Underwater and Hyperbaric Medicine

Overview of Underwater and Hyperbaric Medicine

This specialty focuses on the medical and physiological effects of diving and hyperbaric environments. It addresses diving-related illnesses such as decompression sickness and non-diving conditions like carbon monoxide poisoning and non-healing wounds using hyperbaric oxygen therapy (HBOT).

Key Diving-Related Illnesses and Treatments

1. Drowning
   • Cause: Equipment failure or behavior underwater.
   • Treatment: Emergency intervention to stabilize vital signs, followed by care and rehabilitation.
2. Arterial Gas Embolism
   • Cause: Air embolisms entering arteries due to ruptured pulmonary vessels.
   • Symptoms: Neurological issues ranging from mild to severe, potentially life-threatening.
   • Treatment: Emergency oxygen administration and advanced care in a hyperbaric center.
3. Decompression Sickness (“The Bends”)
   • Cause: Nitrogen bubbles forming due to rapid ascent.
   • Symptoms: Joint pain, fatigue, paralysis, and unconsciousness.
   • Treatment: 100% oxygen therapy and hyperbaric recompression.
4. Nitrogen Narcosis
   • Cause: High dissolved nitrogen levels affecting the nervous system.
   • Symptoms: Confusion, euphoria, and impaired judgment.
   • Treatment: Immediate ascent to a shallower depth.
5. Hypothermia
   • Cause: Exposure to cold water.
   • Symptoms: Decreased body temperature, shivering, fatigue.
   • Treatment: Warming, providing insulation, and administering warm fluids.
6. Other Conditions
   • Lung overexpansion injuries, barotrauma, and oxygen toxicity may also occur. Treatment requires expertise in hyperbaric medicine.

Non-Diving Applications of Hyperbaric Oxygen Therapy (HBOT)

1. Non-Healing Wounds
   • Conditions: Diabetic foot ulcers, pressure ulcers, venous stasis ulcers.
   • Mechanism: Increases oxygen delivery to stimulate blood vessel growth, fight infections, and reduce inflammation.
2. Carbon Monoxide Poisoning
   • Cause: Toxic gas exposure.
   • Treatment: HBOT displaces carbon monoxide from hemoglobin, restoring oxygen levels.
3. Other Indications
   • Radiation Injury: Treating damage from radiation therapy.
   • Osteomyelitis: Chronic bone infections.
   • Crush Injuries and Burns: Enhances healing and tissue regeneration.
   • Neurological Conditions: Stroke, cerebral edema, traumatic brain injuries.

Advancements in Underwater and Hyperbaric Medicine

• Dive Planning Tools: Improved computerized tables for safer dives.
• New Research Areas: Exploring HBOT in diabetic foot syndrome, burns, and severe anemia.
• Emerging Technologies: Anticipated advancements in treatment efficacy and accessibility.

When to Consult a Specialist

• Persistent Symptoms After Diving: Joint pain, confusion, breathing issues.
• Exposure to Carbon Monoxide: Headache, dizziness, or fatigue.
• Chronic Wounds: Non-healing ulcers or radiation-induced injuries.
• Neurological Symptoms: Post-stroke care or traumatic brain injury.

For precise treatment and advanced care, consult an experienced specialist in underwater and hyperbaric medicine.