This book is designed to be a physician's guide for those interested in diving and hyperbaric environments. It is not a detailed document for the erudite researcher; rather, it is a source of information for the scuba-diving physician who is searching for answers put to him by his fellow nonmedical divers. Following the publication of The Underwater Handbook: A Guide to Physiology and Performance for the Engineer there were frequent requests for a companion volume for the physician. This book is designed to fill the void. Production of the book has been supported by the Office of Naval…mehr
This book is designed to be a physician's guide for those interested in diving and hyperbaric environments. It is not a detailed document for the erudite researcher; rather, it is a source of information for the scuba-diving physician who is searching for answers put to him by his fellow nonmedical divers. Following the publication of The Underwater Handbook: A Guide to Physiology and Performance for the Engineer there were frequent requests for a companion volume for the physician. This book is designed to fill the void. Production of the book has been supported by the Office of Naval Research and by the Bureau of Medicine and Surgery, Research and Development Command, under Navy Contract No. NOOOOI4-78-C-0604. Our heartfelt thanks go to the many authors without whose contributions the book could not have been produced. These articles are signed by the responsible authors, and the names a~e also listed alphabetically in these preliminary pages. Every chapter was officially reviewed by at least one expert in the field covered and these reviewers are also listed on these pages. Our thanks go to them for their valuable assistance. We are grateful to Marthe Beckett Kent for editing Chapter III. Our thanks also go to Mrs. Carolyn Paddon for typing and retyping the manuscripts, and to Mrs. Catherine Coppola, who so expertly handled the many fiscal affairs.
I The Diving Environment.- A. Introduction.- B. Types of Diving.- C. Natural Diving Environments.- References.- D. Man-Made Diving Environments.- References.- II Physics of Diving and Physical Effects on Divers.- A. Introduction.- B. Pressure.- C. Pathophysiology of Gases Associated With Diving.- D. Gas Laws.- E. Characteristics of Gas.- F. Buoyancy.- G. Energy in Diving.- H. Effects of Changing Pressure on the Diver.- I. Summary.- References.- III Physiology of Diving.- A. Respiration.- References.- B. Immersion Effects.- References.- C. Cardiovascular Effects.- References.- D. High Pressure Nervous Syndrome.- References.- E. Inert Gas Narcosis.- References.- F. Women and Diving.- References.- G. Monitoring of Vital Signs; Doppler Monitoring.- References.- H. Thermal Considerations.- References.- I. Metabolism and Dietary Effects.- References.- J. Hyperbaric Arthralgia.- References.- K. Vestibular and Auditory Function.- References.- L. Vision.- References.- M. Breath-Hold Diving.- References.- IV Decompression Theory.- A. Introduction.- B. Defining the Problem.- C. The Haldane Concepts.- D. Using the Haldane Concepts.- E. Post-Haldane Difficulties.- F. U.S. Navy Initiative.- G. Diffusion vs. Perfusion.- H. Data From Tunnel Workers.- I. Bubble Generation and Growth.- J. Diving Tables Today.- K. General Observations.- References.- V Immediate Medical Evaluation of the Diving Casualty.- A. Introduction.- B. Emergency Care.- C. Diagnosis.- References.- VI Diagnosis and Treatment of Decompression Sickness.- A. General Survey.- References.- B. Inner Ear Decompression Sickness.- References.- C. Neurological Forms of Decompression Sickness.- References.- D. Delay After Decompression Sickness before Diving Again.- VII Diagnosis and Treatment of Gas Embolism.- A. Pulmonary Barotrauma and Arterial Gas Embolism.- B. Pulmonary Barotrauma.- C. Arterial Gas Embolism.- References.- VIII Near-Drowning.- A. Definitions.- B. Modifying Factors.- C. History.- D. Physiological Changes.- E. Treatment.- Case Histories.- References.- IX Diagnosis and Treatment of Other Diving-Related Conditions.- A. The Unconscious Diver.- References.- B. Osteonecrosis.- References.- C. Microbes and the Diver.- References.- D. Ear and Sinuses.- References.- E. Blast.- References.- F. Dangerous Marine Life.- References.- G. Spontaneous Pneumothorax.- References.- X Emergency Treatment While under Pressure.- A. Use of Drugs and Related Substances under Diving Conditions.- References.- B. Anesthesia for Emergency Surgery under High Pressure.- References.- XI Physical and Psychological Examination for Diving.- A. Physical Standards for Diving.- Appendix A.- Appendix B.- Appendix C.- Appendix D.- Appendix E.- References.- B. Psychological Standards for Diving.- References.- XII Stress Physiology and Behavior Underwater.- A. Introduction.- B. Concept of Stress.- C. Stress in Diving.- D. Diving Accidents.- E. Diver Panic.- F. Concluding Remarks.- References.- XIII Safety Considerations.- A. Introduction.- B. The Diver.- C. The Dive.- D. Diving at Altitudes above Sea Level.- E. Flying after Diving.- F. Fire Safety.- G. Electrical Safety.- H. Blast.- I. Drowning.- J. Hazards of Marine Life.- K.Escape and Rescue.- L. Ice Diving.- References.- XIV Equipment and Procedures.- A. Treatment Chambers.- References.- References.- B. Scuba Diving.- References.- C. Surface-Supplied Diving.- D. Deep Diving and Saturation Systems.- References.- XV Diving Accident Investigation.- A. Accident Reporting.- B. Objectives of Diving Accident Investigation.- C. Authority for Investigation and Autopsy.-D. The Autopsy in Diving Accident Investigations.- E. Medical Investigation of Fatal Diving Accidents.- F. Summary.- References.- Appendixes.- Appendix A: Glossary.- Appendix B: Abbreviations and Acronyms.- Appendix C: Pressure Conversion Table.- Author Index.
