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Diving: do not disregard immersion pulmonary edema

European waters are slowly however absolutely warming up; and for water sports activities fanatics; particularly scuba diving; it is going to quickly be time to secure again on the water. Rehabilitation dives are a possibility to carry out ajournaltimeplete overhaul of your tools and evaluation some fundamentals to make sure your security and that of your group members. If scuba diving; freediving or bottle diving; has bjournaltimee extensively democratized over the final  twenty years; particularly due to main adjustments in tools; it’s nonetheless a hazardous exercise; and realizing them effectively continues to be one of the simplest ways to keep away from them.

Coaching of leisure divers and supervisors makes them conscious of djournaltimepression illness (ADD) and barotrauma (attributable to sudden stress variations within the ears; sinuses; or lungs). However one other; a lot much less well-known kind of diving accident can happen: pulmonary immersion edema (OPI). It primarily impacts individuals over 50 years of age and hypertensive; however it has additionally been described in younger; wholesome divers. If cared for rapidly; this edema typically progresses favorably; however deaths acquire been reported.

Underestimated accident

First described in 1989; OPI is taken into account uncommon; however its affect could also be underestimated. On the one hand; when signs are gentle and divers get well rapidly; emergency division visits aren’t systematic. Then again; diagnostic errors are frequent as OPI continues to be poorly understood by divers and caregivers; and accidents can recede inside a couple of hours. A examine carried out in France by the Saint-Anne hyperbaric  middle in Toulon; signifies that 14% of the diving accidents handled between 2005 and 2010 have been OPI; or 99 circumstances out of 707.

OPI is most frequently manifested by shortness of breath (dyspnea) that may happen with immersion; however most frequently begins at depth and worsens with ascent. The opposite signs are coughing and the presence of foamy sputum and even bloody sputum; markers of lung hurt. Chest tightness with out precise ache and / or a sense of being near dying has additionally been reported. Signs that may trigger panic within the diver or hisjournaltimepanions; precipitate the ascent and in addition trigger a djournaltimepression accident (see field).

Predispositions and Enabling Components

The statement of circumstances of OPI allowed figuring out components that would favor the prevalence of this accident; amongst them immersion in chilly water (<19 ° C); bodily exertion and arterial hypertension. Age appears to play an critical function in divers; and most circumstances are reported in individuals over 45 years of age. Weight problems; stress; hyperhydration and even taking non-steroidal anti-inflammatory medicine (NSAIDs) is also concerned; in addition to tools (poorly adjusted regulator; adjustedjournaltimebination…). However these associations stay unsure and should be confirmed.

Any suspicious and strange occasion that happens inside 24 hours of a dive needs to be the topic of a medical session and the OPI is not any exception to this rule. Within the occasion of a confirmed or extremely suspicious accident; a cardiological and pulmonary analysis needs to be carried out. The seek for arterial hypertension needs to be carried out in all circumstances.

Please be aware {that a} current hyperbaric and underwater follow was lately opened on the Vaudois College Hospital (CHUV). Obtain leisure {and professional} divers.

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Tailored from -Immersion pulmonary edema–; Dr. B. Desgraz et al.; Swiss Medical Evaluation; 2017; 13; 1324-1328.

Appeared in Planète Santé Journal N ° 29 – Mars 2018



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