Aquarius Redang Dive Centre

  • Home
  • Covid 19 INFO
  • About
  • SDI
  • Green Fins Member
  • Activity
  • Price
  • Payment
  • Booking
  • Gallery
  • Accomodation
  • Contact Us
  • Term and Condition
  • Blog
  • Marine Envenomation First Aid kit
  • Home
  • Covid 19 INFO
  • About
  • SDI
  • Green Fins Member
  • Activity
  • Price
  • Payment
  • Booking
  • Gallery
  • Accomodation
  • Contact Us
  • Term and Condition
  • Blog
  • Marine Envenomation First Aid kit

Inner Ear Barotrauma

12/12/2015

1 Comment

 
Picture
Inner Ear Barotrauma

Straining or a forceful Valsalva can cause rupture of the round or oval window , as first described by Fred Pullen in 1971. This results in a fistula with drainage of fluid into the middle ear, sensineural hearing loss, vertigo, or tinnitus and should be operated upon immediately to correct the fistula. They should not be recompressed if the above symptoms occur during a dive that has not required decompression.

Inner Ear Decompression Sickness
Here are two references to this entity:
​
1.    Inner Ear Decompression Sickness (IEDCS)--manifested by tinnitus, vertigo, nausea, vomiting, and hearing loss--is usually associated with deep air or mixed gas dives, and accompanied by other CNS symptoms of decompression sickness (DCS). Early recompression treatment is required in order to avoid permanent inner ear damage. They present an unusual case of a scuba diver suffering from IEDCS as the only manifestation of DCS following a short shallow scuba dive, successfully treated by U.S. Navy treatment table 6 and tranquilizers. This case suggests that diving medical personnel should be more aware of the possible occurrence of IEDCS among the wide population of sport scuba divers. Aviat Space Environ Med 61 (6): 563-566 (Jun 1990)

2.    Inner ear decompression sickness (IEDCS) is one form of Type II decompression sickness. Most cases of IEDCS have been associated with saturation dives, so there are very few reports of occurrence following shallow scuba dives. They present a case of a diver who suffered from IEDCS following a shallow scuba dive (30m), and was successfully treated by the protocol outlined in U.S. Navy treatment table 6. This case suggests that there is the possibility of occurrence of IEDCS, even following a shallow scuba dive, if proper decompression procedures are not adhered to. In addition, detailed analysis of diving profiles should be used to distinguish the inner ear dysfunction seen in some divers from inner ear barotrauma which may be attributable to IEDCS. Nippon Jibiinkoka Gakkai Kaiho 95 (4): 499-504 (Apr 1992).

1 Comment

ENT Guidelines for the Medical Examination of Scuba Divers

4/13/2015

2 Comments

 
Hi divers, today i will list out absolute and relative contraindication for Ear problem in Scuba Diving

Absolute Contraindications

  • Inability to equalize pressure in the middle ear by auto-inflation. This may be due to a correctable problem such as polyps, nasal septal deviation or coryza in which case the diver can be reevaluated after correction of the problem.
  • Perforation of the tympanic membrane. Until fully healed or successfully repaired with good Eustachian tube function, diving is contraindicated.
  • Open, nonhealed perforation of the TM.
  • Tympanoplasty, other than myringoplasty (Type I)
  • History of stapedectomy. * Recent studies have shown that this is not necessarily true. See this article:.
  • CONCLUSIONS: Stapedectomy does not appear to increase the risk of inner ear
    barotrauma in scuba and sky divers. These activities may be pursued with
    relative safety after stapes surgery, provided adequate eustachian tube
    function has been established.
  • History of inner ear surgery
  • Status post laryngectomy or partial laryngectomy
  • History of vestibular decompression sickness
  • Radical mastoidectomy (posterior) involving the external canal is disqualifying. (Closed childhood OK)
  • Meniere's disease is disqualifying
  • Labyrinthitis
  • Perilymphatic fistula
  • Cholesteatoma is disqualifying
  • Cerumen impactions -remove before allowing to dive.
  • Stenosis or atresia of the ear canal-disqualifying.
  • Facial paralysis secondary to barotrauma
  • Tracheostomy, tracheostoma
  • Incompetent larynx due to surgery (Cannot close for valsalva maneuver)
  • Laryngocoele  

