(img) Wanna see a DCI-causing gas bubble doing the nasty?

[DocVikingo]

[basic leg vein anatomy --> http://bigveins.com/Vein center in Modesto.jpg]

DCI about did in this poor senior diver.

Symmetrical femoral vein bubble caused by decompression illness -- Kondo et al. -- Emergency Medicine Journal

Regards,

DocVikingo

 

[flots am]

[basic leg vein anatomy --> http://bigveins.com/Vein%20center%20in%20Modesto.jpg]

DCI about did in this poor senior diver.

Symmetrical femoral vein bubble caused by decompression illness -- Kondo et al. -- Emergency Medicine Journal

Regards,

DocVikingo

Cool! (not cool to have, just cool to see)

So what finally happened? Did the bubble finally dissolve? Can the guy walk?

flots.

 

[Hawkwood]

Could you explain the image a bit? The arrows are pointing to the bubbles? I assume I am looking at a cross-section of the leg, but what would it look like without the "bubbles". I don't have frame of reference, sorry.

Bill

 

[Duke Dive Medicine]

Could you explain the image a bit? The arrows are pointing to the bubbles? I assume I am looking at a cross-section of the leg, but what would it look like without the "bubbles". I don't have frame of reference, sorry.

Bill

You're looking at a bottom-up view with the patient's right side at the left of the image. The big white blotches are the femoral heads in the acetabuli of the pelvis. The sacrum is at the bottom of the image; directly above that is the rectum. The oval bubble right in the middle is probably air in the Foley catheter balloon. Interesting case report. Thanks for posting, Doc!

 

[TSandM]

Fascinating -- those bubbles are HUGE.

 

[Hawkwood]

You're looking at a bottom-up view with the patient's right side at the left of the image. The big white blotches are the femoral heads in the acetabuli of the pelvis. The sacrum is at the bottom of the image; directly above that is the rectum. The oval bubble right in the middle is probably air in the Foley catheter balloon. Interesting case report. Thanks for posting, Doc!

Thank you.

 

[DocVikingo]

So what finally happened? Did the bubble finally dissolve? Can the guy walk?flots.

Hey flots,

I've wondered about that myself.

The article is an "Images in emergency medicine" piece and these tend to be brief and without much clinical detail. It does not say anything about the ultimate degree of recovery, and it's highly unlikely that any follow up would be published.

Regards,

DocVikingo

 

[flots am]

Hey flots,

I've wondered about that myself.

The article is an "Images in emergency medicine" piece and these tend to be brief and without much clinical detail. It does not say anything about the ultimate degree of recovery, and it's highly unlikely that any follow up would be published.

I hate it when that happens.

Thanks for the post though. It was cool to be able to see what it looks like.

On more of a treatment note, it's my understanding that O2 Seizures are a temporary and non-fatal unless underwater. I'm not a doctor or chamber operator, so it's entirely possible I'm wrong.

Is it standard practice to discontinue decompression because of seizures?

flots.

 

[Duke Dive Medicine]

On more of a treatment note, it's my understanding that O2 Seizures are a temporary and non-fatal unless underwater. I'm not a doctor or chamber operator, so it's entirely possible I'm wrong.

Is it standard practice to discontinue decompression because of seizures?

flots.

There's a risk-benefit continuum there. Repeated seizures can result in permanent brain damage, but there are ways to control them if a diver is sick enough that aborting the treatment would be detrimental. There isn't much detail in the article so it's hard to say what their rationale was.

 

[DocVikingo]

Is it standard practice to discontinue decompression because of seizures?flots.

Hi flots,As DDM has said, one has to weigh the risks v benefits in each such case. Convulsions can be managed when O2 recompression therapy is deemed critically necessary, and this patient would have had an IV already in place and administering a select short-acting benzodiazepine would have been easy. However, he was described as, "On arrival, he did not breathe spontaneously, and his level of consciousness as defined by the Glasgow coma scale (sic) was 3 (E1V1M1)". E1V1M1 means that no eye-opening, verbal or motor response could be elicited; he scored at the floor of the assessment device. In other words, he was in a deep coma. Under such conditions, administration of any drug that may cause respiratory/central nervous system depression would be very ill-advised.Regards,DocVikingo