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Drunkning i samband med apparatdykning - Drowning during scuba diving Hans rnhagen Frbundslkare Svenska sportdykarfrbundet hans@ornhagen.se www.ornhagen.se www.ssdf.se HLR2014 - Om Drunkning Tylsand 3-4 juni 2014 Slide 2 Google gave 7 790 000 hits when seaching for drowning while diving in Mars 2014. After drowning, heart problems constitute the second most common cause of death among divers. Slide 3 Recreational diving, also called sportsdiving or amateur diving, is either -Breathhold diving, also called apnea diving -Or SCUBA (Self Contained Underwater Breathing Apparatus) Sometimes difficult to distinguish in statistics and reports. Anyone dressed in black in water is a diver. Slide 4 HLR2014 - Om Drunkning Tylsand 3-4 juni 2014 How dangerous is it to dive? Data on fatality risks from www.About.comwww.About.com 1 out of every 211,864 dives ends in a fatality (DAN 2010) 1 out of every 126,626 marathon runners died of sudden cardiac arrest while running a marathon between 1975-2003 (National Safety Council) 1 out of every 116,666 skydives ended in a fatality in 2000 (United States Parachuting Association). Slide 5 5 HLR2014 - Om Drunkning Tylsand 3-4 juni 2014 Slide 6 Number of fatalities during recreational scuba diving in some Nordic countries 6 HLR2014 - Om Drunkning Tylsand 3-4 juni 2014 Slide 7 From Divers Alert Network fatality statistics 2009. A total of 91 coroners reports after scuba diving fatality. HLR2014 - Om Drunkning Tylsand 3-4 juni 2014 Slide 8 Diving Fatality Data (www.divingmedicine.info) In the ANZ survey in half the deaths (56%), critical events developed when the diver was either running low or was out-of-air (LOA, OOA). When equipment was tested following death, few victims had an ample air supply remaining. The DAN survey found 41% in this situation. HLR2014 - Om Drunkning Tylsand 3-4 juni 2014 Slide 9 9 The authors conclusion regarding the most important factors contributing to 947 fatalities in recreational diving. (Denoble et al, UHM, dec 2008) Lack of breathing gas41% Separation from buddy57% Cardio vascular illness30% HLR2014 - Om Drunkning Tylsand 3-4 juni 2014 Slide 10 10 Pre existing medical illness in 947 fatalities in recreational diving in USA 1992 -2003 (Denoble et al, UHM, dec 2008) Number% Cardio vascular illness25227 Diabetes 37 4 Astma 29 3 Other lung problem 28 3 Epilepsia 11 1 HLR2014 - Om Drunkning Tylsand 3-4 juni 2014 Slide 11 11 Data frn Divers Alert Network USA, DAN 2006 HLR2014 - Om Drunkning Tylsand 3-4 juni 2014 Slide 12 Diving Fatality Data (http://www.divingmedicine.info) 90% died with their weight belt on. 56% were alone when they died. 50% did not inflate their buoyancy vest. 25% encountered their difficulty first on the surface, (50% actually died on the surface.) 10% were under training when they died. 10% were advised that they were medically unfit to dive. 5% were cave diving. 1% of rescuers became a victim. HLR2014 - Om Drunkning Tylsand 3-4 juni 2014 Slide 13 Slide 14 Slide 15 Two types of oxygen equipment for 100% oxygen breathing. Both contain 1000 NL of oxygen and have an outlet for a free-flow mask. Slide 16 HLR2014 - Om Drunkning Tylsand 3-4 juni 2014 From 2010 the European Resuscitation Council recommends ventilation to be started in water. (Soar J et al in Resuscitation. 2010;81:1400-33.) From Diving and Hyperbaric Medicine, June 2013 Rescue of drowning victims and divers: is mechanical ventilation possible underwater? A pilot study The answer is: No The reason is: The breathing valve is not built to deliver the pressure required for inflation of the immersed lung because the exhalation valve opens. Slide 17 HLR2014 - Om Drunkning Tylsand 3-4 juni 2014 Slide 18 Slide 19 Slide 20 Slide 21 Slide 22 http://www.youtube.com/watch?v=ki2D8j0Dq-Q HLR2014 - Om Drunkning Tylsand 3-4 juni 2014 Slide 23 This device will inflate your BCD before you are out of air or if you have not taken a breath in 30 sec. Profylaxis is always better than treatment Soon in a dive shop near you HLR2014 - Om Drunkning Tylsand 3-4 juni 2014 DIVO by Aventics GmbH Soon in a dive shop near you