to remain grey. Her color did not return, she had audible rales and began coughing bloody fluid up. All divers back on the boat we began back to the nearest dock where an ambulance was waiting.
The DAN doctor cleared this as non-rapid ascent related. But diagnosed it as acute pulmonary edema, brought on by unstable
hypertension, and use of Sudafed pre dive. My buddy has been told she is to never dive again. She is a fortunate lady to still be alive. We cared for her appropriately and she continued the vacation staying at the hotel and resting while we dove. I assisted her during the surface time when needed. The doctor and I stayed with her the entire way home and helped her in the airports. She is a very determined and headstrong lady, that still is in some denial over the seriousness of her condition. We have since learned she was taking BP medications, what kind she did not even know. She also, had to go to the ER 5 hours after we got home with her BP 240/120, and she then told us her BP has always been difficult to control.
How did she get medical clearance??? I don't know, I suspect that she made light of this and possibly did not document all facts.
I know the waiver we completed for the boat operator did not reflect this. One last thing she did not have DAN insurance. Did not understand the importance of this.
Lessons learned:
1- Be honest about your health.
2-Never dive beyond your capabilities.
3-Always have DAN coverage.
4-If Sudafed is necessary pre dive, don't dive.
5- I will always carry my BP cuff and stethoscope on these trips.
I know this is long but I hope it will help others.
