scubadoc Ten Foot Stop

July 24, 2007

Scuba diver killed by lightning in Florida

Filed under: Interesting Newsscubadoc @ 8:27 am
Scuba diver killed by lightning in Florida

DEERFIELD, Fla., July 23 (UPI) — A scuba diver near Deerfield Beach, Fla., was killed in what investigators said appears to be a lightning strike on the diver’s air tank.

Stephen Wilson, 36, of Deerfield Beach, was pulled from the water after being struck by lighting about 30-feet away from the boat he was returning to, Miami’s WPLG-TV reported Monday.

“We saw the paramedics arrive. There were about three trucks and they were trying to resuscitate the man,” Christopher Virtue, who witnessed the accident, told the television station.

Wilson taken to the North Broward Medical Center where he was pronounced dead. The medical examiner at the hospital will release a statement revealing whether Wilson died from drowning or electrocution, WPLG-TV said.

See Also: Lightning and Diving

Medical Assessment Of Fitness to Dive Course

Filed under: Interesting Newsscubadoc @ 8:19 am
To all–
This is a reminder that we have scheduled our next Medical Assessment for Fitness to Dive course for Mobile, Alabama, USA and will be held October 4-7, 2007.  We will be at the Marriott Grand Hotel, Point Clear Resort and Spa where we have arranged for a discounted room rate of $179 USD.  This reduced rate is open as of October 3rd and continues through October 7th.  Reservations at the resort may be made by telephoning them directly at (800) 544-9933, to get the discounted rate, you need to mention the Undersea and Hyperbaric Medical Society meeting/course.  Reservations for the course can be made through September 3, 2007…after this date, reservations can be made only on a space and rate available basis.
The cost of $680 USD for the course has not been changed since we began this course four years ago.  Consequently, this may be the last time you can receive what has been called “the cheapest 33 CME hours anywhere” at the $680 cost.  Inflation has caught up with us and we will need to increase the cost of the course beginning with our spring 2008 course. 
Please note that while this is a course was developed and is organized for physicians and taught by physicians, we do understand that Physician Assistants and Nurse Practitioners do perform physical examinations under the supervision of a physician.  Because of this we invite P.A.’s and Nurse Practitioners to apply for the course.  We have made this exception in the past and it has worked out fine…we will continue to do so.
While Dr. Peter B. Bennett has assumed the position as UHMS Executive Director and I have moved into a “retirement” mode, I will continue on the faculty of our Medical Assessment for Fitness to Dive Course.  I will stay in touch to let you know how things are going with this course that has done much to solve a major international problem and is regarded by attendees as a top notch course.
To apply for the course go to our website at and scroll down the opening page until you see the course advertised.  There you can find application forms to either register on line or print a form for fax or mail.  If you use the fax or mail system, please use the following:  Fax 919-490-5149  Address:  21 W. Colony Place, Suite 280, Durham  NC  27705.
Remember that our Fitness to Dive Course is now approved by four European organizations in addition to the UHMS approval here in the U.S.
Hope to see lots of you in Mobile in October!

July 22, 2007

Navy secretary decides hyperbaric chambers to remain unused

Filed under: Interesting Newsscubadoc @ 8:35 am

Secretary of the Navy Donald Winter says these unfinished hyperbaric chambers at Portsmouth Naval Medical Center aren't necessary because patients can get treatment at local civilian hospitals.
Secretary of the Navy Donald Winter says these unfinished hyperbaric chambers at Portsmouth Naval Medical Center aren’t necessary because patients can get treatment at local civilian hospitals. THE VIRGINIAN-PILOT FILE PHOTO

By KATE WILTROUT, The Virginian-Pilot
© July 19, 2007 | Last updated 10:54 PM Jul. 19

The unfinished hyperbaric chambers at Portsmouth Naval Medical Center will stay that way, Secretary of the Navy Donald Winter has decided.

Winter told members of Virginia’s congressional delegation this week that the $3.75 million steel chambers, installed in a specially built wing of the hospital in 2000, aren’t necessary because patients needing treatment with pressurized oxygen can get it at local civilian hospitals.

