RT Book, Section A1 Piantadosi, Claude A. A2 Hall, Jesse B. A2 Schmidt, Gregory A. A2 Kress, John P. SR Print(0) ID 1107715158 T1 Diving Medicine and Drowning T2 Principles of Critical Care, 4e YR 2015 FD 2015 PB McGraw-Hill Education PP New York, NY SN 9780071738811 LK accessanesthesiology.mhmedical.com/content.aspx?aid=1107715158 RD 2024/03/28 AB Immersion and diving produce physiologic effects from increased hydrostatic pressure and its effects on the physical behavior of gases.Diving with compressed air (or other breathing mixtures) causes the body to take up extra nitrogen or other inert gases in proportion to the pressure change. During ascent, these dissolved gases must leave gradually through the lungs to avoid decompression sickness (DCS).DCS is caused by gases leaving solution and forming bubbles in body tissues, leading to musculoskeletal pain (bends) or neurologic symptoms due to direct vascular damage, ischemia, edema, and inflammation.DCS usually manifests within minutes to hours of surfacing and is emergently treated with high-flow O2 and the administration of fluids. Oxygen recompression in a hyperbaric chamber is the definitive treatment for signs and symptoms and for the prevention of recurrences, even if delayed 1 or 2 days.Arterial gas embolism (AGE) is the result of overexpansion of the lungs during ascent from diving with compressed gas. It is usually associated with rapid ascent and CNS symptoms and after drowning, is the second leading cause of fatalities in recreational diving. AGE is a medical emergency that also occasionally occurs in the hospital setting.Drowning is defined by asphyxia in water, and is usually associated with aspiration of water. In survivors, the primary injuries are to the brain, heart, lungs, and kidneys. Drowning is common in children, and in young adult males, and is often associated with drug or alcohol ingestion.Drowning may be accompanied by traumatic injuries and complicated by acute respiratory distress syndrome (ARDS), often of late onset and often aggravated by aspiration of gastric contents or other foreign debris.Drowning may be complicated by pneumonia (or sepsis) caused by unusual pathogens present in contaminated water. However, the prophylactic administration of antibiotics is not recommended.