Annual Diving Report - Divers Alert Network

APPENDIX A. DIVE INJURY CASE REPORTS
APPENDIX A. DIVE INJURY CASE
REPORTS
Case 1 – Infrequent teenage diver with pain and sensory symptoms
that became worse during flight and partially resolved on
recompression.
A very fit 16-year-old male in excellent health had made 10 dives in his one year of certification.
On the day of his injury, he made four dives during which he followed the divemaster. His
morning dives were to 50 fsw (15 msw) for 30-35 minutes with a short safety stop, less than 45
minutes on the surface, and a second dive to 30 fsw (9 msw) for about 30 minutes with a 2
minutes safety stop at 15 fsw (5 msw). After a 5.5 hour surface interval, he dived to 50 fsw (15
msw) for 35 minutes with no safety stop. After a 10 minute surface interval, he again dived to 50
fsw (15 msw) for approximately 30 minutes with a 3 minute safety stop. The day was trouble-free.
He awoke the following morning with mild joint aches that increased in the early afternoon. The
aching was most noticeable in his hands, knees, ankles and feet. He then developed an
uncomfortable sensation in his arms and legs and did not feel well for the remainder of the day.
He had never experienced similar symptoms.
At 42 hours after his last dive and 30 hours after the onset of symptoms, he flew home with his
family at a cabin altitude of 6,000 ft (1,829 m). His joint pain was constant with position and
movement, and he developed a slight swelling in his extremities. During the flight, the discomfort
increased from a 5 to a 7-8 on a 0-10 scale. He was seen in the local hospital emergency
department upon arrival that night. The odd skin sensations had resolved at the time of evaluation
and no other signs or symptoms were found by the examining physician.
He was recompressed on a 5 hour, U.S. Navy Treatment Table 6 with incomplete symptom relief.
There was no significant change the following morning during a 2 hour treatment. His symptoms
improved over the following week.
Case 2 – Student diver diving at altitude with multiple symptoms that
resolved with recompression 48 hours after onset.
The diver was an active 32-year-old female in good health except for smoking a pack-a-day for
15 years. She was taking an open-water certification course at an altitude of approximately 4,000
ft (1,219 m). Her first dive was to about 20 ffw (6 mfw) for 25 minutes with a slow normal ascent
followed by a 15 minute surface interval. The next dive was to 60 ffw (18 mfw) for 10 minutes with
a slow ascent to 20 ffw (6 mfw) and a 3 minute safety stop followed by a 90 minute surface
interval. Her final dive began at 20 ffw (6 mfw) for 5 minutes, progressed to 45 ffw (13 mfw) for 10
minutes, and then to about 55 ffw (18 mfw) for 3 minutes. She surfaced after a slow ascent to 20
ffw (6 mfw) over 3 minutes and a 10 minute safety stop. The total bottom time was approximately
64 Annual Diving Report: 2006 Edition