“My present plan is to maintain the status quo of these chambers in case they are required in the future,” Winter wrote to U.S. Sen. John Warner, R-Va., in a letter dated July 16.

click here

The Navy has estimated that it could cost between $4 million and $8 million to get the two vessels operational. Funding to finish the project died in Congress in 2001.

Besides treating decompression sickness, hyperbaric therapy is used to speed the healing of certain kinds of wounds, compromised skin grafts, complications from radiation treatment and problematic amputations.

In five business case analyses between 1997 and 2003, Navy doctors and an outside consulting firm estimated that the chambers - which would hold as many as 26 patients at a time - could save the medical center more than $1 million annually by treating people in-house.

In addition, the case studies concluded, the hyperbaric chambers would reduce the number of secondary surgeries and follow-up visits for patients.

Navy hospital CO doesn’t want oxygen chambers finished


July 20, 2007

Northeast Chapter of the Undersea & Hyperbaric Medical Society

Filed under: Interesting Newsscubadoc @ 4:40 pm

NOVEMBER 10-11, 2007

The 2007 Northeast Chapter Meeting will be held November 10-11, at the Hotel Viking,One Bellevue Avenue, Newport RI .  There will also be two pre-courses on November 9 (one on Acrylics & the other a CHT/CHRN Exam review course).


Friday: 8:00am-5:00pm: Acrylics Pre-course


Friday: 8:00am-4:00pm: CHT/CHRN Review Course


Friday: 5:00pm: CHT/CHRN Exam


Saturday: 8:00am -5:00pm  

  • Opening Reception: 6:00pm  (Sponsored by )

Sunday: 8:00am -12noon


Saturday Breakfast Buffet, Saturday Lunch Buffet and Sunday Continental Breakfast are included with Registration.



Room rate at the $179.00The Hotel Viking agrees to hold the above room block until October 16, 2007 . Reservations received after this date will be accepted at the group rate based upon hotel availability. The above rates are subject to city and state taxes, currently totaling 13%. This tax is subject to change.  Reservations are to be made by each individual calling the hotel directly at 800-556-7126 between the hours of 9a.m. – 5p.m. EST Monday through Friday.  In order to insure guest room availability, callers must specify the event they are attending by the cut-off date.   CUT-OFF DATE: OCTOBER 16, 2007.  When making your reservations, you must identify yourself as part of the “UNDERSEA AND HYPERBARIC MEDICIAL SOCIETY.”   Online hotel reservations will be available soon.  Individual reservations canceled within seventy-two (72) hours prior to their scheduled arrival date, will be charged a one-night cancellation fee equal to the guest room rate plus a 7% tax. 


NBDHT CHT /CHRN Exam will be held Friday, November 9 at 5pm . If you sit for this test and attend the NE Chapter meeting, you will receive the credit hours towards your license.  




Pacific Chapter Of THE UHMS MEETING

Filed under: Interesting Newsscubadoc @ 7:58 am

NOVEMBER 2-3, 2007



TIME:             Friday            8:00 a.m. to 5:00 p.m.

                        Saturday         8:00 a.m. to 4:00 p.m.


LOCATION: Catalina Canyon Resort & Spa, Catalina, CA

Room Rates: Single/Double: $99.95; Triple: $119.95; Quadruple: $139.95

Reservations: 800-253-9361 or 888-478-7829






Friday: This session should be of interest to the medical professional (technologist, nurse and physician).  The hyperbaric medicine scientific symposium will provide an update about current medical knowledge, mechanisms of action and clinical applications.  Presentations will include new research topics and reviews of clinical hyperbaric medicine.  Continuing education credits are available.


Saturday: Presentations during this session should be of interest to the recreational diving community, and members of commercial and scientific diving organizations.  Topics will include fitness to dive, mixed gas diving, cold water diving, recognition and treatment of dysbaric disorders, and other relevant information.





