Diving Accident Evacuations by Helicopter and Immersion Pulmonary Edema

2020 ◽  
Vol 91 (10) ◽  
pp. 806-811
Author(s):  
Laëtitia Corgie ◽  
Nicolas Huiban ◽  
Jean-Michel Pontier ◽  
François-Xavier Brocq ◽  
Jean-François Boulard ◽  
...  
Keyword(s):  
Pulmonary Edema ◽  
Decompression Sickness ◽  
Mediterranean Coast ◽  
Military Hospital ◽  
Emergency Unit ◽  
Diving Accident ◽  
Landing Zone ◽  
Diving Accidents ◽  
Non Invasive Ventilation ◽  
Life Threatening

BACKGROUND: Scuba diving activities expose divers to serious accidents, which can require early hospitalization. Helicopters are used for early evacuation. On the French Mediterranean coast, rescue is made offshore mainly by a French Navy Dauphin or at a landing zone by an emergency unit EC 135 helicopter.METHODS: We retrospectively analyzed diving accidents evacuated by helicopter on the French Mediterranean coast from 1 September 2014 to 31 August 2016. We gathered data at the Center for Hyperbaric Medicine and Diving Expertise (SMHEP) of the Sainte-Anne Military Hospital (Toulon, France), the 35 F squadron at Hyres (France) Naval Air Station, and the SAMU 83 emergency unit (Toulon, France).RESULTS: A total of 23 diving accidents were evacuated offshore by Dauphin helicopter and 23 at a landing zone on the coast by EC 135 helicopter without hoist. Immersion pulmonary edema (IPE) accounted for one-third of the total diving accidents evacuated by helicopter with identified causes. It was responsible for at least half of the deaths at the dive place. A quarter of the rescued IPE victims died because of early cardiac arrest.DISCUSSION: Helicopter evacuation is indicated when vital prognosis (IPE and pulmonary overpressure in particular) or neurological functional prognosis (decompression sickness) is of concern. IPE is the primary etiology in patients with serious dive injuries that are life-threatening and who will benefit from helicopter evacuation. A non-invasive ventilation device with inspiratory support and positive expiratory pressure must be used, in particular for IPE.Corgie L, Huiban N, Pontier J-M, Brocq F-X, Boulard J-F, Monteil M. Diving accident evacuations by helicopter and immersion pulmonary edema. Aerosp Med Hum Perform. 2020; 91(10):806811.

Early application of non‐invasive ventilation for children with pulmonary edema after drowning

2021 ◽  
Author(s):  
Nihan Şık ◽  
Hüseyin Bahadır Şenol ◽  
Aykut Çağlar ◽  
Durgül Yılmaz ◽  
Murat Duman
Keyword(s):  
Pulmonary Edema ◽  
Invasive Ventilation ◽  
Early Application ◽  
Non Invasive ◽  
Non Invasive Ventilation

scholarly journals Role of Non-invasive Ventilation in Managing Life-threatening Acute Exacerbation of Interstitial Pneumonia

2010 ◽  
Vol 49 (14) ◽  
pp. 1341-1347 ◽  
Author(s):  
Keisuke Tomii ◽  
Ryo Tachikawa ◽  
Kazuo Chin ◽  
Kimihiko Murase ◽  
Tomohiro Handa ◽  
...  
Keyword(s):  
Acute Exacerbation ◽  
Interstitial Pneumonia ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Life Threatening

Severe acute pancreatitis- it's diagnosis and management- A study of 20 cases

2019 ◽  
Vol 8 (2) ◽  
pp. 17-29
Author(s):  
Mohammad Monir Hossain ◽  
S M Shakwat Hossain ◽  
Delowar Hossain
Keyword(s):  
Acute Pancreatitis ◽  
Conservative Treatment ◽  
Severe Acute Pancreatitis ◽  
Pancreatic Necrosis ◽  
Military Hospital ◽  
Fatty Tissue ◽  
Ct Findings ◽  
Contrast Enhanced Ct ◽  
Management Protocol ◽  
Life Threatening

