![]() Although uncommon, generalized seizures at depth are often fatal, because divers may drown or arterial gas embolism may be precipitated during rescue to the surface. 18 Generalized seizures or syncope can also occur in 5 to 10 percent of patients. Symptoms develop at depth without warning and consist of focal seizures (e.g., facial or lip twitching occurs in 50 to 60 percent of patients), vertigo, nausea and emesis, paresthesias, visual constriction and respiratory changes. In general, the higher the oxygen content in the Nitrox mixture, the shallower the dive to minimize the potential for oxygen toxicity. When diving with Nitrox, the diver is at risk of oxygen toxicity if the maximum oxygen depth limit and/or the oxygen time limit is exceeded. Nitrox is a breathing mixture that contains more than 21 percent oxygen (usually 32 to 36 percent), and allows extended bottom time. In the recreational diver, the most likely cause of oxygen toxicity is diving with oxygen enriched air (i.e., Nitrox). Reduce depth and oxygen exposure, supportive care, seizure management see arterial gas embolism treatment Usually precipitated during pre-dive activities or at depthĪvoid precipitating stimuli, dive conservatively, consider prophylactic therapyįocal seizures, visual constriction, nausea, emesis, vertigo, paresthesias, rare generalized seizures Pounding, throbbing pain nausea, emesis, photophobia Usually develops within minutes of ascent, may persist without recompression treatment Severe generalized headache associated with alteration of consciousness and other signs Paresthesias/sensory loss in trunk and/or extremities, leg weakness, loss of bowel/bladder function ![]() Within 30 to 60 minutes of surfacing (> 50 percent), 90 percent by six hours significant time-depth exposure requiredĬonfusion, focal weakness, fatigue, visual loss, diplopia, speech dysfunction, gait abnormality, headache Within five minutes of surfacing (> 80 percent) or during ascent significant time-depth exposure not requiredġ00 percent oxygen, United States Navy Table 6 algorithm recompression, supportive careĪcute vertigo, nausea, emesis, nystagmus, tinnitus, sensorineural hearing loss ![]() Stupor, confusion, coma, seizures, focal weakness, visual loss Ipsilateral facial paralysis, resolves within hoursĪcute vertigo, nausea, emesis, tinnitus, sensorineural hearing loss often associated with middle ear barotraumaĮNT evaluation, bed rest, head elevation, stool softeners consider surgical exploration if symptoms persist Improved equalization techniques, oral and nasal decongestants with otorrhea use antibiotics These medications however can wear off at depth, possibly leading to complications on ascent.Acute pain, vertigo, hearing loss, rupture or hemorrhage of tympanic membraneĭuring descent usually, possible during ascent Some divers use nasal sprays or oral medications to temporary shrink swollen mucus membranes and aid sinus and middle ear equalisation. ![]() This not only makes clearing difficult, but it may prevent it altogether. The mucus membrane will retain fluid and swell, narrowing the pathways to the sinuses and the Eustachian tubes. It may indicate a pre-existing problem, most commonly from infection or allergies. ![]() If you could not equalise during a previous dive then you should not be diving until the problem is resolved. If you still can’t equalise you will have to endure the pain in order to reach the surface.
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