Mailing List Archive

Mailing List: techdiver

Message Display

This procedure should, after some practice, take five minutes or less.  DCS
tends to show up after 30 to 60 minutes.  Therefore, it is not necessary to
administer the test immediately.  It can follow the initial cleanup and
storing of gear.  It should be performed as a matter of routine but most
certainly whenever a diver complains or indicates any kind of pain after a
dive.  Many divers try to shrug off a pain as 'just a little over exertion'
this exam will often detect if it is just that or more.

First ask the diver some general information questions - what is your name,
where are you ... . You should be listening for abnormal speech and\or
disorientation.

Next hold up some fingers about 18" in front of the divers face and have the
diver tell you how many.  Change the number a few times and try to relax the
diver by making this a little silly exercise.  Then hold up one finger and
ask the diver to follow your finger with their eyes while keeping their head
still.  Watch for any jerky motion of either or both eyes.  This jerking
motion is called nystagmus.

We now move to the face.  Put your fingertips against the divers jaw bone and
have them clench their teeth.  Then ask them to wrinkle their forehead.  At
this point instruct them to stick out their tongue and move it in all fout
directions.  Ask for a big smile.  In all four of the above you are looking
for the ability to perform each task and symetry of muscle use.

We not move down to the shoulders.  Have the diver tilt their head back and
swallow, watch for movement of the adam's apple.  Then place one hand on each
shoulder and have the diver shrug.  Finally place a hand on one side of the
diver's face and have them push against your hand and then check the other
side.

To check hearing rub your fingers together near the diver's ear and have them
identify the sound.  They are to close their eyes as you move your hand away
from their ear while continuing to make the sound. They need to let you know
when\where they stop hearing it and then do the other side the same way.

We now move to the rest of the body.  With the diver dressed in light clothing
and pockets empty explain that you are going to lightly run your fingertips
over their body and they should feel a normal light touch which is eqaul on
both sides of their bdies.  They need to let you know if they do not feel your
touch or if it is not even and where.  If this occures try to zero in on
exactly where it occured and you should plan to mark the area, this will be
helpful for further medical examination. Have them close their eyes and begin
tracing over their body from head to toe.  Note that the neuro pathways of the
hands and feet run with the bones so you need to trace from side to side
rather than up and down.  Try to overlap sections so as not to miss any area.

Muscle tone is next.  Have the diver place their fists together in front of
their chest with their elbows parallel to the ground.  Push gently against
their elbows first down then up and have them push against your pressure. 
Next have them pull against you as you pull their fists away from their body
and then reverse direction. Note: this is not a tug-of-war. :)  Evaluate their
grip by having them squeeze two fingers of each hand in their's.  Have the
diver sit and place a hand on their thigh and ask them to raise first one then
other, apply some equal resistance.  Finally have the diver lift a foot and
place your hand beneath it and have them press down like riding a bicycle.

Have the diver stand with their feet together and eyes closed for several
seconds just let them stand still, then ask them to walk in place bringing
each upper leg up to about parallel with the ground. Note: protect your diver
against falling while doing these tests.  The divers arms should be straight
out in front of them while their walking.  The last test involves having the
diver alternately touch their nosetip and your finger which should be about
18" in front of their nose.  Have the diver Place their index finger on their
nose tip and then you finger.  Have them change hands and repeat this several
times.

Note any lack of even responses or anything that appears abnormal.  If you are
properly trained and equipped take a blod pressure before and after each dive.
 It is a good idea to do a rapid field neuro while the diver is relaxed even a
few days or more before a dive to establish a baseline to compare later
results against.  If anything appears abnormal further medical examination is
called for and should be sought.

This is not an advertisement for Diver Rescue International but rather a
statement that their MedDive Class is not just for medical providers.  If you
do a lot of diving you or someone in your group could benefit everyone by
taking the class.  It spends a lot of time getting into diagnosis and
treatment as well as the above and affords time to practice all the skills
they have taught, you do not need to be a diver or have ever dove to take the
class.

I hope this will help and may it make your divers even safer!  Any questions
anyone has I will be delighted to answer or get an answer as I only know a few
of them :).

Coleman Sachs, SGT
Boone County (KY) Water Rescue
EMS Coordinator

Navigate by Author: [Previous] [Next] [Author Search Index]
Navigate by Subject: [Previous] [Next] [Subject Search Index]

[Send Reply] [Send Message with New Topic]

[Search Selection] [Mailing List Home] [Home]