Relative Contraindications
  • Recurrent otitis externa or media
  • Eustachian tube dysfunction
  • History of Tympanic Membrane perforation
  • Significant hearing loss in one ear
  • Midface fracture
  • Facial nerve paralysis
  • Full mouth prosthetic devices
  • Head and neck radiation
  • Migraine, severe (scotomata, CNS symptoms and stroke after diving)


Posted by tornado194 at 22:44 No comment
2 Comments

Essential recommendations to be great diver

3/5/2014

1 Comment

 
Essential recommendations to be great diver

1. Learn how to breathe. 

This is a little bit of a difficult suggestion, as a person on the significant rules of scuba diving is always to hardly ever hold your breath.
Breathe in a natural way. It may seem counterintuitive, but the much more you concentrate on how you might be respiratory, the speedier you will use your air. The simplest way is concentrating focus on what you see and doing in water rather then focus on respiration. You are SCUBA diving, love the experience!


Since you might be maintaining neutrally buoyant , you control your breathing .It is alright to concentrate in your respiratory sometimes for this objective.
In underwater ,  its not recomended to hold your breath for more than a second or two. This dangers each lung overexpansion accidents (i.e. popping like a balloon), and messing along with your blood CO2 concentrations.


2  Use dive computer.


 Most certified scuba divers are trained working with dive tables to observe blood-nitrogen stages. This permits you can get a price to ascertain how deep you are able to get your dives and for how long.
The problem along with the dive tables is they are based on your maximum depth (or perhaps a couple depths relying over the table). This is not extremely precise mainly because whilst you may consider 90% within your dive at 40ft. when you choose a pair minutes at 70ft., you can make use of the tables as though you were being at 70ft. for that complete dive.
Dive computer keep an eye on your depth many situations each individual minute (if not every single next) and work out your blood-nitrogen ranges considerably extra correctly. Dive desktops also incorporate your safety halt and also your surface the perfect time to enable the highest volume of "bottom time".

3.Swim  with only your Fins. 


Scuba divers have on fins not just to compensate for the additional drag of each of the gear worn, but additionally to permit swimming to become completed additional efficiently.
Efficiency is the key to get the most base time; exerting much less electrical power implies you breathe fewer air. Seasoned divers will often tuck or fold their arms inside of a streamline vogue and only use their arms for stabilization or when reaching to the touch or grab a thing.
Swim with reasonably straight and rigid legs to maximize thrust. Steer using your legs and fins, and make use of your lung volume to aid ease ascending or descending.
Keep away from speedy kicks along with your knees bent, or "doggie paddling." This system is inefficient, utilizing up more of the air for considerably less motion, and you simply have substantially considerably less charge of your fins. I have been on many dives in which a doggie paddler kicked and killed a lovely bit of coral or stirred up the sand so visibility turned terrible for everyone.
Make an effort to stay clear of applying your hands even though swimming. This really is difficult, especially for beginner divers. But while you strengthen your buoyancy management and discover how to do almost all of your moving all-around with your fins, you'll arrive at rely significantly less on your palms for steadiness and wonderful angle command. Notice your dive learn future time; he is probable swimming together with his arms crossed, laid out horizontally on his belly, stretched out to comprehensive length. Goal to emulate that.

4.Continue to be in good shape


 Scuba diving is a really forgiving sport; it's minimal influence and does not involve extraordinary exertion, but body fats hinders you in more way than one particular.
Overall body fat increase buoyancy, so much more bodyweight over the dive belt is required. Much larger bodies demand greater wetsuits which can be tougher for getting a good suit, in addition to provides buoyancy. Staying in form also allows you to definitely swim with a lot less drag and less work (for the many factors outlined while in the swim with all your fins part. On top of that, overall body body fat, though primarily inert, makes use of oxygen to survive, and wastes the oxygen your muscle mass could be employing.
A powerful diver can even exert significantly less strength than the usual weak diver, thus necessitating fewer oxygen.

5 .Keep properly hydrated and never fatigued. 


Dehydration is usually a hazardous state to become in even though scuba diving. The filtered air your breathe through the tank is incredibly dry (it must be, to prevent the tank from rusting), plus your are exerting a very good offer of strength even though swimming, subsequently, that you are perspiring.
Dehydration will increase the quantity of air necessary to swim due to the fact your red blood cells are certainly not doing the job to their fullest. Scuba diving even though dehydrated has also been proven to raise blood-nitrogen concentrations.
Diving while fatigued is also not a very good idea. This will bring on even bigger exhaustion or exhaustion and may induce cramps or other critical difficulties underwater. Don't press oneself much too challenging, you want your mind and physique for being leading notch before you decide to get into the h2o.
Diving that has a cold might be risky in the event your ears and sinuses are associated. In the event you elect to do that, go very slowly but surely and return to the area when you are not able to equalize. No dive is worth burst eardrums!

