Surviving an asthma attack

[simonc]

I was wondering whether it is possible in theory to survive an asthma attack whilst diving?

Say a diver had a mild attack with narrowing of the airways but not complete blockage. This would mean in theory they had increased residual air in their lungs (dead volume) per breath.

Thus if they ascended the chance of barotrauma would increase.

But could they ascend slower....say 3m per min, rather than 9 m per min?? Would this alow adequate ventilation and reduce the risk of barotrauma. Of course this comes with the assumptions of adequate air in tank, no decompression limits etc.

Is their a ratio.....50% narrowing = ascend 50% slower?? Intertesting theory, but impossible to test. Based on medical physics is it possible?

Thanks and happy diving.

 

[rcohn]

I've heard stories of divers surviving attacks. Never happened to me. The risks of diving with asthma have been somewhat overstated; it is not really clear what the true risks of an attack may be. Obviously any severe asthma attack, that significantly limits a divers exercise capacity, is very dangerous when diving. However, a mild attack does not mean certain embolism.

Ralph

 

[IslandHopper]

As long as you can think clearly during an attack, just keep your reg in and make as normal an ascent as possible .... no reason why it should be a problem form reasonable depths (reasonable would depend on your experience diving, and your ability to cope during an attack.)

 

[DocVikingo]

Along with issues like asthma-related exertional limitation, panic, loss of consciousness & drowning during scuba, there is evidence mildly suggestive of increased rates of decompression illness.

The reduction in airway size that is a cardinal feature of asthma could cause trapping of gas in the lung during ascent. If this gas expands faster that it can be exhaled through narrowed airways, lung rupture could result with arterial gas embolism or pneumothorax.

Given that an entirely trapped pocket of pressurized gas in the lung probably can cause rupture of tissue just within the ascent from 4' to the surface, what do you see as "reasonable depths" for divers with asthma?

As an aside, I would imagine that thinking clearly and making a controlled ascent might prove difficult for the diver in the throes of a major attack who can't breathe & is starving for oxygen.

Best regards.

DocVikingo

 

[IslandHopper]

Well ... that's why "reasonable" would depend on the particular diver's experience with diving AND their experience with asthma.
I believe the term (that many people seem to have forgotten) is "PERSONAL RESPONSIBILITY".
There are certainly some people with asthma that have no business diving. But there are others who's "attacks" are mild enough and their personal ability to remain calm and deal with it would allow them to dive. What is reasonable would be a personal decision.
Could there be a risk of lung injury ? well of course ! ... but that risk is there for people WITHOUT asthma as well. Let the person consider the increased risk, and decide for themselves if it is worth it.

 

[IndigoBlue]

Well ... that's why "reasonable" would depend on the particular diver's experience with diving AND their experience with asthma...

I doubt that.

If a person has asthma, then he/she should not become certified to dive.

If a person develops asthma after certifying (rare), then he/she should give up diving.

I am aware of there being some flexibility in some agencies with non-insulin dependent diabedes. But not any "flexibility" with asthma.

 

[CuriousMe]

I doubt that.

If a person has asthma, then he/she should not become certified to dive.

If a person develops asthma after certifying (rare), then he/she should give up diving.

I am aware of there being some flexibility in some agencies with non-insulin dependent diabedes. But not any "flexibility" with asthma.

First off, getting diagnosed with Asthma as an adult isn't as rare as you think.

Secondly, I'm curious how you came to the above opinion about Asthma being an absolute contraindication to diving?

I do know that there are agencies that have flexibility with Asthma....I believe SSI is one of them....I'd have to look up the others.....other folks here probably have that info at their fingertips.

Peace,
Cathie

 

[IndigoBlue]

First off, getting diagnosed with Asthma as an adult isn't as rare as you think.

Secondly, I'm curious how you came to the above opinion about Asthma being an absolute contraindication to diving?

I do know that there are agencies that have flexibility with Asthma....I believe SSI is one of them....I'd have to look up the others.....other folks her probably have that info at their fingertips.

Peace,
Cathie

I cannot speak for SSI. You may want to check with your SSI instructor and see what he/she tells you. I would be very surprised if you were not told the same thing I just told you.

 

[CuriousMe]

I cannot speak for SSI. You may want to check with your SSI instructor and see what he/she tells you. I would be very surprised if you were not told the same thing I just told you.

I'm certified already (actually not with SSI either...I just happened to know that they have a flexible position on diving with asthma)...but I'll get you the document that they speak about asthma in.

But I am curious what you based your opinion about any form of asthma being an absolute contraindication to diving.

Peace,
Cathie

 

[simonc]

IndigoBlue,

Your post is quite niave. See DocVikingo's comments below and those of the YMCA http://www.ymcascuba.org/ymcascub/asthmatc.html. SSI also has a protocol for training asthmatics to dive http://www.scubasciences.com/pdf files/Medical Stuff/ssi-asthmatic information.pdf. Asthma comes in all manner of types and thankfully your opinion is similar to those of the growing minority. I suspect one of the major reason physicians have disqualified asthmatics from diving is that they cannot guarantee they will take their medication as directed on a regular basis. Thus making that person more prone to an asthma attack whilst diving. Compliance is the issue and if an asthmatic is stupid enough to dive with uncontrolled asthma then they bare the consequences. Having said that, we really don’t have evidence to show that asthma and diving don’t mix. It makes sense that increased airway resistance would predispose AGE, but who is going to test it? I don’t think you’ll get too many asthmatics volunteering to dive and have an asthma attack induced, then asked to ascend to see the effects. You cannot punish the masses for the stupidity of the few. We are a litigious society and physicians are naturally guarding their backs. Check out the SSI's protocol, VERY impressive. But then we have come to expect this from SSI. PADI should get with the program!
Until the mid-1990s, asthma was largely considered an absolute contraindication to diving. However, thinking in the medical and professional dive community has rather radically altered since then, and those with asthma can now be certified under certain circumstances. Although they differ somewhat, the YMCA, BASC and Undersea and Hyperbaric Medicine Society each offer protocols guiding medical clearance to dive.

For example, the YMCA* criteria include a requirement that all asthmatics have normal resting and exercise pulmonary function tests with no degradation after exercise. The criteria allow those taking routine preventative medications to be evaluated while continuing their treatment. Also required is the ability to exercise and tolerate stress without becoming symptomatic while on maintenance medications, and the absence of a need for “rescue” inhalers during times of stress or exertion.

Thanks,

SimonC