For more information:

Go to:


July 16, 2007

Stingray Envenomation: A Retrospective Review of Clinical Presentation and Treatment in 119 Cases

Filed under: Interesting Newsscubadoc @ 8:45 am

Stingray Envenomation: A Retrospective Review of Clinical Presentation and Treatment in 119 Cases

Richard F. Clark MDlow asterisk, , Corresponding Author Contact Information, Robyn Heister Girard MD, Daniel Rao MDlow asterisk, , Binh T. Ly MDlow asterisk, and Daniel P. Davis MD
Department of Emergency Medicine, University of California, San Diego Medical Center, San Diego, California
low asteriskDivision of Medical Toxicology, University of California, San Diego Medical Center, San Diego, California
Received 17 January 2006;  revised 12 November 2006;  accepted 3 February 2007.  Available online 30 May 2007.


Stingray stings are common along coastal regions of this country and the world. The tail of the stingray contains a barbed stinger attached to a venom gland and contained within an integumentary sheath. During a sting, the stinger and sheath can become embedded in the soft tissue of the victim, and venom is injected into the wound. Stingray venom most often causes severe pain on contact, although the exact mechanism of toxicity is not certain. Hot water immersion of the stung extremity has been reported to be effective in relieving pain associated with the envenomation, but large studies of this therapy have not been performed. We retrospectively reviewed stingray stings presenting to our Emergency Department (ED) over an 8-year period. Cases were divided into acute (group 1, within 24 h of the sting) and subacute (group 2, 24 h or more after the sting) presentations. Charts were abstracted for information concerning the victim’s history, physical examination, treatment, diagnostic imaging, and outcome, including the effectiveness of hot water immersion as analgesia, and use of antimicrobials. A total of 119 cases were identified and abstracted, 100 in group 1 and 19 in group 2. Of the group 1 patients initially treated with hot water immersion alone, 88% had complete relief of pain within 30 min without administration of any other analgesic. In the patients who initially received a dose of analgesic along with hot water immersion, none required a second dose of analgesics and all had complete pain relief before discharge. There were no adverse effects (such as thermal burns) with this therapy. Analysis of infectious complications in group 1 patients demonstrated a significant number of patients returning to the ED with wound infections when prophylactic antibiotics were not administered at initial presentation. Our findings suggest that hot water immersion was effective in decreasing or eliminating the pain associated with stingray envenomation in our series. Due to the high potential for bacterial contamination in these puncture wounds, standard antibiotic prophylaxis may be prudent. Although stingray barbs can be radio-opaque, radiography in our series failed to detect barbs or other foreign bodies in stung extremities, although no barbs or other stinger material were found on inspection of wounds.

Keywords: stingray; sting; envenomation; venom; treatment

Corresponding Author Contact InformationReprint Address: Richard F. Clark, md, 200 W. Arbor Dr., San Diego, CA 92103-8676

Journal of Emergency Medicine
Volume 33, Issue 1, July 2007, Pages 33-37


July 12, 2007

UHMS Gulf Coast Chapter Annual Scientific Meeting

Filed under: Interesting Newsscubadoc @ 6:22 pm

Meeting Contact
Suzanne Pack
UHMS Gulf Coast Chapter

UHMS Gulf Coast Chapter Annual Scientific Meeting
August 30-September 1, 2007
Loews Vanderbilt Hotel
Nashville, Tennessee
Call for Papers

There is still room on the schedule for abstracts, original papers, or case studies. If you are interested in presenting at the 2007 UHMS Gulf Coast Chapter Meeting in Nashville, Tennessee, please submit your topic to Suzanne Pack by Monday, July 16. See the web site for submittal requirements.

Abstracts and Lectures are invited from all members of the Undersea and Hyperbaric Medical Society and those other individuals who have demonstrated a clear interest in clinical, technical and safety factors germane to the wound care and, hyperbaric and undersea environments.

