Decompression sickness after a highly conservative dive in a diver with known persistent foramen ovale: Case report.

A diver returned to diving, 15 months after an episode of neuro-spinal decompression sickness (DCS) with relapse, after which she had been found to have a moderate to large provoked shunt across a persistent (patent) foramen ovale (PFO), which was not closed. She performed a single highly conservative dive in line with the recommendations contained in the 2015 position statement on PFO and diving published jointly by the South Pacific Underwater Medicine Society and the United Kingdom Sports Diving Medical Committee. An accidental Valsalva manoeuvre shortly after surfacing may have provoked initial symptoms which later progressed to DCS.

A technical diving-related burns case: treatment in a remote location.

Injuries suffered as a result of a rebreather oxygen explosion and fire occurred to a diver on vacation in the island state of Chuuk, Micronesia. The medical and logistical management of the diver in a remote location are described. The mechanism of both the fire and the subsequent blast and burn injuries are discussed.

Cerebral arterial gas embolism in a professional diver with a persistent foramen ovale.

A 33-year-old, male professional scallop diver diving on the Outer Hebrides in Scotland rapidly developed symptoms of cerebral arterial gas embolism following a provocative dive with possibly a fast ascent. During transfer by helicopter to the mainland for treatment, his symptoms improved on surface oxygen. He was recompressed on a Royal Navy Treatment Table 62 (RN TT62) with complete resolution.

Saturation treatment in shore-based chambers for divers with deteriorating cerebro-spinal decompression sickness.

Nearly 4% of all primary recompression treatments in Scotland employ saturation tables (helium/oxygen-oxygen/air or oxygen/air alone). These cases usually involve divers presenting at the surface who then develop deteriorating spinal cord injury with varying degrees of cerebral involvement. Treatment is delivered either through immediate saturation therapy or through conversion of failing or failed primary treatment.

Analyses of treatment for divers with actual or suspected decompression illness.

Introduction: We examined national and single-centre datasets in Scotland to determine any trends in the treatment of diving-related disease and to assess how the choice of first treatment may be linked to the divers' condition on referral and on discharge.

Method: Two datasets were analysed: (1) 300 divers treated for actual or suspected decompression illness by the Dunstaffnage Hyperbaric Unit (Oban) between 1972 and 2007; and (2) 536 divers treated by the Scottish recompression chamber network between 1991 and 2003 (some data were common to both sets). The type and frequency of initial and any subsequent hyperbaric treatment used were examined.

Emergency recompression: clinical audit of service delivery at a national level.

Clinical audit is an essential element to the maintenance or improvement of delivery of any medical service. During the development phase of a National Recompression Registration Service for Scotland, clinical audit was initiated to provide a standardised tool to monitor the quality of outcome with respect to the severity of presentation. A functional audit process was an essential consideration for planned future measurement of treatment efficacy at local (single hyperbaric unit) and national (multiple hyperbaric units) scales.

Comparative incidences of decompression illness in repetitive, staged, mixed-gas decompression diving: is 'dive fitness' an influencing factor?

Wreck diving at Bikini Atoll consists of a relatively standard series of decompression dives with maximum depths in the region of 45-55 metres' sea water (msw). In a typical week of diving at Bikini, divers can perform up to 12 decompression dives to these depths over seven days; on five of those days, divers can perform two decompression dives per day. All the dives employ multi-level, staged decompression schedules using air and surface-supplied nitrox containing 80% oxygen.

Two case reports of epileptic seizures related to probable cerebral arterial gas embolism.

Two cases are presented of divers suffering epileptic seizure and loss of consciousness as a result of probable cerebral arterial gas embolism (CAGE). Both cases had apparently problem-free dives with no obvious provocation for CAGE, though one case may have been having repeated embolisms for some time in their diving career. Demonstrated also is the Type III form of decompression sickness, where spinal cord disease follows CAGE in a biphasic manner.

The consequences of misinterpreting dive computers: three case studies.

Three cases are presented where there is a direct link between how the divers used their dive computers and the eventual requirement for their therapeutic recompression. The first case involves a diver with a previous history of decompression incidents making adjustments to their dive computer without understanding the outcomes of those alterations. The second case involves two divers running out of air and surfacing having missed significant amounts of decompression, caused by the dive computer not reducing their decompression obligation in actual time.