Background: Severe acute pancreatitis is defined as pancreatitis in which there is persistent organ failure that does not resolve within 48 hours. Severe acute Pancreatitis is characterized by pancreatic necrosis, a severe systemic inflammatory response and often multiorgan failure. Severe acute pancreatitis is a serious and life threatening disease. Mortality varies from 20 to 50 percent. Objective: The objectives of this study are to develop our knowledge about presentation and diagnosis of severe acute pancreatitis, and to develop a standard management protocol to rescue that patient suffering from severe acute pancreatitis. Methods: This observational study was carried out in Combined Military Hospital (CMH) Dhaka, during the period of August 2014 - Feb 2015. A total 20 patients of severe acute pancreatitis were studied prospectively, evaluated and managed. Results: In this study, out of 20 patients 12(60%) male and 08(40%) female. Male: Female = 3:2. The youngest patient of this series was 03 years and oldest was of 55 years. First categorization of severity of acute pancreatitis was done on the basis of Ranson score. Those patients whose score is 3 or more are categorized as severe. After categorization subsequent management was planned on the basis of laboratory and CT findings. Out of 20 patients all have raised WBC, serum Calcium level decrease in 16 patients, LDH raised in 16 patients, PaO2 decrease in 14 patients, Base deficitincreased in 12 patients, and blood urea nitrate raised in 14 patients. Contrast enhanced CT scan done in all patients and 12 patients were found with reduced enhancement in pancreas, peripancreatic edema and stranding of fatty tissue and remaining 8 patients have fluid collected in peri- and retro pancreatic space. Total 12 patients were given conservative treatment. Remaining 8 patients were operated whose CT findings were reduced enhancement in pancreas and these patients were suspected for infective pancreatic necrosis. In this study 3 patients were expired. Out of these three patients, 2 patients underwent operative intervention and 1 patient was given conservative treatment. Conclusion: Severe acute pancreatitis is a life threatening condition. Its serious regional and systemic involvement causes multiple organ or system failure. Early diagnosis and effective treatment can significantly reduce the mortality and morbidity. CBMJ 2019 July: Vol. 08 No. 02 P: 17-29

A Case Report: Acute Respiratory Distress in a Patient with Anemia

2021 ◽  
Vol 8 (6) ◽  
Author(s):  
Kotnala S ◽  
◽  
Wadhawan S ◽  
Parmar GM ◽  
◽  
...  
Keyword(s):  
Case Report ◽  
Respiratory Distress ◽  
Pulmonary Edema ◽  
Cardiogenic Pulmonary Edema ◽  
Unique Case ◽  
Proper Management ◽  
Life Threatening ◽  
Timely Treatment

Acute respiratory distress can be life threatening if proper management is delayed. The cause of respiratory distress needs to be diagnosed quickly in order to administer appropriate and timely treatment. However, it is sometimes difficult to tease out various conditions that can present as acute respiratory distress. We present such a unique case of acute respiratory distress in a patient with anemia. We show how the ability to differentiate between cardiogenic and non-cardiogenic pulmonary edema can help in diagnosis and appropriate timely management of acute respiratory distress.

scholarly journals Concurrent Negative-Pressure Pulmonary Edema (NPPE) and Takotsubo Syndrome (TTS) after Upper Airway Obstruction

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Evan Harmon ◽  
Sebastian Estrada ◽  
Ryan J. Koene ◽  
Sula Mazimba ◽  
Younghoon Kwon
Keyword(s):  
Airway Obstruction ◽  
Pulmonary Edema ◽  
Negative Pressure ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Takotsubo Syndrome ◽  
Negative Pressure Pulmonary Edema ◽  
Acute Airway Obstruction ◽  
Increased Risk ◽  
Life Threatening

Upper airway obstruction is a potentially life-threatening emergency often encountered in the acute care, perioperative, and critical care settings. One important complication of acute obstruction is negative-pressure pulmonary edema (NPPE). We describe two cases of acute upper airway obstruction, both of which resulted in flash pulmonary edema complicated by acute hypoxic respiratory failure. Though NPPE was suspected, these patients were also found to have Takotsubo syndrome (TTS). Neither patient had prior cardiac disease, and both subsequently had a negative ischemic workup. Because TTS is a condition triggered by hyperadrenergic states, the acute airway obstruction alone or in combination with NPPE was the likely explanation for TTS in each case. These cases highlight the importance of also considering cardiogenic causes of pulmonary edema in the setting of upper airway obstruction, which we suspect generates a profound catecholamine surge and places patients at increased risk of TTS development.

scholarly journals Immersion Pulmonary Edema in Female Triathletes

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Eric A. Carter ◽  
Michael S. Koehle
Keyword(s):  
Pulmonary Edema ◽  
Water Immersion ◽  
Water Environment ◽  
Previous History ◽  
Signs And Symptoms ◽  
Contributing Factors ◽  
Long Distance ◽  
Oxygen Administration ◽  
Capillary Stress ◽  
Life Threatening