I The Diving Environment.- A. Introduction.- B. Types of Diving.- C. Natural Diving Environments.- References.- D. Man-Made Diving Environments.- References.- II Physics of Diving and Physical Effects on Divers.- A. Introduction.- B. Pressure.- C. Pathophysiology of Gases Associated With Diving.- D. Gas Laws.- E. Characteristics of Gas.- F. Buoyancy.- G. Energy in Diving.- H. Effects of Changing Pressure on the Diver.- I. Summary.- References.- III Physiology of Diving.- A. Respiration.- References.- B. Immersion Effects.- References.- C. Cardiovascular Effects.- References.- D. High Pressure Nervous Syndrome.- References.- E. Inert Gas Narcosis.- References.- F. Women and Diving.- References.- G. Monitoring of Vital Signs; Doppler Monitoring.- References.- H. Thermal Considerations.- References.- I. Metabolism and Dietary Effects.- References.- J. Hyperbaric Arthralgia.- References.- K. Vestibular and Auditory Function.- References.- L. Vision.- References.- M. Breath-Hold Diving.- References.- IV Decompression Theory.- A. Introduction.- B. Defining the Problem.- C. The Haldane Concepts.- D. Using the Haldane Concepts.- E. Post-Haldane Difficulties.- F. U.S. Navy Initiative.- G. Diffusion vs. Perfusion.- H. Data From Tunnel Workers.- I. Bubble Generation and Growth.- J. Diving Tables Today.- K. General Observations.- References.- V Immediate Medical Evaluation of the Diving Casualty.- A. Introduction.- B. Emergency Care.- C. Diagnosis.- References.- VI Diagnosis and Treatment of Decompression Sickness.- A. General Survey.- References.- B. Inner Ear Decompression Sickness.- References.- C. Neurological Forms of Decompression Sickness.- References.- D. Delay After Decompression Sickness before Diving Again.- VII Diagnosis and Treatment of Gas Embolism.- A. Pulmonary Barotrauma and Arterial Gas Embolism.- B. Pulmonary Barotrauma.- C. Arterial Gas Embolism.- References.- VIII Near-Drowning.- A. Definitions.- B. Modifying Factors.- C. History.- D. Physiological Changes.- E. Treatment.- Case Histories.- References.- IX Diagnosis and Treatment of Other Diving-Related Conditions.- A. The Unconscious Diver.- References.- B. Osteonecrosis.- References.- C. Microbes and the Diver.- References.- D. Ear and Sinuses.- References.- E. Blast.- References.- F. Dangerous Marine Life.- References.- G. Spontaneous Pneumothorax.- References.- X Emergency Treatment While under Pressure.- A. Use of Drugs and Related Substances under Diving Conditions.- References.- B. Anesthesia for Emergency Surgery under High Pressure.- References.- XI Physical and Psychological Examination for Diving.- A. Physical Standards for Diving.- Appendix A.- Appendix B.- Appendix C.- Appendix D.- Appendix E.- References.- B. Psychological Standards for Diving.- References.- XII Stress Physiology and Behavior Underwater.- A. Introduction.- B. Concept of Stress.- C. Stress in Diving.- D. Diving Accidents.- E. Diver Panic.- F. Concluding Remarks.- References.- XIII Safety Considerations.- A. Introduction.- B. The Diver.- C. The Dive.- D. Diving at Altitudes above Sea Level.- E. Flying after Diving.- F. Fire Safety.- G. Electrical Safety.- H. Blast.- I. Drowning.- J. Hazards of Marine Life.- K.Escape and Rescue.- L. Ice Diving.- References.- XIV Equipment and Procedures.- A. Treatment Chambers.- References.- References.- B. Scuba Diving.- References.- C. Surface-Supplied Diving.- D. Deep Diving and Saturation Systems.- References.- XV Diving Accident Investigation.- A. Accident Reporting.- B. Objectives of Diving Accident Investigation.- C. Authority for Investigation and Autopsy.-D. The Autopsy in Diving Accident Investigations.- E. Medical Investigation of Fatal Diving Accidents.- F. Summary.- References.- Appendixes.- Appendix A: Glossary.- Appendix B: Abbreviations and Acronyms.- Appendix C: Pressure Conversion Table.- Author Index.
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