Current Topic List

  • Opening Remarks - TBA
  • Edgar End Lecture - Clinical Studies in Hyperbaric Oxygen Therapy for Autism - Dan Rossignol
  • Britannic: Rebreathers and Deep Diving - John Chatterton
  • Radiation Proctitis: Results of an International RCT - Dick Clarke
  • Hyperbaric Radiation Sensitization: Review and Clinical Update - Dick Clarke
  • Mixed Gas Diving - Stephen Rydzak
  • Ethics in Wound Management: Palliative Care - Stephen Rydzak
  • Autoimmune Disorders and the Use of Hyperbaric Oxygen Therapy - Helen Gelly
  • Are You Ready For Your Survey? (TJC, UHMS,…) - Laura Josefsen
  • Identifying Decompression Illness in Divers - Joel Dovenbarger
  • Treating Divers with a Treatment Table 6 - Joel Dovenbarger
  • Treatment of DCS in Remote Locations - Tom Bozzuto
  • ABSTRACT: Hyperbaric Case Studies: Necrotizing Fasciitis - Sherry Williams
  • ABSTRACT: Retrospective study of 202 transcutaneous oxygen studies: Negative Oxygen challenge results does it mean anything? - Jayesh Shah
  • ABSTRACT: Hyperbaric Medicine at Altitude: Issues To Consider - Eugene Worth
  • Abstract: Case Discussions in Hyperbaric Medicine: To Treat or Not to Treat, That is the Question - Eugene Worth

More to Come…

For Meeting Information and Registration CLICK HERE or contact Suzanne Pack at 210-614-3688 or

July 8, 2007

PSDiver Monthly Issue 40 — July 07, 2007

Filed under: Interesting Newsscubadoc @ 10:42 am

July 07, 2007 — PSDiver Monthly Issue 40

Promoting free education, safety information and news for Fire, Police and SAR Dive and Water Rescue Teams

Issue 40 Contact Photo Issue 40 of PSDiver Monthly is now available for download
Click to launch to

  IN THIS ISSUE of PSDiver Monthly

** A young boy and his father are enjoying a sailboat ride on the lake when a sudden storm flips the boat. The 6 year old and his father are thrown into the water and are kept afloat by their lifejackets. As the sailboat sinks in over 100′ of water, the boy becomes entangled in the rigging is is pulled from his fathers grip. The ensuing search and recovery effort is intense.

**A study on heavy metal contaminates in LA Harbor.

**Flooding in various parts of the world is creatnig a variety of problems for flood and swift water rescue teams. Read about some of the events that have occured as a result of the flooding.

**News of Interest for Public Safety Dive Teams and Water Rescue and Recovery Teams

**PSDM Issue 40 Continuing Education

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Our Sponsors Include:
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Shark Marine
Rescue ONE Connector Boats
Dive Lights International
Harri s Acoustic Products
Submerssible Systems
Scuba4Less Online
Ocean Management Systems
DUI - Diving Unlimited International
Swat Headsets
Trelleborg Viking
Techical Rescue Magazine
Ocean Technology Systems
Marine Sonic Technology, Ltd
The Personal Retriever
The Public Safety Diving Association (PSDA) has recognized the PSDiver Monthly Continuing Education Program for credit towards their annual CE Renewal Requirement. See the CE section in this issue for details. OTHER AGENCIES have been invited to interact with the PSDM CE Program and may be participating soon. If you use the program, contact your training agency to see what you can do to receive CE credit.

About PSDiver Monthly

PSDiver Monthly was created as a way to help improve awareness, education and safety for Public Safety Dive Teams and Water Rescue and Recovery Teams. PSDiver Monthly subscriptions are FREE.

PSDiver Monthly is an Internet E-zine specifically designed for Public Safety Divers and Water Rescue Technicians. News articles and information from around the world as well as independent articles, special features, safety notices and continuing education will be shared in each issue.

Corporations who believe in the work that Public Safety Divers and Water Rescue and Recover Teams perform and who wish to show their support sponsor this e-zine. This is and will be the place to get the most current news affecting the Public Safety Diving and Water Rescue community as well as the most current equipment and ocassionally, special pricing from our sponsors.

Fire Department Dive Teams, EMS Dive Teams, Police Divers, SAR divers and Flood and Swift Water rescue teams should all benefit from this publication.

PSDiver Monthly Website:

FREE Internet Discussion Group for Public Safety Divers and Water Rescue and Recovery Teams

We also offer a free RELATED Discussion Group for Public Safety Divers and Water Rescue and Recovery Teams.

Founded on Dec 9, 2000 this MODERATED discussion group has over 1,200 members worldwide, and provides an incredible FREE resource for your team and team members! Being MODERATED, there is NO SPAM generated by joining!


