Diving and hyperbaric medicine最新文献_第7页

Self-reported vitality and health status are higher in Dutch submariners than in the general population. 荷兰潜艇艇员自我报告的活力和健康状况高于普通人群。

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2023-09-30 DOI: 10.28920/dhm53.3.218-223

Antoinette Houtkooper, Thijs T Wingelaar, Edwin L Endert, Pieter-Jan Am van Ooij

{"title":"Self-reported vitality and health status are higher in Dutch submariners than in the general population.","authors":"Antoinette Houtkooper, Thijs T Wingelaar, Edwin L Endert, Pieter-Jan Am van Ooij","doi":"10.28920/dhm53.3.218-223","DOIUrl":"10.28920/dhm53.3.218-223","url":null,"abstract":"Introduction: Living aboard submarines has a potential negative effect on health. Although studies have evaluated specific health hazards and short-term outcomes, long-term health effects have not been investigated in this population.Methods: Veteran submariners were contacted through the veterans' society and administered a World Health Organisation validated questionnaire (SF-36) assessing their physical, emotional, and social functioning. Scores were compared with those of the general (reference) population and scores in veteran submariners were differentiated by rank, time at sea and time in service. Statistical analyses were performed using the Wilcoxon signed rank and Kruskal-Wallis tests.Results: Of the 1,025 submariners approached in December 2019, 742 (72.4%) completed and returned the questionnaire before July 2020. All 742 were men, of median age 68 (interquartile range [IQR] 59-76) years (range 34-99 years). Of these subjects, 10.3% were current smokers, 64.4% were former smokers and 23.7% had never smoked. Submariners scored significantly better (P < 0.001) than the general population on all eight domains of the SF-36. Except for 'pain' and 'change in health status over the last year', scores for all domains decreased with age. Scores were not significantly affected by smoking status, rank, service, and time at sea.Conclusions: Dutch veteran submariners have better self-reported vitality and health status than the general Dutch population. Rank, service, and time at sea did not significantly affect scores of Dutch submariners.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"53 3","pages":"218-223"},"PeriodicalIF":0.8,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10735697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10306277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Delivering manual cardiopulmonary resuscitation (CPR) in a diving bell: an analysis of head-to-chest and knee-to-chest compression techniques. 在潜水钟中进行人工心肺复苏术（CPR）：头到胸部和膝盖到胸部按压技术的分析。

IF 0.9 4区医学

Diving and hyperbaric medicine Pub Date : 2023-09-30 DOI: 10.28920/dhm53.3.172-180

Graham Johnson, Philip Bryson, Nicholas Tilbury, Benjamin McGregor, Alistair Wesson, Gareth D Hughes, Gareth R Hughes, Andrew Tabner

{"title":"Delivering manual cardiopulmonary resuscitation (CPR) in a diving bell: an analysis of head-to-chest and knee-to-chest compression techniques.","authors":"Graham Johnson, Philip Bryson, Nicholas Tilbury, Benjamin McGregor, Alistair Wesson, Gareth D Hughes, Gareth R Hughes, Andrew Tabner","doi":"10.28920/dhm53.3.172-180","DOIUrl":"10.28920/dhm53.3.172-180","url":null,"abstract":"Introduction: Chest compression often cannot be administered using conventional techniques in a diving bell. Multiple alternative techniques are taught, including head-to-chest and both prone and seated knee-to-chest compressions, but there are no supporting efficacy data. This study evaluated the efficacy, safety and sustainability of these techniques.Methods: Chest compressions were delivered by a team of expert cardiopulmonary resuscitation (CPR) providers. The primary outcome was proportion of chest compressions delivered to target depth compared to conventional CPR. Techniques found to be safe and potentially effective by the study team were further trialled by 20 emergency department staff members.Results: Expert providers delivered a median of 98% (interquartile range [IQR] 1.5%) of chest compressions to the target depth using conventional CPR. Only 32% (IQR 60.8%) of head-to-chest compressions were delivered to depth; evaluation of the technique was abandoned due to adverse effects. No study team member could register sustained compression outputs using prone knee-to-chest compressions. Seated knee-to-chest were delivered to depth 12% (IQR 49%) of the time; some compression providers delivered > 90% of compressions to depth.Conclusions: Head-to-chest compressions have limited efficacy and cause harm to providers; they should not be taught or used. Prone knee-to-chest compressions are ineffective. Seated knee-to-chest compressions have poor overall efficacy but some providers deliver them well. Further research is required to establish whether this technique is feasible, effective and sustainable in a diving bell setting, and whether it can be taught and improved with practise.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"53 3","pages":"172-180"},"PeriodicalIF":0.9,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10597601/pdf/DHM-53-172.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10310532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hyperbaric oxygen treatment in children: experience in 329 patients. 329例儿童高压氧治疗经验。

