Theories on why this skin DCS w/ neuro (DAN report)

Please register or login

Welcome to ScubaBoard, the world's largest scuba diving community. Registration is not required to read the forums, but we encourage you to join. Joining has its benefits and enables you to participate in the discussions.

Benefits of registering include

  • Ability to post and comment on topics and discussions.
  • A Free photo gallery to share your dive photos with the world.
  • You can make this box go away

Joining is quick and easy. Log in or Register now!

M DeM

Contributor
Messages
358
Reaction score
51
Location
NYC
# of dives
200 - 499
Was reading the DAN 2017 accident & fatality report, and they don't posit any reasons why this might have happened aside of her giving wrong dive profile info?

Thoughts? Here it is:


p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 10.0px Helvetica; color: #5187a0} p.p2 {margin: 0.0px 0.0px 0.0px 0.0px; font: 10.0px Helvetica}

CASE 2-09: SKIN MOTTLING WITH CEREBRAL

NEUROLOGICAL SYMPTOMS

The caller had noticed itching across her abdomen, a mottled rash and deep muscle pain several hours following the last of six dives over two days. The itching began approximately three hours after the end of her last dive. Her symptoms had gotten progressively worse in the previous two hours, and she was seeking suggestions. She admitted to having had some trouble equalizing during her descents
and ascents, but otherwise had had no issues during her dives. She did not have her computer with her (it was in her dive locker), so she reported her dive profiles as she remembered them.

Her estimated dive profiles, all on 30% EAN, were as follows:

Day 1

#1: 70 fsw (21 msw) for 60 mins; SI of 2:00

#2: 50 fsw (15 msw) for 50 mins

Day 2

#1: 90 fsw (27 msw) for 55 mins; SI of 1:00

#2: 60 fsw (18 msw) for 50 mins; SI of 2:00

#3: 70 fsw (21 msw) for 50 mins; unknown SI

#4: 40 fsw (12 msw) for 55 mins


She had then been admitted to a local hospital with a hyperbaric facility. The physician detected some left-hand grip weakness and balance instability and an inability to walk heel-to-toe; results of a Romberg test were also positive. She was treated in the recompression chamber with one round of USN TT6 and two of USN TT5, for a total of three HBO treatments, before complete resolution of all her balance and strength issues was achieved.

She called seeking referrals for follow-up. The treating physician had recommended that she wait six months before returning to diving.

She was a volunteer diver at a local aquarium, where she typically did dives in 15 to 20 fsw (5 to 6 msw). She asked if she might be able to get back in the water at the aquarium sooner than six months. She had been diving for eight years and had done about 250 dives, excluding aquarium dives. She had never had problems previously. She was advised to discuss her health and her diving practices with an experienced
dive physician before she returned to diving.
 
reasons why this might have happened

She was breathing a ppN2 greater than .79 and then went shallower such that tissue ppN2 was above ambient. Just because that doesn’t get every one all the time doesn’t mean it will never get anyone.
 
She was breathing a ppN2 greater than .79 and then went shallower such that tissue ppN2 was above ambient. Just because that doesn’t get every one all the time doesn’t mean it will never get anyone.
That's really interesting... thanks for the reply!
 
Poss PFO, bubbles forced across during valsalva, report suggests she was struggling to equalise on descent and ascent.
 
Poss PFO, bubbles forced across during valsalva, report suggests she was struggling to equalise on descent and ascent.
Valsalva? Definitely didn't learn that in OW -- excuse me while I go google.
 
Was reading the DAN 2017 accident & fatality report, and they don't posit any reasons why this might have happened aside of her giving wrong dive profile info?

Thoughts? Here it is:


p.p1 {margin: 0.0px 0.0px 0.0px 0.0px; font: 10.0px Helvetica; color: #5187a0} p.p2 {margin: 0.0px 0.0px 0.0px 0.0px; font: 10.0px Helvetica}

CASE 2-09: SKIN MOTTLING WITH CEREBRAL

NEUROLOGICAL SYMPTOMS

The caller had noticed itching across her abdomen, a mottled rash and deep muscle pain several hours following the last of six dives over two days. The itching began approximately three hours after the end of her last dive. Her symptoms had gotten progressively worse in the previous two hours, and she was seeking suggestions. She admitted to having had some trouble equalizing during her descents
and ascents, but otherwise had had no issues during her dives. She did not have her computer with her (it was in her dive locker), so she reported her dive profiles as she remembered them.

Her estimated dive profiles, all on 30% EAN, were as follows:

Day 1

#1: 70 fsw (21 msw) for 60 mins; SI of 2:00

#2: 50 fsw (15 msw) for 50 mins

Day 2

#1: 90 fsw (27 msw) for 55 mins; SI of 1:00

#2: 60 fsw (18 msw) for 50 mins; SI of 2:00

#3: 70 fsw (21 msw) for 50 mins; unknown SI

#4: 40 fsw (12 msw) for 55 mins


She had then been admitted to a local hospital with a hyperbaric facility. The physician detected some left-hand grip weakness and balance instability and an inability to walk heel-to-toe; results of a Romberg test were also positive. She was treated in the recompression chamber with one round of USN TT6 and two of USN TT5, for a total of three HBO treatments, before complete resolution of all her balance and strength issues was achieved.

She called seeking referrals for follow-up. The treating physician had recommended that she wait six months before returning to diving.

She was a volunteer diver at a local aquarium, where she typically did dives in 15 to 20 fsw (5 to 6 msw). She asked if she might be able to get back in the water at the aquarium sooner than six months. She had been diving for eight years and had done about 250 dives, excluding aquarium dives. She had never had problems previously. She was advised to discuss her health and her diving practices with an experienced
dive physician before she returned to diving.

Hi @M DeM ,

As Ken alluded to, the risk of DCS in diving is not zero, even without something going awry. Deeper, longer dives carry a higher probability of DCS. Known risk factors are heavy work/exercise on the bottom and cold on decompression. The evidence for dehydration is mixed, despite what you might hear.

Best regards,
DDM
 
Hi @M DeM ,

As Ken alluded to, the risk of DCS in diving is not zero, even without something going awry. Deeper, longer dives carry a higher probability of DCS. Known risk factors are heavy work/exercise on the bottom and cold on decompression. The evidence for dehydration is mixed, despite what you might hear.

Best regards,
DDM
thanks!
 
https://www.shearwater.com/products/peregrine/

Back
Top Bottom