Mark Phillips
Editor / Publisher

July 7, 2007

Hospital Under Investigation After Closing Hyperbaric Chamber

Filed under: Interesting Newsscubadoc @ 6:47 am

State officials have been asked to investigate the closure of an emergency hyperbaric chamber by a West Palm Beach hospital.Divers have protested the move by St. Mary’s Medical Center to discontinue its emergency hyperbaric oxygen services — which are used to treat “the bends.”The bends, or decompression sickness, is caused by nitrogen gas bubbles that can form in a diver’s lungs and bloodstream as he moves from deeper water toward the surface.

The results can include restricted blood flow and damaged blood vessels.The services are not available anywhere in the county, and the nearest chamber is in Miami.A spokeswoman said Florida Attorney General Bill McCollum is investigating whether St. Mary’s decision violated its purchase agreement, days after Palm Beach County Health Director Jean Malecki asked McCollum’s office to intervene.Doctors said transporting divers with the bends long distances puts patients at a greater risk because more time elapses before treatment.

July 6, 2007

Winthrop Opens New Wound Healing Center

Filed under: Interesting Newsscubadoc @ 10:11 am

Winthrop celebrates the dedication of its new Hyperbaric Medicine Center. Cutting the ribbon are (l.-r.) John DaVanzo, Trustee, Village of Mineola; Scott Gorenstein, MD, Clinical Director of the Hyperbaric Medicine Program; Daniel P. Walsh, President and CEO of Winthrop; Rochelle Battino, Administrative Director of the Wound Healing Center and Hyperbaric Medicine Program; John Collins, Winthrop’s Chief Financial Officer and Chief Operating Officer; Lewis E. Williams, MD, Medical Director of the Wound Healing Center; and Daniel Abbruzzese, Vice President for Facilities Management at Winthrop.

In response to the growing need for specialized medical care for non-healing wounds, Winthrop-University Hospital recently opened a comprehensive Wound Healing Center and Hyperbaric Medicine Program.

Non-healing wounds can occur for many reasons, from poor circulation and diabetic neuropathy to complications following surgery and even ill-fitting footwear. The need for expert wound care has increased in recent years for several reasons, including the notable rise in type 2 diabetes, which often leads to non-healing wounds in the feet and legs. Also, with people living longer, there are more senior citizens, who often require assistance with non-healing wounds.

Winthrop-University Hospital’s new comprehensive Wound Healing Center and Hyperbaric Medicine Program provides patients with expert and specialized treatment of persistent wounds. The Wound Healing Center at Winthrop employs a team approach, drawing upon the expertise of vascular surgeons, orthopaedic surgeons, plastic surgeons, podiatrists, infectious disease specialists and internists, as well as nurses, medical assistants, diabetologists and orthotists.

“Our mission is the healing of all wounds referred to us,” said Lewis E. Williams, MD, Medical Director of the Wound Healing Center. “In our evaluation and management of the patient, we take into account any adverse aspect that could interfere with the wound healing process. By utilizing the extensive resources of our Wound Healing Center and Hyperbaric Medicine Program, we can offer tremendous healing potential for our patients.”

The Center utilizes a great array of treatment options that have been made possible by recent scientific advances in wound healing. Among those options is the new Hyperbaric Medicine Program, which employs pure oxygen and atmospheric compression to promote the healing of wounds that were unresponsive to other treatments.

Hyperbaric therapy has proven to be an extremely useful tool in the treatment of non-healing wounds, and has helped many patients to avoid amputations that at one time would have been considered inevitable.

“Hyperbaric oxygen therapy has been used to treat a variety of medical conditions,” said Scott Gorenstein, MD, Clinical Director of Winthrop’s Hyperbaric Medicine Program. “Most commonly hyperbaric oxygen is used to promote healing in patients with diabetic wounds, however here at Winthrop we also look forward to treating patients with a variety of other conditions, such as the side affects from radiation therapy.”

The hyperbaric units at Winthrop are constructed of clear materials, which reduce discomfort in patients who experience confinement anxiety. They are large enough for a patient to comfortably read a book, and are equipped with individual flat-screen televisions and access to an extensive library of movies.

