If she's a DM candidate, I guess this never happened before with her. If she continues with diving somehow, she oughta think about a full-face mask. She's not narcoleptic, right?
diver passes out at 10mt
- Thread starter eternaljonah
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OP
No she is not narcoleptic as far as we know, she has had a few doctors check her out and they all say that she's fine. i took her diving alone today to 30mt for 30min and she was fine. was keeping my eyes on here like a hawk. She say's she want to continue diving, her mom say's its fine and the other instructor think its fine. so???? we do not have a diving medic here in south India :-(
What can I do to check or make sure she'll be fine?
What can I do to check or make sure she'll be fine?
eternaljonah,
First, thank you for being an advocate for this diver and for continuing to seek information.
I can tell you that as diving medical professionals, we would want to determine the cause of this diver's unconsciousness before we cleared her to resume diving. If we were unable to determine with a reasonable degree of certainty why she passed out, given the information you have provided, we would recommend that she not dive again, at least not as an independent certified diver. First, becoming unconscious under water is potentially lethal, as has already been pointed out. She had you there to rescue her this time, but that may not always be the case. A full face mask may be beneficial as Tom noted above, but IMO that should be part of a larger, dedicated plan for keeping her safe. Several organizations (DiveHeart is one that we work with) have techniques and procedures for divers with disabilities. I don't think that she should just go buy a full face mask and then assume that she'll be fine if she passes out under water. Tom can correct me if I'm wrong but I don't believe that was his intended message.
Second, there are too many medical issues that cause unconsciousness that can also cause death. Cardiac dysrhythmia (irregular heart beat) is a good example. These issues don't take a diving physician to find. I would like to have more details as to how the physicians who saw her came to the conclusion that she would be fine to dive.
Best regards,
DDM
First, thank you for being an advocate for this diver and for continuing to seek information.
I can tell you that as diving medical professionals, we would want to determine the cause of this diver's unconsciousness before we cleared her to resume diving. If we were unable to determine with a reasonable degree of certainty why she passed out, given the information you have provided, we would recommend that she not dive again, at least not as an independent certified diver. First, becoming unconscious under water is potentially lethal, as has already been pointed out. She had you there to rescue her this time, but that may not always be the case. A full face mask may be beneficial as Tom noted above, but IMO that should be part of a larger, dedicated plan for keeping her safe. Several organizations (DiveHeart is one that we work with) have techniques and procedures for divers with disabilities. I don't think that she should just go buy a full face mask and then assume that she'll be fine if she passes out under water. Tom can correct me if I'm wrong but I don't believe that was his intended message.
Second, there are too many medical issues that cause unconsciousness that can also cause death. Cardiac dysrhythmia (irregular heart beat) is a good example. These issues don't take a diving physician to find. I would like to have more details as to how the physicians who saw her came to the conclusion that she would be fine to dive.
Best regards,
DDM
If this woman was struggling to complete the 800M swim, I think her body may have been way overtaxed and did not have the time to recover for the dive. While in the act of swimming, the body would continue to do what the mind wants through sheer will power/concentration. However, once the swim was completed, and esp if there was no "warm down" transition to stopping, the body shut down and went into recovery (faint)... I have seen it twice before in different sports in completely healthy (according to drs) people. Scary. Sometimes it's just the body's way of saying "Too much!". A warm down from a very strenuous activity is important. Just stopping can be a form of shock to the system.
So is it possible that this person is healthy and just "over did it"?
So is it possible that this person is healthy and just "over did it"?
OP
So a recap: she has had an ECG and blood tests(sugar level a little low) and the doctor say she appears fine, she is 160cm and weights 71kg and is 19 years old. not very physically fit and a little over weight.
She pushed herself during the 800mt snorkel swim and then after 10min rest went for a dive and passed out after 7min, was out fro 3-5 min. bcd may have been tight (or may have appeared so since it was inflated on the surface)
She is convinced she is fine and every test i ask her to do is a struggle. She has dived with me since and she appeared fine.
could she really just have overdone it? and if yes would you try and resimulate that ex:make her do another 800mt swim and then run for a Km or so, then have her breath of a hard breathing Reg on the surface? for 15min while ……
She pushed herself during the 800mt snorkel swim and then after 10min rest went for a dive and passed out after 7min, was out fro 3-5 min. bcd may have been tight (or may have appeared so since it was inflated on the surface)
She is convinced she is fine and every test i ask her to do is a struggle. She has dived with me since and she appeared fine.
could she really just have overdone it? and if yes would you try and resimulate that ex:make her do another 800mt swim and then run for a Km or so, then have her breath of a hard breathing Reg on the surface? for 15min while ……
I have been following this thread with great interest. While its medical aspect is well beyond my Army Medic training of the 80's, as an instructor is is very fascinating and providing an train of thought I never had before.
