TY  - CHAP
M1  - Book, Section
TI  - Chapter 112. Diving Medicine and Near Drowning
A1  - Piantadosi, Claude A.
A1  - Brown, Steven D.
A2  - Hall, Jesse B.
A2  - Schmidt, Gregory A.
A2  - Wood, Lawrence D.H.
PY  - 2005
T2  - Principles of Critical Care, 3e
AB  - Immersion  and  diving  produce  physiologic  effects  from  increased  hydrostatic  pressure  and  its  effects  on  the  behavior  of  gases.When  diving  with  compressed  air  or  other  breathing  gases,  the  body  takes  up  extra  nitrogen  or  other  inert  gas,  which  must  be  allowed  to  leave  through  the  lungs  gradually  to  avoid  decompression  sickness  (DCS).  DCS  occurs  when  gas  comes  out  of  solution  and  forms  bubbles  in  body  tissues,  which  causes  pain  or  neurologic  symptoms  by  obstruction  of  blood  flow  and  initiation  of  secondary  inflammatory  events.DCS  is  treated  by  prompt  administration  of  high-flow  O2  and  hydration.  Oxygen  recompression  therapy  is  definitive  treatment  for  symptom  resolution  and  avoiding  recurrence,  even  if  delayed  1  or  2  days.Arterial  gas  embolism  is  usually  the  result  of  pulmonary  overpressurization  during  ascent  from  diving  with  compressed  gas  and  may  occur  at  shallow  depths.  Arterial  gas  embolism  is  the  second  leading  cause,  after  drowning,  of  fatalities  in  recreational  diving.Near  drowning  (ND)  is  caused  by  asphyxia  underwater,  which  may  or  may  not  be  associated  with  aspiration.  The  primary  injuries  are  to  the  brain,  heart,  lungs,  and  kidneys.In  young  adults,  ND  is  often  associated  with  drug  or  alcohol  ingestion  and  may  be  accompanied  by  traumatic  injuries.ND  may  be  complicated  by  acute  respiratory  distress  syndrome;  its  onset  may  be  delayed  or  aggravated  by  aspiration  of  gastric  contents  or  other  foreign  debris  and  pneumonia.ND  may  be  complicated  by  pneumonia  (or  sepsis)  caused  by  unusual  pathogens  present  in  contaminated  water.  Prophylactic  antibiotic  treatment  is  not  indicated.  
SN  - 
PB  - The McGraw-Hill Companies
CY  - New York, NY
Y2  - 2022/05/26
UR  - accessanesthesiology.mhmedical.com/content.aspx?aid=2282766
ER  -