Pneumothorax and diving

[beche de mer]

Dr.,
I know what a pneumothorax is and I've been to DAN. My question is, If I have a SPT underwater what or how should it be treated? Would a needle work to releive pressure underwater or would it cause downing?If It could work how would it be preformed. I plan to never dive below 20 meters. If I felt a pneumothorax starting should I asend ASAP to keep more air from entering my cavity? Would an emergency asent overweigh the risks of a tension pneumothorax. Could you please help, I'm writing because like most Americans I don't have Med. Insurance. I'm not looking for advice just answers if you have them. Thanks-Rye

So, if I understand you correctly, the scenario is this:

Unilung is pottering about at 20 metres, suddenly feels pain in chest. "uh-oh, looks like I have another pneumothorax!" Commences gentle ascent, while unsheathing chest needle. Shrugs off tank, unzips wet-suit, palpates intercostal space suitable for needle insertion. Inserts needle, thus relieving tension pneumothorax. Gratifying outflow of bubbles.

"Whew, that feels better! Umm..should I complete the dive now, or play it safe and surface? Let's not be foolhardy. Better go topside."

It's pure Fantasyland. You cannot diagnose and treat a tension pneumothorax underwater. As has been stated in the other thread, a history of spontaneous pneumothorax would be regarded by most dive examiners as an absolute contra-indication to diving.

Go skydiving, go work in Iraq, or run with the bulls at Pampalona, but don't go scuba diving.

 

[UniLung]

not trying to be mean but if you can read, I'm looking for answers not advice. Read my questions and if you have the answers then reply. Thanks

 

[MookieMoose]

People have tried to answer your questions, but you don't seem willing to listen because you don't like the answers...

I will try to directly address the questions as you asked them in your aorginal post. Here goes:


-How dangerous would it be if I only planned on going to a max depth of 20 meters?

Given the history you have presented, it would be very dangerous for you to dive to any depth. You should speak to a doctor with some diving expertise to confirm this, but don't get your hopes up.

- If somthing did go wrong would it be safer to do a emergency asent other then deal with a tension pneumothorax?

If something did go wrong at depth, you can't really diagnose let alone treat it at depth, and surfacing will probably reault in a tension pneumo. In other words, you have made yourself very injured and possibly dead for the sake of a dive.

- What about carring an IV needle to releve pressure if a tension pneumo did happen? and what is the proceedure?

Needle decompression of a tension pneumothorax is not the sort of thing you want to try on yourself, nor do you want anybody without the specific training and propper, sterile equipment to try. Having the equipment on hand is useless without the training, and without someone with the training (a doctor, critical care nurse, or advanced life support paramedic), you wouldn't know what equipment to get.

- Do you know of people that dive like myself?

No, I don't. People in your situation are told that they should not dive. The risks are simply too great.

- What are the statisics of people diving with these problems and haveing problems?

I don't know if anybody has such statistics, becuase people that have had a spontaneous pneumothorax are told not to dive. Period.

ANY info is much appreciated. Thanks so much -Rye[/QUOTE]

I'm sorry, this is probably not what you want to hear, but diving is probably out of the question. If you REALLY believe that you are safe to dive, have that confirmed by a doctor with some expertise in hyperbaric medicine. With a history of spontaneous pneumothorax, no training agency will teach you to dive without confirmation from a doctor that it is safe for you to dive because even the training dives in the pool could kill you.

Sorry

Cam

 

[gazzahawkes]

Hello
I have been working as a dive medic and run several diving evacuation stations
Im an instructor with 4 agencies.


18mths ago I had a fitness for dive query about someone as unfortunate as yourself to have sp.I advised it was to risky.

Eventually after much deliberation and study on the internet the guy decided to not state his problem at the dive school. like yourself he wondered if the needle could help on onset of symptoms.

15 dives later he was into diving and had finished his advance course.

Two days later I was left to pronoce him dead and having to phone his family and deal with the embassies.