Pulmonary edema has been reported in SCUBA divers, apnea divers, and long-distance swimmers however, no instances of pulmonary edema in triathletes exist in the scientific literature. Pulmonary edema may cause seizures and loss of consciousness which in a water environment may become life threatening. This paper describes pulmonary edema in three female triathletes. Signs and symptoms including cough, fatigue, dyspnea, haemoptysis, and rales may occur within minutes of immersion. Contributing factors include hemodynamic changes due to water immersion, cold exposure, and exertion which elevate cardiac output, causing pulmonary capillary stress failure, resulting in extravasation of fluid into the airspace of the lung. Previous history is a major risk factor. Treatment involves immediate removal from immersion and in more serious cases, hospitalization, and oxygen administration. Immersion pulmonary edema is a critical environmental illness of which triathletes, race organizers, and medical staff, should be made aware.

scholarly journals Amlodipine overdose with hypotension and noncardiogenic pulmonary edema

2016 ◽  
Vol 13 (1) ◽  
pp. 27-29 ◽  
Author(s):  
Anish Hirachan ◽  
Sushil Baral ◽  
Miqdaadh Shareef ◽  
Rishikesh Rijal ◽  
Laxman Tibrewala
Keyword(s):  
Hospital Stay ◽  
Pulmonary Edema ◽  
Calcium Gluconate ◽  
High Flow ◽  
Suicidal Intent ◽  
High Flow Oxygen ◽  
Refractory Hypotension ◽  
Life Threatening ◽  
History Of ◽  
Threatening Situation

Amlodipine overdose can be a life threatening situation when it is manifested as noncardiogenic pulmonary edema. Treatment remains challenging when it is complicated with refractory hypotension and pulmonary edema. Here we describe a 23 year old female with history of ingestion of 45 tabs (5mg) of amlodipine as a suicidal intent and presented within 36 hours to the hospital. High flow oxygen, IV fluids, calcium gluconate infusion and antibiotics were used for the management. After 7 days of hospital stay, patient was discharged with full recovery.   Nepalese Heart Journal 2016; 13(1): 27-29

Decompression Sickness Damaging the Spinal Cord in a Scuba Diver: Case Report

1987 ◽  
Vol 3 (2) ◽  
pp. 41-45
Author(s):  
B.G. Mathew
Keyword(s):  
Spinal Cord ◽  
Decompression Sickness ◽  
The United States ◽  
Neurological Involvement ◽  
Detailed Knowledge ◽  
Type I ◽  
Type Ii ◽  
Pulmonary Barotrauma ◽  
Emergency Personnel ◽  
Diving Accidents

Scuba diving has become a popular sport resulting in an increased incidence of diving accidents. A survey done by the United States Navy from 1955 to 1960 revealed that decompression sickness (D.C.S.) is the most common serious complication experienced by scuba divers and the third most likely cause of death. The major cause is drowning and the second is arterial gas embolism from pulmonary barotrauma.D.C.S. has been classified into two groups. Type I includes the less severe forms with bubbles in the skin (“itches”), joints and other tissues. Type II includes the serious conditions with neurological involvement “staggers.” A detailed knowledge of D.C.S., commonly known as “the bends,” is essential to both divers and emergency personnel in order to minimize the morbidity and mortality associated with this condition.A case of Type II bends with spinal cord damage is presented and the condition discussed.

Evaluation of a Simplified Index of Initial Prognosis in Polytrauma

1987 ◽  
Vol 3 (1) ◽  
pp. 7-9
Author(s):  
Philippe Scherpereel ◽  
Jean-Pierre Vandenameele ◽  
Daniel Hochart ◽  
Jean-Claude Marson ◽  
Patrick Goldstein
Keyword(s):  
Emergency Care ◽  
Injury Severity ◽  
Severity Index ◽  
Spinal Trauma ◽  
Initial Assessment ◽  
Emergency Unit ◽  
Severity Scale ◽  
Injury Score ◽  
Reliable Tool ◽  
Life Threatening

Three hundred cases of polytrauma were investigated to evaluate the reliability of the Lindsey severity index. This simplified injury score can be used by paramedics or low-skilled emergency practioners to obtain a correct screening of patients and an initial prognosis on the basis of a simple injury severity scale. An evaluation by the Lindsey index was done in the field and at the emergency care unit. Results compare the final status of the patient which was obtained using the Patel score, derived from the patient's chart after his discharge. The Lindsey index demonstrated a correct assessment of the patient's status in 60% of the cases at the scene of the accident and 77% in the emergency unit. Most of the errors were due to underevaluations of the skull and spinal trauma. Patel's scale emphasizes locomotor sequellae, while skeletal injuries seldom provide life-threatening events, widely considered in the Lindsey index. Lindsey's index is a simple and reliable tool for initial assessment and a useful method of teaching.

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