In addition, each hyperbaric unit at Winthrop is outfitted with a profile screen identical to the one monitored by the technician, which allows the patient to watch his or her progress throughout the treatment. The hyperbaric chambers are climate controlled for patient comfort, with two-way communication with the technician or doctor. The chambers at Winthrop are the largest individual-size units available today, able to accommodate individuals weighing up to 700 pounds.

During hyperbaric oxygen therapy treatment, the patient breathes 100 percent oxygen while enclosed in a pressurized chamber. Inhaling the pure oxygen allows greater amounts of oxygen (up to five times more than normally) to be absorbed into the bloodstream and then carried to the tissue that needs improved healing. The consistent delivery of pure oxygen to the affected site(s) encourages the growth of new blood vessels within the wound and eliminates certain poisons that may have hampered previous treatments, while improving the body’s response to infection.

Winthrop currently has three hyperbaric chambers installed, with a fourth to follow to allow for flexible and accommodating scheduling.

As a major regional healthcare provider, Winthrop provides comprehensive care to its patients. The creation of a multidisciplinary Wound Healing Center and Hyperbaric Medicine Program at Winthrop is a welcome extension of the Hospital’s commitment to providing a complete complement of care to the community.

For additional information about the Wound Healing Center and Hyperbaric Medicine Program at Winthrop, please call (516) 663-8498.

Brain damage in divers - an Editorial You Might Have Missed

Filed under: Interesting Newsscubadoc @ 10:07 am

BMJ 1997;314:689 (8 March)


Brain damage in divers

Diving itself may cause brain damage–but we need more evidence


Diving involves risk of neurological injuries. These may arise from decompression illness (a label which recognises the difficulty in distinguishing clinically decompression sickness due to gas nucleation from gas invasion caused by pulmonary barotrauma), anoxia (caused by near drowning), and the toxic effects of high partial pressures of breathing gases. The possibility that divers and others working in hyperbaric conditions may acquire neuropsychological damage without a clear history of a precipitating event is worrying. Since 1978 five international meetings have discussed this possibility, but no consensus exists whether diving per se causes brain damage.

Much of the evidence of functional abnormalities in divers with no history of decompression illness is anecdotal. Many reports describe findings in mixed groups of divers, some with and some without prior decompression illness.1 2 The most quoted study involved a snapshot assessment of intellectual function in Australian abalone divers,3 with no assessment of change over time and no controls. The psychological assessment probably failed to reflect the characteristics of these particular individuals, and their dive practices.

Nevertheless, degeneration and vasculopathy are seen after death in the brains and spinal cords of unaffected divers which resemble the abnormalities found after decompression illness.4 5 Retinal fluorescein angiography in divers with no history of decompression illness has demonstrated vasculopathy, which may be a marker for neurovascular injury.6 Concern is heightened by evidence of long term injuries to other organs, such as crippling dysbaric osteonecrosis in divers and caisson workers years after hyperbaric exposure.

When neurological damage occurs in divers the prime suspects are gas bubbles. Gas nucleation is generally accepted to be the initiating event in most of the syndromes collectively known as decompression sickness. However, free gas does not invariably lead to decompression sickness. Doppler ultrasound can detect “silent” bubbles in the venous blood of many asymptomatic divers. Most bubbles are filtered out by the pulmonary capillaries. It was once believed that a critical amount of gas nucleation was required before decompression sickness occurred. We now know that this may be true for extreme decompressions in individuals without intracardiac or pulmonary right to left shunts, but in those with a shunt a relatively small bubble load can result in paradoxical gas embolism.7 8

Decompression sickness can affect many systems, but the serious effects are neurological. There is usually abrupt or rapid evolution of a focal central neurological deficit (or deficits). The injury may be mild or severely disabling; it may be permanent or resolve spontaneously or with treatment with oxygen and recompression; episodes may recur. Clinically the spectrum of neurological decompression sickness resembles that of thromboembolic cerebrovascular disease, with one exception: decompression sickness commonly affects the spinal cord. This difference may be explained by the considerable gas load in the cord at the end of many dives compared with the gas content of an equivalent weight of brain tissue. The greater blood flow to the brain means that more gas bubbles embolise the brain, but more dissolved gas is available to amplify embolic bubbles in the cord. Conceivably recurrent subclinical decompression sickness may result in a condition analogous to multi-infarct dementia with gas embolism rather than thromboembolism as the initiator.

