MINOR DIVING ACCIDENTS

Any symptom, such as PINS AND NEEDLES, ITCHING, REDDISH SKIN SPOTS, JOINT OR MUSCLE PAIN, after an immersion, must be regarded as a possible beginning of Decompression Disease, so we suggest you refer immediately to Chapter 2.8, SEVERE DIVING ACCIDENTS, or ask for MEDICAL ADVICE VIA RADIO .

1. Minor or type 1 decompression disease
   
   It is basically manifested by:
   
   
   • Joint pain without arthritis, or muscular pain.
   • Itching.
   • Skin spots, especially reddish lesions and spots in thorax, shoulders and legs.
   
   These symptoms may appear immediately after immersion or minutes or hours after.
   
   If a diver shows these symptoms:
   
   
   • Place in lateral recumbent position, on the left side.
   • Give oxygen (OTHER MATERIAL OUTSIDE THE DRAWERS, first aid kits A and B; refer to Chapter 6.8, OTHER NURSING PROCEDURES) to the maximum possible concentration until the hyperbaric chamber is reached. Remove oxygen if convulsions occurs.
   • Evacuate the patient to the closest hyperbaric chamber (Chapter 2.8, SERIOUS DIVING ACCIDENT). Keep in mind that these symptoms may be due to the initial stage of a severe decompression disease. Single chambers are not recommended.
   • Ask for MEDICAL ADVICE VIA RADIO .


2. Ear lesions (otic baric trauma)
   
   In any situation, such as colds, allergies, acute and chronic rhino-pharyngeal inflammatory conditions, where it may not be possible to "compensate", it is better not to dive.
   
   
   

   Picture 7-118: Ear pressure changes while descending.

   
   
   

   Picture 7-119: Ear pressure changes while ascending.

   
   
   Nasal decongestants used sporadically may be useful, such as methoxamine (DRAWER 6, first aid kits A and B). Their regular use causes mucosa atrophy and ends up being inefficient.
   
   When it is not possible to "compensate" during immersion, ascend a little or stop where the problem has arisen. If, even when doing this, it is not possible to compensate, go back to the surface and stop diving.
   
   The baric trauma symptoms vary according to the severity of the lesions. They may appear during, after or even days after the immersion. From minor to major severity they are:
   
   
   • Blocked ear feeling (it cannot be compensated).
   • Abnormal ringing or noise.
   • Nausea. Earache
   • Hearing loss.
   • Vertigo.
   • Nostril or ear bleeding.
   
   The slow progressing deafness, common in professional divers with years of experience, may reduce pain sensibility due to hardening of the tympanic membrane. These divers may suffer a severe baric trauma without having perceived the initial warning symptoms.
   
   The treatment varies according to symptoms. General advice:
   
   
   1. Do not dive until full recovery.
   2. Antibiotics, anti inflammatory medication and analgesics, as suggested by MEDICAL ADVICE VIA RADIO .
   3. Do not give ear drops.


3. Para nasal sinuses lesions (sinusitis)
   
   The symptoms may be:
   
   
   • Forehead or face pain.
   • Blood traces or fresh blood through the nose.
   
   The treatment in minor cases should consist of antibiotics and anti inflammatory medication orally, according to MEDICAL ADVICE VIA RADIO .



4. Toothache
   
   It is due to the baric trauma on tooth decay. It may be worsened by cold water. It is not advisable to dive until the injured tooth has been repaired.
   In an acute case, give an analgesic such as paracetamol (DRAWER 3, first aid kits A, B, and C) and ask for MEDICAL ADVICE VIA RADIO .



5. Abdominal pain
   
   The gases inside the abdominal loops during ascension may expand causing an abdominal colic, with vague discomfort, belching, etc.
   The reduction in the ascending speed, or even stopping for a moment, while keeping calm. Changing position while stopping and placing the head upside down is also useful.
   To treat, refer to Chapter 8.23, GASES (BLOATING).