What he hadnt considered was how he was going to releive his sp whilst uncouncious from injury underwater.

Unfortunatly i still get people who cannot or will not accept the risk for their condition.These same people keep our chambers and coroner busy.

PLEASE YOU ASKED FOR STATISTICS DONT BECOME ONE...

base jumping rocks.
good luck for the future

Gary

 

[pipedope]

1. Maintain depth.
2. Say your prayers.
3. Calmly get your slate or wetnotes.
4. Write on the slate your condition and any last messages for family and friends.
5. Have your buddy surface and raise the alarm. Then the buddy should return with additional gas.
6. The boat declares emergency and gets evac and ALS on site.
7. You surface directly into the hands of the ALS team.
8. If several miracles happen at once you might have a chance of surviving.

There are several problems with this that make the situation worse.

First, during the waiting for ALS time your condition may get worse such that you may die if you stay down. You WILL die if you surface before ALS is onsite.
Well, there is a finite chance of you living through it but unless every lottery ticket you have ever bought has been a BIG winner, I wouldn't count on it.
Second, the damage caused by expansion when you surface may cause serious problems for the rest of your life, if you do live.

Third, if you live, your friends and the people who were on the boat may beat you bloody for doing something so crazy.

Of course, you could always dive in a 1 ATM suit.

 

[Doc Harry]

You would be lucky to survive long enough to ascend and/or treat your spontaneous pneumo. Good luck.

 

[TheAvatar]

not trying to be mean but if you can read, I'm looking for answers not advice. Read my questions and if you have the answers then reply. Thanks

Not to be mean, but don't, as a non-medically trained person, ask medically trained persons for answers on how to use a needle to treat a tension pneumo on yourself underwater!!!!!! EMT-I's are not even permitted to execute that procedure on others. Paramedics, where they are allowed to do this, must call and ask a Dr.'s permission, IfIRecallCorrectly. That is all to treat others on the surface in an ambulance or ER, not self-treatment underwater. You want text instructions over the f***ing internet from people you don't know on how to do it yourself??? I sincerely doubt any MD would endanger/embolden you by explaining it in such a situation knowing your motives.


Sidenote: I bet he'd notice JVD and trachea displacement underwater.

 

[TheAvatar]

It should be a hint when people are telling you that, for YOU, given your condition, B.A.S.E. JUMPING IS SAFER!!!!

Something else that is much safer by comparison for your case (image Copyright 2004 - TheAvatar):

 

[downunderjenn]

if you love the water, have you tried snorkeling at the surface, no going under? or reading books on sea life or working as a volunteer in an aquarium-not diving but helping feed or something of that nature.

Please, do not dive! Please, never lie about medical conditions and never encourage others to do so. This is a serious sport. The rules are for your safety, but you are responsible for your actions. I don't believe mandating more restriction to the sport, or more legislation, but what you propose to do is terrifying.

You can satisfy your love for the sport in other ways, perhaps canoeing. Do you have children? I am sure they would love to see Sea World, or go to a water park, or swim at the beach.

Always consult your doctor. I understand your insurance need, as I too did not have insurance for a long time. If you cannot afford insurance, you really should not afford scuba diving, or at least pay full doctor fees and get checked up and get valid medical dive information. However, you will probably find you should consider what your goals are. Why do you want to dive? Is there another activity that will appease you? Sailing? Water skiing?

Again, please do not dive. You endanger more than yourself, but yourself should be enough to send up a red stop flag.

 

[Seabear70]

Ok, I am going to be rude here. If you dive, you are playing russian roulette with your lungs. If you keep it up, soner or later, it is going to hurt you, bad. Most likely, it will kill you.

Can you survive a pneumothorax under water? Yes, Maybe.

I realize that the answer you want is that there is a way to do this safely, but there isn't. And if you insist on diving, you are not just endangering yourself, but the people you dive with, they depend on you, ya know?

I am truly sorry. I am the type of person who tells everyone that they should dive, and I mean it. But with this type of condition, you need to stay on the surface.