6.Be the very first ones within the water. 


When diving off a community boat with other divers, be sure you along with your diving buddy are suited up and able to get damp when you're permitted to acquire from the drinking water, try and be in the h2o 1st.Obtaining from the drinking water to start with will maintain you from sweltering within your wetsuit topside any more than you must. You may also reach be just one from the initial down, which means you won't pass up a point.

7.Continue being as shallow as you possibly can devoid of missing something. 


The shallower you're, the significantly less amount of compressed nitrogen is coming into your blood stream and every breath utilizes a reduce proportion with the air from a tank. This allows you to definitely remain down for a longer period on this tank, and also the lessened nitrogen will allow you to definitely continue to be down for a longer period on subsequent dives.
Do not pass up anything at all vital or incredible nevertheless. Staying able to remain underwater for any while devoid of seeing anything at all isn't considerably enjoyable, so ensure you continue to be deep enough to appreciate the beauty and marvel from the sea!

8.Make use of a snorkel around the surface instead of the regulator. 
With a snorkel you may previously have a look for the bottom in the area, whilst looking forward to your buddies. Sometimes it truly is necessary to come up with a surface area swim before you descend. A lot of people and not using a snorkel swim backwards in that circumstance, providing you do not make use of your regulator though you are still for the floor.
1 Comment

Stone FIsh

2/27/2014

1 Comment

 

Stone Fish

Synanceia is actually a genus of fish on the loved ones Synanceiidae, the Stonefishes, whose members are venomous, unsafe, and in some cases deadly to individuals. It is amongst probably the most venomous fish presently recognized during the planet.[1][2] They are found inside the coastal locations of Indo-Pacific oceans at the same time as off the coast of Florida and in the Caribbean.Synanceia are largely maritime, however some species are recognised to are living in rivers. Its species have powerful neurotoxins secreted from glands on the base of their needle-like dorsal fin spines which adhere up when disturbed or threatened.[3] The vernacular identify with the species, the stonefish, derives from the stonefish's ability to camouflage alone using a gray and mottled colour comparable to the colour of a stone.[4] Swimmers might not recognize them, and may inadvertently move on them, triggering a sting. When the stonefish is disturbed, it could inject an level of venom proportional towards the amount of pressure applied to
Picture
Picture
Picture
Dorsal Spine
Picture

Clinical sign and symptom

Picture
Local reaction with swelling, severe pain and redness at puncture site
•Most dangerous venomous fish in the world

•13 dorsal spine ,3 anal spines and 2 pelvic spines.


–Most cause local reaction
–Systemic reaction rare


–Local reaction

•Severe pain, swelling,redness,celullitis, vesicle or bullae

–Systemic reaction
•Pallor, diaphoresis,nausea,muscle weakness,dyspnoe,headahce,delirium, convulsion,hypotension,syncope


•**animal study = pulmonary hemorrhage,myotoxic,neurotoxic,hypotension primary cause of death in animal studies.

Treatment 

•Most of protein of venom are extremely labile and inactivated by heating
•Immerse the affected area in water as hot as is tolerable usually relieves pain from a sting.
•Spines should be removed
•The wound should be scrubbed and irrigated with fresh water.
•Oral antibiotics if infected.
•Suture if wound large lacerated
•Update anti tetanus
•Analgesic
•Supportive treatment if systemic reaction occur
1 Comment

Cat Fish

2/24/2014

2 Comments

 

All catfish, except members of Malapteruridae (electric catfish), possess a strong, hollow, bonified leading spine-like ray on their dorsal and pectoral fins. As a defense, these spines may be locked into place so that they stick outwards, which can inflict severe wounds.In several species catfish can use these fin rays to deliver a stinging protein if the fish is irritated.This venom is produced byglandular cells in the epidermal tissue covering the spines.In members of the family Plotosidae, and of the genus Heteropneustes, this protein is so strong it may hospitalize humans, those unfortunate enough to receive a sting; in Plotosus lineatus, the stings may result in death



Cat fish injuries
severe pain, tissue swelling and redness , muscle spasm and respiratory distress may occur


Picture
Picture
Picture
Position of spine
Picture
Close up spine





Clinical sign and symptom
Picture
Cause swelling and infected wound.Need urgent treatment at hospital
Picture
Need Surgical removal at hospital under local anesthesia
Picture
Local reaction, swelling and redness surrounding of punture site.