There are other neurological insults. During many normal dives neurological effects occur from variations in gas partial pressures. Every depth change of 7 m produces change in ambient pressure equivalent to a trip between sea level and the top of Mount Everest. The narcotic effects of nitrogen at depths of 30 m or less are well described. Narcosis is reversed by ascent but can repeated exposure cause target organ damage like repeated alcohol intoxication? Other breathing gases are also not inert at high partial pressures. Oxygen is neurotoxic. Very deep dives, during which mixtures containing helium are breathed, can result in the high pressure neurological syndrome, which causes excitatory effects including tremor, myoclonus, and convulsions. Repeated insults might produce permanent harm.

Until recently investigational techniques were too insensitive to detect neurological abnormalities in “normal” divers or even in those with clinical effects from decompression illness9. Magnetic resonance imaging seems to offer greatest promise. Reul and colleagues found more hyperintense subcortical white matter lesions in the brains of sport divers than in non-diving controls.10 The difference was due to a subgroup of divers who had multiple brain lesions. In this issue Knauth and colleagues report that multiple brain lesions on magnetic resonance scans in sport divers occur exclusively in those with large right to left shunts (presumed to be patent foramen ovale, though some may be small atrial septal defects or pulmonary arteriovenous shunts) (p 701).11

These observations are consistent with the well documented role of shunts in the pathogenesis of overt decompression illness by means of paradoxical gas embolism but extend this role to subclinical injury. This is plausible. Decompression illness is a spectrum. It may be so mild that divers do not seek treatment.8 Divers who have had decompression illness and in whom we find a large shunt often recollect mild neurological symptoms after earlier dives which they did not consider important at the time. The fact that the illness can be mild adds plausibility to studies showing an increased prevalence of subclinical lesions in divers with a large shunt but also cautions against accepting data uncritically from studies in which subjects were self selected.10 11

The results of magnetic resonance scans in others exposed to hyperbaric conditions have not been entirely consistent. Caisson workers also have an increased prevalence of brain lesions.12 Professional divers do not,13 even though necropsy evidence of pathological injury is commoner than in sport divers.5 Magnetic resonance imaging does not always reveal abnormalities in cases of clear neurological decompression illness.14 These apparent contradictions may be due to differences in imaging techniques, methods of subject recruitment, and confounding variables. Interestingly, magnetic resonance findings do not correlate with the results of psychometric tests or electroencephalograms.12 13 Further investigation into the possibility that diving per se causes brain damage is required, but we must not forget that evidence of pathological change is not proof of functional deficit.

Peter Wilmshurst, Consultant cardiologist a

a Royal Shrewsbury Hospital, Shrewsbury SY3 8XQ

Vaernes RJ, Eidsvik S. Central nervous dysfunctions after near miss accidents in diving. Aviat Space Environ Med 1982;53:803-7.

Todnem K, Nyland H, Skiedsvoll H, Svihus R, Rinck P, Kambestad BK, et al. Neurological long term consequences of deep diving. Br J Indust Med 1991;48:258-66.

Edmonds C, Boughton J. Intellectual deterioration with excessive diving (punch drunk divers). Undersea Biomed Res 1985;12:321-6.

Palmer AC, Calder IM, Hughes JT. Spinal cord degeneration in divers. Lancet 1987;ii:1365-6.

Palmer AC, Calder IM, Yates PO. Cerebral vasculopathy in divers. Neuropathol Appl Neurobiol 1992;18:113-24.

Polkinghorne PJ, Sehmi K, Cross MR, Minassian D, Bird AC. Ocular fundus lesions in divers. Lancet 1988;ii:1381-3.

Moon RE, Camporesi EM, Kisslo JA. Patent foramen ovale and decompression sickness in divers. Lancet 1989;i:513-4.

