Case history
Case history #1
A 26-year-old male recreational diver performed 3 dives over 2 days on compressed air. His maximum depth was 42 m (128 feet), on dive 2. Average depths were 19.5 m (64 feet) overall. Dive durations were between 35 and 45 minutes. During dive 3, the diver's regulator (mouthpiece) jammed open and began to free-flow, discharging air uncontrollably. In a panic he overinflated his buoyancy jacket and ascended from 20 m (66 feet) to the surface in approximately 30 seconds. He had no immediate symptoms, and drove home, noting a twinge of pain in his right shoulder as he loaded his kit into his car. He felt extremely tired and went immediately to bed, but 4 hours later he was awakened from sleep by severe pain in his right shoulder and elbow, and he noted tingling sensations in both hands and feet. On trying to get out of bed, his legs were weak and he collapsed.
Case history #2
A 38-year-old woman had enrolled on a beginners' diving course. She is a smoker and has just recovered from acute sinusitis. On her first pool dive she found it difficult to equalise her ears on descent, but managed to 'push through' and reach a depth of 5 m (16 feet). She surfaced complaining of fullness in her left ear and muffled hearing. On her second dive, she was unable to descend past 3 m (10 feet) because of a blocked sensation in her left ear. While using considerable pressure to clear it, she felt a sudden pain in the same ear, accompanied by a feeling of cold water rushing in and intense vertigo.
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