Unconsciousness/Blocked Airway/Embolism

[divemed06]

I mean this with full respect. Are you a diving doctor ? And if the throat closed off like you said would it still stop air from releasing. Has this in a diving accident in cold water ever happened before ?

Is their a diving doctor in the house.

Well...I've taken a few courses in diving medicine during conferences. Do I consider myself and expert in diving medicine/diving physiology, well, no. However, I do have a VERY solid background in human anatomy, physiology and pathophysiology (hence the MD). I'm currently in the process of training to become an expert in treating emergent patients (hence, the residency in Emergency Medicine). Furthermore, I have treated several dive related injuries, including embolisms. That being said, it really doesn't bother me if you discount my comments. I have nothing to prove. You asked for information from a doctor and I provided information. As with most things in medicine, some docs will say something, while others will say something different. Take the info as you will (however, my comment was accurate!) To answer your second question: it isn't a black and white answer...if the airway pressure from the air coming from your lungs is greater than that of the obstructing element (surrounding tissue, epiglottis etc), than yes, air should be able to be exhaled (just keep in mind that breathing is a dynamic process which requires both voluntary and involuntary process which can be altered by many extrinsic factors). To answer your last question, a recent case of "cold water asphyxiation " surfaced on Scuba-Doc.com. It's rare, but it has happened. Hope this answers your questions.

 

[rmediver2002]

I mean this with full respect. Are you a diving doctor ? And if the throat closed off like you said would it still stop air from releasing. Has this in a diving accident in cold water ever happened before ?

Is their a diving doctor in the house.

Yes it has occured in both drowning victims and diving casualties. It can also occur for a variety of reasons on the surface, cold water is not the only cause.

During autopsy most drowning victims are found to have aspirated very little water, about 10% of victims have aspirated no water at all. This is due to laryngospasm.

http://www.voicedoctor.net/therapy/laryngospasm.html

 

[snuggle]

thanks for supplying that link..it was very informative..i have also heard of what you brought up that in some victims of drowning that no water is found in their lungs..

 

[wolf eel]

[pipedope

Remember also there is a difference between a diver who is simply unconscious and one who is in convulsions.

I am not a doctor nor do I play one on TV.

If the diver's body is rigid, you probably need to maintain depth until they relax, then take them up.]

Please don't take offence but is that not what I was saying. I think so.

This how I view it I have no idea if Pipedope agrees or not.
I realize and I have said it many times that you could embolise but you most likley will not. And not to worry go and do a rapid accent at a rate that you will live. As thats the only way to get help. Remember this all started because of the one accident.
In the deaths with the larynx closing did that occur with a rapid accent as I was asking would the air not relax that reflex with air dispelling ? As the swimmer would not have and the reflex makes sense.
And I can understand if a diver was not lifted from the bottom while he is alive that the throat would remain closed.
Derek

 

[Scuba]

Old thread on subject:

http://www.scubaboard.com/t19127-.html

 

[wolf eel]

Re: Diving - rapid ascent without pulmonary barotrauma

--------------------------------------------------------------------------------

Quote:
Originally Posted by wolf eel
Hello

I am asking a question here as something very much like what happened to you. Did you make it because air was not trapped in the lungs ? Because air could escape because you where relaxed ?
Thanks
Derek



Hi Derek,

Sorry I haven't posted much on Scubaboard recently. What you say is absolutely correct. If the glott is is open (i.e. relaxed) the gas within the lungs can easily escape without causing PB.

If the diver is unconscious (or dead!) the glottis is in the relaxed, open, position so there is seldom any artefactual barotrauma during such a rescue ascent.

It takes conscious effort to close the glottis!

Hope that helps.

Kind regards,

Paul
__________________
Paul Thomas; - Not yet too old to learn something new.

 

[wolf eel]

[Scuba Old thread on subject:]

Thank you.

I hope he has explained it in real terms for some of you. What I have been saying is what happened to him. If your lights are out you have a very good chance to make it another day. Provided that somebody does a rapid accent with you. Besides you get to share the chamber and have somebody to talk to.
Derek

 

[rmediver2002]

Please don't take offence but is that not what I was saying. I think so.

This how I view it I have no idea if Pipedope agrees or not.
I realize and I have said it many times that you could embolise but you most likley will not. And not to worry go and do a rapid accent at a rate that you will live. As thats the only way to get help. Remember this all started because of the one accident.
In the deaths with the larynx closing did that occur with a rapid accent as I was asking would the air not relax that reflex with air dispelling ? As the swimmer would not have and the reflex makes sense.
And I can understand if a diver was not lifted from the bottom while he is alive that the throat would remain closed.
Derek

Air / pressure will not relax this reflex, I had it occur once freediving in water that was 54 f. It will relax in most cases after a few seconds or after the stimulus is removed, when it happened to me I was decending and could not exhale beyond my larynx so could not valsalva.

I agree (and reading through this thread think everyone posting does) that the best chance the unconscious non-breathing diver has is ascent to the surface...

 

[wolf eel]

[rmediver2002 Air / pressure will not relax this reflex, I had it occur once freediving in water that was 54 f. It will relax in most cases after a few seconds or after the stimulus is removed, when it happened to me I was decending and could not exhale beyond my larynx so could not valsalva.

I agree (and reading through this thread think everyone posting does) that the best chance the unconscious non-breathing diver has is ascent to the surface...]

No what was said is that it will cause an embolism you just read how it will not by somebody who lived because of it read it. All of your post(everybodys are still here to read) The stimulus being you are conscious but after you pass out THATS what I have been saying. And so did he. The facts are just that. Most of you all said an embolism is going to happen.
Sorry but I will listen to the guy it worked for he is alive only because that is what happened. Yes it is. I am not looking to go back and forth.
This is a true happening plain and simple he is alive because of it.
Derek

 

[divemed06]

No what was said is that it will cause an embolism you just read how it will not by somebody who lived because of it read it. All of your post(everybodys are still here to read) The stimulus being you are conscious but after you pass out THATS what I have been saying. And so did he. The facts are just that. Most of you all said an embolism is going to happen.
Sorry but I will listen to the guy it worked for he is alive only because that is what happened. Yes it is. I am not looking to go back and forth.
This is a true happening plain and simple he is alive because of it.
Derek

I'd respond but I'm not exactly sure what you are saying... If I understand correctly, because you know someone who survived an uncon ascent and did not embolize, therefore it is impossible to embolize in this situation. Is this accurate? I'm sorry to say but medicine does not work that way. No matter where you stand on this issue, it really makes no difference. You have to surface the unconscious diver and start resus. As a rescuer, if you're debating the "emboli" question while holding onto the uncon diver at depth, you're wasting your brain activity. Get him up and get him out, pump and blow (if required) and get him to the hospital ASAP. The rest is up to the "Man" or "Woman" upstairs...