Pulmonary Oedema incident

[InTheDrink]

This has troubled me with respect to the "unexplained" deaths, from the time I first read about the condition. It is my very great fear that drowning and IPE look enough alike on post-mortem for one to be mistaken for the other.

Indeed, potentially making IPE more common than currently thought. Another reason that awareness of it should be increased IMO.

I wonder about WOB on rebreathers -- I know it's higher than on OC, but by how much? You can induce pulmonary edema in normal people, if you make them pull hard enough to breathe for a long enough period of time. I wonder if this is a factor in CCR IPE cases?

Interesting. I was concerned I'd pack one of my scrubbers too tightly. I also remember having to suck like a hoover to pull some gas through the ADV descending through to 40m. I only took a couple of breaths through before going back to adding manually as the ADV wasn't delivering enough without huge suction. The event occurred several minutes after this.

Of course, I'd be really slow to draw any conclusions about the scrubber or ADV (or my use of them) but they remain worthy of note. In my case there are some other more likely candidates for the trigger.

John


John

 

[InTheDrink]

@InTheDrink: Just a few questions...

• Were you taking any prescription medication(s) at the time of the incident? In particular, were you taking any heart or blood pressure meds?
• Were you taking any anti-seasickness medication at the time? If so, what type and how much? Also, was the dosage on the day of the incident a departure from your regular routine, i.e., took more of the med than on a typical boat dive?
• Is it possible that you were over-hydrated? More specifically, describe your pre-dive fluid intake. Some divers tend to be rather aggressive with drinking fluids prior to a dive due to the notion that dehydration might increase the probability of DCS occurrence.

Hi Bubble,

Good questions all. I hope I don't sound elusive but please let me come back with answers on some of these once I've seen my cardio.

No, no sea-sickness tablets.
No, I wasn't over hydrated. If anything I was a little less hydrated than normal. I am normally aggressive in drinking fluids before diving but wasn't on this day. I'd had a few beers the night before. Two cups of coffee prior to the dive and about a litre of water.

Cheers,
John

 

[Tricia]

John,

Glad to hear you made it OK. I first read the post and then looked to see who had made it and when I saw "In the Drink", I thought, "Oh no!" It's selfish to say this, but your contributions over the years on Scubaboard have been great and it would have been awful for us simple readers to lose you. Thanks for sharing this info about IPE, something I had never heard of until Denisegg's incident. And I think you are very LUCKY that you had people like Simon and Said around you to help.

And folks, this incident and Denisegg's incident are once again a reminder of how important DAN is! I can never understand how people dive without the DAN insurance...

Please do keep us posted on your progress and how you do when you get back in the water.

Cheers,
Trish

 

[InTheDrink]

Cheers Tricia, thanks for your kind words and I must admit I'm pretty pleased to be posting here myself as opposed to my buddy

I lucked out with having an extremely competent instructor and boat crew. I'll keep you posted on progress and if/when I get back in the water.

Cheers,
J

 

[Sas]

That was very scary to read. I am so glad you are ok John.

 

[InTheDrink]

That was very scary to read. I am so glad you are ok John.

Awesome signature Sas. I guess Adurso hasn't met you in the real world so

 

[bletso]

This has troubled me with respect to the "unexplained" deaths, from the time I first read about the condition. It is my very great fear that drowning and IPE look enough alike on post-mortem for one to be mistaken for the other.

I wonder about WOB on rebreathers -- I know it's higher than on OC, but by how much? You can induce pulmonary edema in normal people, if you make them pull hard enough to breathe for a long enough period of time. I wonder if this is a factor in CCR IPE cases?

Makes sense. Poorly placed or hard to breathe ADV's place a heavy load on the lungs. We originally added a manual add to ours and then did away with the ADV and do manual add only. Of course there you have a potential for over inflation. No panacea for sure. Hydrostatic pressures on a rebreather are very much a concern. Even small changes to C/L placement can affect breathing effort (WOB) as well as trim as these cause shifts between the eupneic and lung centroids. Hydrostatic lung loading can shift dramatically in rebreathers due to design, C/L placement and diver trim as I already stated.. Even a loose harness can effect WOB if C/L are allowed to float up and about.

ref Immersed Vol 3 N 1 spring 1998; Aquacorps No 10 Jul/Aug 1995


Safe Diving


Dale

 

[InTheDrink]

I didn't have any issues with the unit and I would say it was functioning correctly but I'd advise against using the ADV in most cases and certainly during descent and manually add instead (which is what I had generally done).

Again, it's worth stating that medical reasons - hypertension, dehydration & possibly some medication remain the most likely culprits in this episode. It's *possible* that they weren't helped by my ill-considered use of the ADV while descending but I'd say that at best it *might* be a minor contributing factor. Remember, the day before I got the wheezing (which I consider as the warning sign to the onset) at 20m and without any use of the ADV.

Cheers,
John

 

[Bubbletrubble]

When reviewing any incident like this, it helps to have a complete picture of what happened -- which includes the meds (prescription or other) that the person had "on board" at the time of the incident. It's important to understand that either the meds or the medical condition which the meds are meant to treat might be a contributing factor in the incident.

In my mind, it seems rather silly to be speculating about the cause of the accident without this critical piece of information.

Glad that you had a good outcome, John. Thanks for sharing your story with us.

 

[InTheDrink]

When reviewing any incident like this, it helps to have a complete picture of what happened -- which includes the meds (prescription or other) that the person had "on board" at the time of the incident. It's important to understand that either the meds or the medical condition which the meds are meant to treat might be a contributing factor in the incident.

In my mind, it seems rather silly to be speculating about the cause of the accident without this critical piece of information.

Glad that you had a good outcome, John. Thanks for sharing your story with us.

Hi Bubble,

I understand your frustration with the incomplete picture. I'll PM you to fill you in and you'll probably then understand. The medication in question is personal in nature and unlikely to have been a factor.

Thanks,
John