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2023-09-30 DOI: 10.28920/dhm53.3.203-209

Figen Aydin

{"title":"Hyperbaric oxygen treatment in children: experience in 329 patients.","authors":"Figen Aydin","doi":"10.28920/dhm53.3.203-209","DOIUrl":"10.28920/dhm53.3.203-209","url":null,"abstract":"Introduction: Paediatric patients, like adults, may undergo hyperbaric oxygen treatment (HBOT) in both life-threatening situations and chronic diseases. There are particular challenges associated with managing paediatric patients for HBOT. This paper documents the indications, results, complications, and difficulties that occur during HBOT for a large cohort of paediatric patients and compares them with adult data in the literature. Methods used to reduce these difficulties and complications in children are also discussed.Methods: This was a 15-year retrospective review of paediatric patients treated with HBOT at two hyperbaric centres. Between January 2006 and June 2021, patients under the age of 18 who received at least one session of HBOT were included.Results: Three hundred and twenty-nine paediatric patients underwent a total of 3,164 HBOT exposures. Two-hundred and fifty-four patients (77.2%) completed treatment as planned and 218 (66.5%) achieved treatment goals without complications. Two patients treated for carbon monoxide poisoning exhibited neurological sequelae. Amputation was performed in one patient with limb ischaemia. Middle ear barotrauma events occurred in five treatments. No central nervous system oxygen toxicity was recorded during the treatments.Conclusions: This patient series indicates that HBOT can be safely performed in pediatric patients with low complication rates by taking appropriate precautions. The cooperation of hyperbaric medicine physicians and other physicians related to paediatric healthcare is important in order for more patients to benefit from this treatment. When managing intubated patients an anaesthesiologist may need to participate in the treatment in order to perform necessary interventions.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"53 3","pages":"203-209"},"PeriodicalIF":0.8,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10735713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10306278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Contemporary practices of blood glucose management in diabetic patients: a survey of hyperbaric medicine units in Australia and New Zealand. 糖尿病患者血糖管理的现代实践：对澳大利亚和新西兰高压医疗机构的调查。

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2023-09-30 DOI: 10.28920/dhm53.3.230-236

Brenda R Laupland, Kevin Laupland, Kenneth Thistlethwaite, Robert Webb

{"title":"Contemporary practices of blood glucose management in diabetic patients: a survey of hyperbaric medicine units in Australia and New Zealand.","authors":"Brenda R Laupland, Kevin Laupland, Kenneth Thistlethwaite, Robert Webb","doi":"10.28920/dhm53.3.230-236","DOIUrl":"10.28920/dhm53.3.230-236","url":null,"abstract":"Introduction: Blood glucose levels may be influenced by hyperbaric oxygen treatment (HBOT). Patients with diabetes mellitus commonly receive HBOT but there is a lack of standardised blood glucose management guidelines. We documented relevant contemporary practices applied for patients with diabetes treated in hyperbaric medicine units.Methods: A survey was administered in 2022 to the directors of all 13 accredited hyperbaric units in Australia and New Zealand to identify policies and practices related to management of patients with diabetes receiving HBOT.Results: Twelve of the 13 units routinely managed patients with diabetes. Three-quarters (9/12) used < 4 mmol·l-1 as their definition of hypoglycaemia, whereas the other three used < 5, < 3.6, and < 3 mmol·l-1. Units reported 26% (range 13-66%) of their patients have a diagnosis of diabetes of which 93% are type 2. Ten (83%) units reported specific written protocols for managing blood glucose. Protocols were more likely to be followed by nursing (73%) than medical staff (45%). Ten (83%) units routinely tested blood glucose levels on all patients with diabetes. Preferred pre-treatment values for treatments in both multiplace and monoplace chambers ranged from ≥ 4 to ≥ 8 mmol·l-1. Seven (58%) units reported continuation of routine testing throughout a treatment course with five (42%) units having criteria-based rules for discontinuing testing for stable patients over multiple treatments. Two-thirds of units were satisfied with their current policy.Conclusions: This survey highlights the burden of diabetes on patients treated with HBOT and identifies considerable variability in practices which may benefit from further study to optimise management of these patients.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"53 3","pages":"230-236"},"PeriodicalIF":0.8,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10735644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10306280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A retrospective review of the utility of chest X-rays in diving and submarine medical examinations. 胸部X光片在潜水和潜艇医学检查中的应用回顾性综述。