Treatment


•Most of protein of venom are extremely labile and inactivated by heating
•Immerse the affected area in water as hot as is tolerable usually relieves pain from a sting.
•Spines should be removed
•The wound should be scrubbed and irrigated with fresh water.
•Oral antibiotics if infected.
•Suture if wound large lacerated
•Update anti tetanus
•Analgesic
•Supportive treatment if systemic reaction occur
2 Comments

Sting Ray

2/13/2014

0 Comments

 
Most stingrays have several barbed stingers (changed from dermal denticles) on the tail, which can be used exclusively in personal-defense. The stinger may possibly reach a approximately 35 cm (14 in), as well as its underside has two lines with venom glands.The stinger is covered having a slim covering of pores and skin, the integumentary sheath, in which the venom is focused.

Stingrays will not vigorously invasion mankind, even though stings do typically take place when a ray is inadvertently stepped on.To avoid moving on a stingray in shallow drinking water, the water needs to be waded via by using a shuffle.Otherwise, prior to wading, rocks might be cast into the drinking water to scare stingrays away.Experience of the stinger leads to local stress (from the lower by itselfswelling, ) and pain muscle mass pains from your venom, and then may result in disease from harmful bacteria or fungus infection.The damage is extremely painful, but seldom daily life-harmful unless the stinger pierces a crucial region.The barb generally breaks away from the injury, and surgical procedure may be needed to eliminate the fragments.

Can happen, infamously including Steve Irwin, though fatal stings are very rare. In this case, the stinger penetrated the thoracic wall surface, resulting in substantial trauma
Picture
Picture
Picture
Picture
Picture
Close up the barb. It has sharp and saw teeth barb which can cause big laceration wound and cause serius injuries.

Clinical Sign and Symptom

Picture
Picture
Picture
Local reaction at punture site
Picture
surgical wound post removal the barb


Sting rays injuries


In a journal :

232 cases in US , 62 hospitalized,majority admitted because need surgical wound closure or secondary infection. 8 patient admitted due to systemic reaction. 2 patient death due to serous laceration wound.

Mechanism : once sting enter flesh, the integumentary sheath surrounding the spine was ruptured and the venom escapes into victim’s tissue.

Puncture site = produce large and severely lacerated wound(depends on sting rays size) , severe pain , swelling and redness at puncture site. 



Systemic rection;

Vomiting,syncope,weakness, nausea,palpitation,swwating, diahrea,cramping, cardia arrhytmias,parasthesia and convulsion may occur.


Animal study

Low concentration of toxin
•Transient vasodilation, bradycardia prolong PR interval, 1st degree heart block


Larger concentration of toxin
•2nd  or 3ed heart block, vasocontrictions, fall systemic arterial pressure, ischaemia of heart muscle. 


Lethal toxin
 vasocontriction, heart block, Low blood pressure,cardiovascular collapsed



Treatment

•Most of protein of venom are extremely labile and inactivated by heating
•Immerse the affected area in water as hot as is tolerable usually relieves pain from a sting.
•Spines should be removed
•The wound should be scrubbed and irrigated with fresh water.
•Oral antibiotics if infected.
•Suture if wound large lacerated
•Update anti tetanus
•Analgesic
Supportive treatment if systemic reaction occur


0 Comments

Lion FIsh

2/9/2014

2 Comments

 
Picture
Picture
Picture


Pterois, commonly known as lionfish, is a genus of venomous marine fish found mostly in the Indo-Pacific. Pterois is characterized by conspicuous warning coloration with red, white, creamy, or black bands, showy pectoral fins and venomous spiky fin rays.



Lion fish injuries

–Puncture site = redness,swelling
–Systemic reaction = nausea, vomiting, fever, breathing difficulties, convulsions, dizziness, headache, numbness, paresthesia (pins and needles), heartburn, diarrhea, and sweating
–Rarely caused temporary paralysis  , heart failure and even death.
–Serious life threatening if allergic reaction occur
–Animal study  = negative inotropic and chronotropic ,depressing effect on rabbit blood pressure.[22] These results are thought to be due to nitric oxide release


Clinical sign and symptom
Picture
Picture
Local reaction at punture site caused swelling, severe pain and redness.


