Annual Diving Report - Divers Alert Network

APPENDIX A. DIVE INJURY CASE REPORTS
31 minutes with 60 ffw (18 mfw) the deepest depth. She returned home to an altitude that was
500 ft (152 m) higher than the dive site.
About one hour after her last dive, she noted tightness in her chest and pain on inhalation on the
right side and in her right shoulder. She also had some shortness of breath with exertion. She
slept well but had numbness on the surface of her entire left arm the following morning. In the
afternoon, she developed tingling over her entire right leg.
The second morning, her symptoms had lessened but persisted, and she decided to seek
evaluation 48 hours after onset. A local clinic ruled out pneumothorax despite continued chest
discomfort and found no objective neurological signs despite continuing complaints of numbness
and tingling. She was recompressed on a 5-hour Table 6 with full resolution during treatment. The
final diagnosis was pain and mild neurological DCS.
Case 3 – Joint aches followed by numbness and tingling that became
worse when flying and resolved with recompression.
A 25-year-old male diver, in good health, a non-smoker, and fit and active, had been certified for
five years with advanced open water and mixed gas training. He had made seven dives in the
past year and 40 since certification.
While on vacation, he made seven dives in four days. On the first three days he made 6 dives
using a nitrox mix to a maximum depth of 90 fsw (27 msw). On the fourth day, he dived on air to
85 fsw (26 msw) for approximately 35 minutes with a brief safety stop at 15 fsw (5 msw). Upon
exiting the water at noon, he began drinking alcohol with friends and by 4 pm, felt generalized
joint aches with an unusual awkward feeling in his left arm. He went to bed and awoke the next
morning with the same aches and pains that were not relieved by over-the-counter pain
medications. He flew that afternoon and experienced new aches and pains which diminished on
landing. After spending the night, he flew again with continuing symptoms.
He was evaluated by a dive physician at which time he complained of joint aches and tingling in
his left hand. He experienced complete relief of symptoms half way through a 2.5-hr USN
Treatment Table 5.
Case 4 - Instructor doing deep dive training developed numbness and
tingling in hands and feet which resolved upon recompression.
A 33-year-old female instructor in good health and well rested had made over 200 dives in the
past year and more than 600 in the past five years. She and a student made a shore entry air
dive in 60 o F (16 o C) water wearing drysuits and using a dive computer. After a long surface swim,
they descended to 160 fsw (49 msw) where they remained for 4 minutes before descending to
200 fsw (61 msw). They surfaced after a total dive time of 20 minutes and did a 4 minute stop at
15 fsw (5 msw) with followed by a long surface swim and walk up the beach. Both divers had
been affected by nitrogen narcosis at depth and were fatigued after the long swim and walk. To
avoid urinating in her drysuit, the dive instructor had limited her fluid intake.
She had a bad headache, which was common for her after cold water diving, with unusual fatigue
and tingling in her hands and feet which she attributed to being cold even though it persisted
longer than usual. Nine hours later, she was still symptomatic and was evaluated at a local
hospital and transferred to another hospital with a chamber where she was recompressed on a
Annual Diving Report: 2006 Edition 65