Info IPE may be more prevalent than previously thought, click through to find out why!

[Jcp2]

https://www.snorkelsafetystudy.com/wp-content/uploads/2021/07/SSS-Final-Report.pdf

It’s not directly diving related, but a three year study of snorkeling deaths in Hawaii, the ocean drowning capital of America indicates that the majority of deaths can be attributed to IPE rather than direct drowning, and that there may be a link to recent air travel.

 

[runsongas]

considering the average diver, just take some little blue pills to prevent it

Prevention and Treatment of Immersion Pulmonary Edema - Full Text View - ClinicalTrials.gov

Prevention and Treatment of Immersion Pulmonary Edema - Full Text View.

clinicaltrials.gov

 

[Jcp2]

The whole report.

https://www.snorkelsafetystudy.com/wp-content/uploads/2022/07/Snorkel-Study-Findings-and-reports.pdf

 

[clownfishsydney]

My view for the past 10 years has been that most scuba diving deaths attributed to drowning are probably IPE, especially ones further back than perhaps five years when more knowledge about IPE was available.

 

[duke dive medicine]

Thanks for sharing! Kudos to the authors and all of those who contributed - a significant effort with some interesting and thought-provoking findings. Some initial thoughts:

- The conclusion of ROPE as the cause of the majority of snorkeling deaths was based partly on details from ten survey respondents/cases of non-fatal drowning that had pulmonary edema as a "(feature) commonly encountered". Were all ten diagnosed with pulmonary edema? How were those ten selected for inclusion in the paper from the 131 survey respondents?

- It was interesting to note that of the ten survey respondents mentioned above, seven of them had some sort of significant exertion involved, which is a precursor to SIPE, or ROPE as the authors call it, whether snorkeling or not.

- The authors noted that it was not possible to diagnose pulmonary edema in the victims of fatal drowning. It is reasonable to assume that the incidence of people susceptible to some sort of swimming-induced pulmonary edema has not changed, so what is behind the roughly seven-fold increase in snorkeling deaths from 1995 to 2019? Has there been that much of an influx of visitors who snorkel?

- There does not appear to be a mention of an association between the snorkels tested and the types of snorkels used by drowning victims or survey respondents.

- The overwhelming majority of snorkels tested had a negative inspiratory pressure of less than 8 cm H2O. The highest was 12.7 cm H2O, which is roughly the performance of a US Divers Conshelf XIV at 70 fsw. Can someone speak to modern tolerances for inspiratory pressures for scuba regulators?

Interested to hear others' thoughts on this.

Best regards,
DDM

 

[Nemrod]

In this case, IPE, the fluid in the lungs is body fluids or derived from the body unlike a classical drowning where the fluid is ingested into the lungs and or a laryngospasm prevents breathing and subsequent passing out and water or environmental fluids then enter the trachea and lungs?

James

 

[Jcp2]

Fluid passes from capillary circulation in lung tissue into the adjacent alveolar air spaces because of increased pulmonary circulatory pressure. A substantial portion of blood volume is in the legs because of gravity (hello varicose veins). In a buoyant (or low gravity) situation as in swimming or diving, this volume returns to the trunk. The circulatory system can compensate by having the heart work harder, like a bilge pump, but sometimes it’s not enough because either the heart cannot increase its work because of weakness (heart disease) or concurrent exercise (athlete) or excess volume (over hydration). I would imagine that astronauts have a similar risk if they overexert themselves.

 

[pauldw]

This is a very, very interesting post. Especially the charts in the the full report linked to in the #3 post. Thank you. Divers should take a look at those study summaries.

 

[tomh1972]

The whole report.

https://www.snorkelsafetystudy.com/wp-content/uploads/2022/07/Snorkel-Study-Findings-and-reports.pdf

Thank you for uploading. The original exec summary left me with many questions as to methodology.

 

[Nemrod]

In the charts the scuba deaths are much less than the snorkel deaths. One big difference between the two groups is training. What little scuba divers get in OW classes it is much more than none which is what snorklers (as opposed to free divers) get.

I am not sure what to make of this report or it's value? But it is intriguing for sure.

Last summer I aspirated seawater due to a regulator malfunction and my preoccupation with other tasks more important to me at the time than breathing. I had a laryngospasm and was essentially without the ability to inhale or exhale for nearly two minutes and went into deco because I could not ascend. I very nearly passed out and probably did momentarily. The urge to bolt to the surface was intense. I was finally able to inhale and exhale enough and violently coughed up water. On the boat I coughed up blood. I had fevers, horrendous night sweats, pneumonia and two courses of antibiotics and two months to rid myself of the pneumonia. Drowning (almost) by aspiration!

James