Wilmshurst PT, Byrne JC, Webb-Peploe MM. Relation between interatrial shunts and decompression sickness in divers. Lancet 1989;ii:1302-6.

Halsey MJ, Elliott DH, eds. Diagnostic techniques in diving neurology. London: Medical Research Council Decompression Sickness Panel, 1987.

Reul J, Weis J, Jung A, Willmes K, Thron A. Central nervous system lesions and cervical disc herniations in amateur divers. Lancet 1995;345:1403-5. [Medline]

Knauth M, Ries S, Pohlmann S, Kerby T, Forsting M, Daffertshofer M, et al. Multiple brain lesions in sport divers: the role of a patent foramen ovale. BMJ 1997;314:701-5.

Fueredi GA, Czarnecky DJ, Kindwall EP. MR findings in the brains of compressed-air tunnel workers: relationship to psychometric results. AJNR 1991;12:67-70

Todem K, Skeidsvoll H, Svihus R, Rinck P, Riise T, Kambestad BK, et al. Electroenceph Clin Neurophysiol 1991;79:322-9.

Warren LP, Djang WT, Moon RE, Camporesi EM, Sallee DS, Anthony DC, et al. Neuroimaging of scuba diving injuries to the CNS. AJR 1988;151:1003-8.

Environmental Tectonics Corporation announced today that it had signed a contract for 24 BARA-MED(R) monoplace chambers

Filed under: Interesting Newsscubadoc @ 10:04 am
Environmental Tectonics Corporation Receives Hyperbaric Chamber Award

PR Newswire

SOUTHAMPTON, Pa., July 5 /PRNewswire-FirstCall/ — Environmental Tectonics Corporation (”ETC” or the “Company”) announced today that it had signed a contract for 24 BARA-MED(R) monoplace chambers, valued at over two million U.S. dollars, with Koike Medical Co., Ltd., ETC’s hyperbaric distributor in Japan.

All chambers will be computer-controlled and will include ETC’s patient- friendly Smooth-Ride(TM) compression protocol. The chambers will also be outfitted with standard connectors to ensure compatibility with Radiometer and Perimed transcutaneous oxygen monitors, and with Koike Medical’s BARAMO, a hyperbaric-compatible critical care monitor that includes ECG, temperature, respiration, pulse / heart rate, and non-invasive blood pressure.

Russell E. Peterson, Ph.D., Director of the BioMedical Systems Group, stated, “The Japanese hyperbaric chamber market is one of the largest in the world and is very important to us. We are pleased that Koike Medical is continuing to expand their presence in this competitive market and are projecting significantly more sales of the BARA-MED(R) monoplace in the coming year.”

Currently, both in the United States and overseas, only a small percentage of hospitals offer hyperbaric oxygen therapy (HBO). The number of chambers is increasing, however, as the benefits of hyperbaric medicine become more widely recognized by mainstream medicine. ETC’s BioMedical Systems Group and our customers remain at the forefront of hyperbaric medicine, in equipment, research, and application. In addition to their regular use in clinical treatments at some of the best medical facilities around the world, ETC hyperbaric chambers are routinely involved in research on new indications for which HBO holds promise, and on the refinement of treatment protocols for established indications.

ETC designs, develops, installs and maintains aircrew training systems, public entertainment systems, process simulation systems (sterilization and environmental), clinical hyperbaric systems, environmental testing and simulation systems, and related products for domestic and international customers.

Contact: Duane D. Deaner, CFO
Tel: 215-355-9100 (ext. 1203)
Fax: 215-357-4000
ETC - Internet Home Page:

July 2, 2007

UHMS Gulf Coast Chapter Annual Scientific Meeting

Filed under: Interesting Newsscubadoc @ 10:05 am

UHMS Gulf Coast Chapter Annual Scientific Meeting
Loews Vanderbilt Hotel
Nashville, Tennessee
August 30 - September 1, 2007 (Labor Day Weekend)

For Registration Information CLICK HERE or go to


For More Information Contact Suzanne Pack (UHMS GCC Secretary) at 210-614-3688 or email at

Reactivated and Maintained by Centrum Nurkowe Aquanaut Diving