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Date: Mon, 25 Feb 2002 16:28:26 -0800 (PST)
From: "Michael J. Black" <mjblackmd@ya*.co*>
Subject: Re: AUE Keys accident
To: Aquanaut Mail <techdiver@aquanaut.com>
The incident report at http://www.mikey.net/aue/incidentreport.htm
(thanks Xavier Merlin for posting the link) is well written and
clearly reveals a clonic-tonic seizure by the victim.  The differential
diagnoses are now, in order of probability:  1) oxtox seizure, or
2) cerebral arterial gas embolism, or 3) primary seizure disorder.
Syncope (fainting) from ascent or from postural hypotension should not
produce a seizure.  Xavier, you are correct in recognizing that the
preferred rescue position is supine, with the legs not elevated, but
it probably does not matter greatly.  The victim is undoubtedly being
evaluated by a neurologist for any seizure disorder, and the fact that
he has already had a seizure would lead some physicians to advise against
returning to diving.  Furthermore, if CAGE is felt to be the final
diagnosis, then pulmonary barotrauma has likely occurred, and again some
physicians would advise against returning to diving.  Sorry folks,
but a seizure for any reason is felt by some docs to be an absolute
contraindication to further diving.  Gotta watch the O2 (keep the pO2's
below MOD and watch the CNS O2 clock).  Hopefully this diver only
suffered an oxtox seizure, has a full recovery without residual
problems, and maybe someday will be cleared to return to diving.

MJB





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