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OK George, but I doubt this guy had a cerebral arterial gas embolism, in spite of what the experts have said. While the experts are correct in treating the incident as CAGE (any diver who loses consciousness upon surfacing should be treated as CAGE until proven otherwise), I vote for oxtox as the most likely cause, followed by syncope of ascent (expansion of intrathoracic gas interfering with venous return to the heart and reduced cardiac output causing fainting), followed by syncope due to postural hypotension, followed by transient hypoxia from faulty equipment or technique. The victim's rapid recovery without neurologic sequelae puts CAGE last on the list of differential diagnoses, although possible. Bottom line: an experienced mixed-gas diver decompressing on pure O2 who loses consciousness upon surfacing is probably not CAGE, but more likely oxtox seizure or syncope of ascent. Rapid, complete recovery is not likely in CAGE. MJB --- George Irvine <girvine@be*.ne*> wrote: > I don't know the whole story, Mike, but if he did have a PFO that opened or > if he did bounce up and down, a small hit might clear up pretty fast, since > he had been breathing oxygen at the time and he was immediately given oxygen > for the boat ride in, and then to the chamber right away. > > I would have thought tox if the guy were not a long time player and the dive > not enough to really expect a tox. > > I think that if there is anything to learn here, it includes dive with good > buddies, get a PFO test, and don't bounce. Other than that, I don't know > what to make of it. They are still examining the guy, so I guess we will > find out. > > The only CNS hits we ever saw in WKPP were shunt ( previously undetected) or > bounce related. The only tox we ever saw was a guy who was on seizure > medication ( not a WKPP diver, but a NOAA test subject where WKPP divers we > acting as safety divers - luckily for that guy. He did die later of the same > problem diving alone.) > > -----Original Message----- > From: Michael J. Black [mailto:mjblackmd@ya*.co*] > Sent: Saturday, February 23, 2002 10:25 AM > To: Aquanaut Mail > Cc: George Irvine > Subject: Re: AUE Keys accident > > > George, > > If this were a cerebral arterial gas embolism (vs. CNS oxtox), > there would be more symptoms and incomplete resolution, requiring > aggressive, multiple chamber treatments. The information on > the net is not consistent with CAGE, but then the net is not > often consistent with accurate information. Fortunate that the > unconscious diver was rescued by a buddy (nearby diver). > > MJB > > > __________________________________________________ > Do You Yahoo!? > Yahoo! Sports - Coverage of the 2002 Olympic Games > http://sports.yahoo.com > __________________________________________________ Do You Yahoo!? Yahoo! Sports - Coverage of the 2002 Olympic Games http://sports.yahoo.com -- Send mail for the `techdiver' mailing list to `techdiver@aquanaut.com'. Send subscribe/unsubscribe requests to `techdiver-request@aquanaut.com'.
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