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From: "George Irvine" <girvine@be*.ne*>
To: "Michael J. Black" <mjblackmd@ya*.co*>, <trey@ne*.co*>
Cc: "Aquanaut Mail" <techdiver@aquanaut.com>
Subject: RE: AUE Keys accident
Date: Sun, 24 Feb 2002 07:12:18 -0500
I would want to agree with this except for the exposure being so short and
non repetitive, and the guy being so used to diving like this, but it was my
first suspicion as well. They are checking this guy out completely, so if
there is any damage it will show up and clarify the situation. Like you say,
with AGE there should be some residual effect, like weakness in some area or
whatever, that will show up upon proper examination.

One thing I think we would all say here - they guy need not be diving until
this is figured out and corrected if possible.

-----Original Message-----
From: Michael J. Black [mailto:mjblackmd@ya*.co*]
Sent: Saturday, February 23, 2002 8:55 PM
To: trey@ne*.co*
Cc: Aquanaut Mail
Subject: RE: AUE Keys accident


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
>
>
> __________________________________________________
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> http://sports.yahoo.com
>



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