Thanks for sharing...
Thanks for sharing...
I would not try to simulate the experience (passout)... esp w/o a medical person to monitor and accept liability to conduct it. It is putting her body through a stressful ordeal. Not sure what you are going to learn by repeating it. I do think it is important that her doctors rule out any other cause.
If everything she does is a struggle, should she be a DM candidate?
JAMA. 2004 Sep 8;292(10):1221-6.
Near-syncope after exercise.
Ziegelstein RC.
Author information
Abstract
Syncope and near-syncope are great diagnostic challenges in medicine. On the one hand, the symptom may result from a benign condition and pose little or no threat to health other than that related to falling. On the other hand, syncope or near-syncope can be the manifestation of a serious underlying condition that poses an imminent threat to life. Patients with a cardiac cause of syncope are at far greater risk of dying in the first year after an episode of syncope or near-syncope than individuals with a noncardiac cause. A cardiac cause of syncope should be considered in every patient with syncope or near-syncope, but it is particularly common in older patients or in patients with known structural heart disease, arrhythmia, or certain electrocardiographic abnormalities. Although many diagnostic tests may be helpful in the evaluation of syncope and near-syncope, the history, physical examination, and electrocardiogram pinpoint the cause in many circumstances. Syncope after exercise may be due to left ventricular outflow tract obstruction from aortic stenosis or hypertrophic obstructive cardiomyopathy but can also suggest the diagnosis of postexercise hypotension in which an abnormality in autonomic regulation of vascular tone or heart rate results in vasodilation or bradycardia after moderate-intensity aerobic activity.
-------------------------------
Obviously not specific to the DM candidate but may reinforce some of our concern. IF the diver has no history, no family history and has had a thorough exam by a knowledgable medical professional that is confident in detecting the sometime subtle EKG changes and heart sounds that may indicate on underlying heart abnormality AND they are confident this will not recur, so be it. But also keep in mind that even if this was just a "simple" faint that this person has demonstrated, very convincingly, that they are at risk for syncope while diving. And even a simple faint can recur. Are you and her willing to accept that risk as the circumstances stand now. Can you guarantee a successful rescue in the future should she faint again? Your call.
Near-syncope after exercise.
Ziegelstein RC.
Author information
Abstract
Syncope and near-syncope are great diagnostic challenges in medicine. On the one hand, the symptom may result from a benign condition and pose little or no threat to health other than that related to falling. On the other hand, syncope or near-syncope can be the manifestation of a serious underlying condition that poses an imminent threat to life. Patients with a cardiac cause of syncope are at far greater risk of dying in the first year after an episode of syncope or near-syncope than individuals with a noncardiac cause. A cardiac cause of syncope should be considered in every patient with syncope or near-syncope, but it is particularly common in older patients or in patients with known structural heart disease, arrhythmia, or certain electrocardiographic abnormalities. Although many diagnostic tests may be helpful in the evaluation of syncope and near-syncope, the history, physical examination, and electrocardiogram pinpoint the cause in many circumstances. Syncope after exercise may be due to left ventricular outflow tract obstruction from aortic stenosis or hypertrophic obstructive cardiomyopathy but can also suggest the diagnosis of postexercise hypotension in which an abnormality in autonomic regulation of vascular tone or heart rate results in vasodilation or bradycardia after moderate-intensity aerobic activity.
-------------------------------
Obviously not specific to the DM candidate but may reinforce some of our concern. IF the diver has no history, no family history and has had a thorough exam by a knowledgable medical professional that is confident in detecting the sometime subtle EKG changes and heart sounds that may indicate on underlying heart abnormality AND they are confident this will not recur, so be it. But also keep in mind that even if this was just a "simple" faint that this person has demonstrated, very convincingly, that they are at risk for syncope while diving. And even a simple faint can recur. Are you and her willing to accept that risk as the circumstances stand now. Can you guarantee a successful rescue in the future should she faint again? Your call.
OP
When i said every test is a struggle I meant every medical test I want her to get done on top of the medical release she has already got. she is not very willing to go through more medical examination, as she believes its a one time event and she's fine.
Probably right that its not a great idea to simulate another over exertion, but she does still have a 400mt swim to do.
Is it my call to tell her she can't dive any more? can we as a dive center cancel her dm training due to this event? hard questions that i'm trying to find answers to…...
Probably right that its not a great idea to simulate another over exertion, but she does still have a 400mt swim to do.
Is it my call to tell her she can't dive any more? can we as a dive center cancel her dm training due to this event? hard questions that i'm trying to find answers to…...
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