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2023-09-30 DOI: 10.28920/dhm53.3.237-242

Willem Aj Meintjes, LaDonna R Davids, Charles H van Wijk

{"title":"A retrospective review of the utility of chest X-rays in diving and submarine medical examinations.","authors":"Willem Aj Meintjes, LaDonna R Davids, Charles H van Wijk","doi":"10.28920/dhm53.3.237-242","DOIUrl":"10.28920/dhm53.3.237-242","url":null,"abstract":"Introduction: Performance of routine Chest X-rays (CXRs) in asymptomatic individuals to assess hyperbaric exposure risk is controversial. The radiation risk may overshadow the low yield in many settings. However, the yield may be higher in certain settings, such as tuberculosis-endemic countries. We evaluated the utility of routine CXR in diving and submarine medical examinations in South Africa.Methods: Records of 2,777 CXRs during 3,568 fitness examinations of 894 divers and submariners spanning 31 years were reviewed to determine the incidence of CXR abnormality. Associated factors were evaluated using odds ratios and a binomial logistic regression model, with a Kaplan-Meier plot to describe the duration of service until first abnormal CXR.Results: An abnormal CXR was reported in 1.1% per person year of service, yielding a cumulative incidence of 6.5% (58/894) of the study participants. Only four individuals had a clinical indication for the CXR in their medical history. A range of potential pathologies were seen, of which 15.5% were declared disqualifying and the rest (84.5%) were treated, or further investigation showed that the person could be declared fit.Conclusions: In South Africa, a routine CXR has a role to play in detecting abnormalities that are incompatible with pressure exposures. The highest number of abnormalities were found during the initial examinations and in individuals with long service records. Only four individuals had a clinical indication for their CXR during the 31-year span of our study. Similar studies should be performed to make recommendations in other countries and settings.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"53 3","pages":"237-242"},"PeriodicalIF":0.8,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10735703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10306282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Atypical distally distributed cutis marmorata decompression sickness associated with unconventional use of thermal protection in a diver with persistent foramen ovale. 一名患有持续性卵圆孔的潜水员患上了与非常规使用热保护相关的非典型分布于远端的皮肤干燥减压病。

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2023-09-30 DOI: 10.28920/dhm53.3.285-289

Petra Magri Gatt, Emily Diacono, Lyubisa Matity, Kurt Magri

引用次数: 0

Carbon monoxide poisoning: lest we forget. 一氧化碳中毒:以免我们忘记。

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2023-09-30 DOI: 10.28920/dhm53.3.292

Bruce Mathew, Gerard Laden

引用次数: 0

Snorkelling and breath-hold diving fatalities in Australian waters, 2014 to 2018. 2014年至2018年，澳大利亚水域发生的浮潜和屏气潜水死亡事件。

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2023-09-30 DOI: 10.28920/dhm53.3.210-217

