Cases reported "Inert Gas Narcosis"

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1/5. Mononeuropathy of the medial branch of the deep peroneal nerve in a scuba diver.

    Peripheral mononeuropathies occur only rarely in association with decompression illness. The sites previously reported to be affected are areas of potential entrapment in which a peripheral nerve traverses a confined area. In these instances, the pathophysiology has been presumed to be mechanical pressure in an enclosed space by a gas bubble. A rare case is now presented of a peripheral mononeuropathy of the medial branch of the deep peroneal nerve in a scuba diver following surfacing from a 195 foot dive. This case differs from prior reports of mononeuropathy in association with decompression illness in that the affected nerve does not traverse a confined site in which mechanical compression by a gas bubble is likely. The mechanism of injury is hypothesized to be a manifestation of decompression illness with a gas bubble causing blood flow obstruction and an ischemic infarct. ( info)

2/5. Aseptic bone necrosis in Japanese divers.

    Medical examination was performed on the divers in Ohura for 7 years from 1969 to 1972. Aseptic bone necrosis was found in 268 of 450 divers (59.5%). men with over 5 years of experience in diving were highly affected (more than 54.4%). These bone lesions were found most frequently in the proximal end of the femur and the humerus. There was a significantly higher incidence of bone lesions in the men who dived over 30 meters. In the group of men with one or more bone lesions, 73.1% were known to have been treated for bends. The bone, once exposed to a certain compression of air, would have a tendency to develop bone lesions even after cessation of diving. Type A2 (linear opacity) led to the structural failure of the joint surface of the femur and the humerus. Histopathological study was carried out on the sections of bone obtained from three autopsy cases and four operated cases. Formation of air bubbles in the bone marrow cavity seemed to be the most important as the cause for the occurrence of aseptic bone necrosis, and local circulatory disturbance might be the most responsible for the progression of the bone lesion. ( info)

3/5. nitrogen narcosis and alcohol consumption--a scuba diving fatality.

    nitrogen narcosis can cause death among experienced scuba divers. nitrogen under pressure affects the brain by acting as an anesthetic agent. Furthermore, the consumption of ethanol along with diving will cause the symptoms of nitrogen narcosis to occur at depths less than 30 m. Our case deals with an experienced diver who drank alcoholic beverages before diving and developed symptoms of nitrogen narcosis at a shallow depth. These two conditions contributed to his death by drowning. ( info)

4/5. A SCUBA-diving fatality.

    An investigation by a Naval Board of Inquiry into the circumstances of a fatal naval diving accident is presented. Although drowning contributed to the fatal outcome, massive arterial gas embolism is thought to have been the principal cause of death, and the value of post-mortem computed tomography scanning for its detection is demonstrated. The possibility is discussed of diver error due to unfamiliarity with equipment and procedures, compounded by nitrogen narcosis. The shortfall in expertise of coronial inquiries into diving deaths is emphasized against a background of increasing popularity of sports diving around australia. The implications for the offshore industry are obvious and suggest the need for a federal diving inspectorate. ( info)

5/5. Observations after loss of consciousness under water.

    Two diving incidents were investigated in which 1) an experienced professional diver (A) lost consciousness during an air dive to 69 meters, and 2) an amateur sports diver (D) lost consciousness during a 40-meter air dive. In subsequent tests both divers' ventilatory responses to inspired carbon dioxide were found to be extremely low. Under simulated diving conditions, Divers A and D exhibited marked carbon dioxide retention during exercise at 30 meters (end-tidal PCO2 = 65 and 57 mmHg, respectively) and at 70 meters, Diver A stopped work in less than 3 min because of severe dizziness. Reduced sensitivity to carbon dioxide, perhaps caused by the interaction of hypercapnia and nitrogen narcosis, is thought to have been partly responsible for these incidents. ( info)


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