Treatment


•Most of protein of venom are extremely labile and inactivated by heating
•Immerse the affected area in water as hot as is tolerable usually relieves pain from a sting.
•Spines should be removed
•The wound should be scrubbed and irrigated with fresh water.
•Oral antibiotics if infected.
•Suture if wound large lacerated
•Update anti tetanus
•Analgesic
•Supportive treatment if systemic reaction occur
2 Comments

Hyoid, Fire Corals and Anemones

2/1/2014

1 Comment

 
Picture
Picture
Picture
Picture
Picture

Clinical Sign

Picture
Picture
Picture
Stinging cells called nematocysts, which release thousands of tiny spring-loaded venomous darts upon contact with the skin, causing a painful rash and burning sensation. Its cause local reaction to systemic reaction for who have hypersensitive reaction.

Treatment


First Aid

Apply house vinegar (5% vinegar solution) to deactivate the stinging cells
Analgesic, topical steroid
1 Comment

Sea Urchins

1/25/2014

1 Comment

 
Picture
Picture

Clinical sign

Picture
Picture
Picture
Picture
•Sea urchins or urchins, sometimes called sea hedgehogs, are small, spiny, globular animals.
•There are c. 950 species, it was animal but in primitive shape
Picture
•2 defence mechanism

Spines
•inflict a painful wound when they penetrate human skin, but are not dangerous


Pedicellarines
•tiny, jaw-like structures that can clasp onto a diver’s skin and inject a painful poison
Picture
Picture
•Venom effects

–Severe pain, swelling and redness at puncture site
–Multiple deep puncture wounds may cause fatigue, weakness, muscle aches, shock, paralysis, and      

   respiratory failure. Death may occur.

*Neurotoxic
*Hemolytic 
*Suppresive effect on heart


(*animal study )

Treatment

•Immerse the affected area for 30-90 minutes in water as hot as the injured person can tolerate
•remove any large spines in the wound. If joint involved,need surgical removal.
•Remove the pedicellaria by applying shaving cream to the affected area and gently scrap with a razor.
•Antibiotic , Analgesic
1 Comment

Box Jellyfish

1/23/2014

3 Comments

 
Picture
•Chironex fleckeri (Phyasalia Pysalis) , Carukia barnesi and Malo kingi are some of the most venomous beings on the planet. Every tentacle has about 500,000 cnidocytes, each cnidocytes contain of nematocysts, Nematocysts is a cnidocyte is an incredible mobile made up of one huge secretory organelle or cnida (plural cnidae) that describes the phylum Cnidaria(corals, ocean anemones, hydrae, jellyfish, and so forth.). Cnidae can be used as prey capture and protection from predators. A cnidocyte fires a construction which contains the toxin, from the cnidocyst (often known as a cnida or nematocyst). This is responsible for the stings supplied by jellyfish.
Picture

Sign and Symptom

Picture
Sign and symptom

–Local reactions :  pain, hive like lesions
–Systemic : nausea,vomiting,,diahhrea,dizziness,diaphoresis,muscle cramp or spasms or death


Venom effects

–Hemolytic
–Cardiovascular toxicities
–Neurotoxicity
–Liver toxicity
–Muscular toxicity
–* research : toxic symptom dose- dependent
–> 5mg/kg = heart failure + lungs odema
–5-10 mg/kg = hearts + nervous system symp
–>10mg/kg = typical central nervous symp (convulsion,body trembling.ophisthotonus)


Treatment

Remove stingers by applying shaving foam to the sting area. Scrape the skin a razor, knife blade, or credit card
Rinse immediately with vinegar
mild hydrocortisone cream or oral antihistamine
Anti venom or antibiotic if severe reaction
3 Comments
<<Previous

    Picture

    Author

    My name Ahmad Fadzlullah Hamzah.Currently working as Medical Officer at Emergency Department Kulim Hospital,Kedah Malaysia.I'm interested in Scuba Diving and Enviromental Medicine.


    Check Price
    BOOK NOW !

    Archives

    December 2015
    April 2015
    March 2014
    February 2014
    January 2014
    December 2013

    Categories

    All

    RSS Feed

Powered by Create your own unique website with customizable templates.