John Lippmann

{"title":"Snorkelling and breath-hold diving fatalities in Australian waters, 2014 to 2018.","authors":"John Lippmann","doi":"10.28920/dhm53.3.210-217","DOIUrl":"10.28920/dhm53.3.210-217","url":null,"abstract":"Introduction: This study investigated snorkelling and breath-hold diving deaths in Australia from 2014-2018 and compared these to those from 2001-2013 to identify ongoing problems and assess the effectiveness of countermeasures.Methods: Media reports and the National Coronial Information System were searched to identify snorkelling/breath-hold diving deaths for 2014-2018, inclusive. Data were extracted from witness and police reports, medical histories, and autopsies. An Excel® database was created and a chain of events analysis conducted. Comparisons were made with the earlier report.Results: Ninety-one fatalities (78 males, 13 females, median age 48 years [range 16-80]) were identified with one third likely doing some breath-hold diving. Fifty-two of 77 with known body mass index were overweight or obese. Approximately two thirds were inexperienced snorkellers and 64 were alone. Fifty-one were tourists. Planning shortcomings, such as solo diving and diving in adverse conditions, as well as pre-existing health conditions and inexperience predisposed to many incidents. Primary drowning was the likely disabling condition in 39% of cases with drowning recorded as the cause of death (COD) in two thirds. Cardiac events were the likely disabling conditions in 31% although recorded as the COD in 21% of cases.Conclusions: Increasing age, obesity and associated cardiac disease have become increasingly prevalent in snorkelling deaths and there is a need for improved health surveillance and risk management. Closer supervision of inexperienced snorkellers is indicated. Apnoeic hypoxia from extended breath-holding and poor supervision remain a problem. The increased risk of harvesting seafood in areas frequented by large marine predators needs to be appreciated and managed appropriately.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"53 3","pages":"210-217"},"PeriodicalIF":0.8,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10751292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10306276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A retrospective review of divers treated for inner ear decompression sickness at Fiona Stanley Hospital hyperbaric medicine unit 2014-2020. 2014-2020年Fiona斯坦利医院高压医疗室接受内耳减压病治疗的潜水员的回顾性回顾。

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2023-09-30 DOI: 10.28920/dhm53.3.243-250

Jeremy S Mason, Peter Buzzacott, Ian C Gawthrope, Neil D Banham

{"title":"A retrospective review of divers treated for inner ear decompression sickness at Fiona Stanley Hospital hyperbaric medicine unit 2014-2020.","authors":"Jeremy S Mason, Peter Buzzacott, Ian C Gawthrope, Neil D Banham","doi":"10.28920/dhm53.3.243-250","DOIUrl":"10.28920/dhm53.3.243-250","url":null,"abstract":"Introduction: Inner ear decompression sickness (IEDCS) is increasingly recognised in recreational diving, with the inner ear particularly vulnerable to decompression sickness in divers with a right-to-left shunt, such as is possible through a persistent (patent) foramen ovale (PFO). A review of patients treated for IEDCS at Fiona Stanley Hospital Hyperbaric Medicine Unit (FSH HMU) in Western Australia was performed to examine the epidemiology, risk factors for developing this condition, the treatment administered and the outcomes of this patient population.Methods: A retrospective review of all divers treated for IEDCS from the opening of the FSH HMU on 17 November 2014 to 31 December 2020 was performed. Patients were included if presenting with vestibular or cochlear dysfunction within 24 hours of surfacing from a dive, and excluded if demonstrating features of inner ear barotrauma.Results: There were a total of 23 IEDCS patients and 24 cases of IEDCS included for analysis, with 88% experiencing vestibular manifestations and 38% cochlear. Median dive time was 40 minutes and median maximum depth was 24.5 metres. The median time from surfacing to hyperbaric oxygen treatment (HBOT) was 22 hours. Vestibulocochlear symptoms fully resolved in 67% and complete symptom recovery was achieved in 58%. A PFO was found in 6 of 10 patients who subsequently underwent investigation with bubble contrast echocardiography upon follow-up.Conclusions: IEDCS occurred predominantly after non-technical repetitive air dives and ongoing symptoms and signs were often observed after HBOT. Appropriate follow-up is required given the high prevalence of PFO in these patients.","PeriodicalId":11296,"journal":{"name":"Diving and hyperbaric medicine","volume":"53 3","pages":"243-250"},"PeriodicalIF":0.8,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10735645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10299457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Response to Metelkina and Barbaud. 对Metelkina和Barbaud的回应。

IF 0.8 4区医学

Diving and hyperbaric medicine Pub Date : 2023-09-30 DOI: 10.28920/dhm53.3.291

Oscar Plogmark, Carl Hjelte, Magnus Ekström, Oskar Frånberg

引用次数: 0