Drunkning i samband med apparatdykning Drowning during scuba

Drunkning i samband med apparatdykning Drowning during scuba diving Hans Örnhagen Förbundsläkare Svenska sportdykarförbundet hans@ornhagen. se www. ssdf. se HLR 2014 - Om Drunkning Tylösand 3 -4 juni 2014

Google gave 7 790 000 hits when seaching for ”drowning while diving” in Mars 2014. After drowning, heart problems constitute the second most common cause of death among divers. HLR 2014 - Om Drunkning Tylösand 3 -4 juni 2014

Recreational diving, also called sportsdiving or amateur diving is either - Breathhold diving, also called apnea diving - Or SCUBA (Self Contained Underwater Breathing Apparatus) Sometimes difficult to distinguish in statistics and reports. ”Anyone dressed in black in water is a diver. ”

How dangerous is it to dive? Data on fatality risks from www. About. com 1 out of every 211, 864 dives ends in a fatality (DAN 2010) 1 out of every 126, 626 marathon runners died of sudden cardiac arrest while running a marathon between 1975 -2003 (National Safety Council) 1 out of every 116, 666 skydives ended in a fatality in 2000 (United States Parachuting Association). HLR 2014 - Om Drunkning Tylösand 3 -4 juni 2014

9 8 Total number of fatalities during recreational scuba diving in Sweden 7 6 5 4 3 2 1 HLR 2014 - Om Drunkning Tylösand 3 -4 juni 2014 2012 2010 2008 2006 2004 2002 2000 1998 1996 1994 1992 1990 1988 1986 1984 1982 1980 1978 1976 1974 0 5

Number of fatalities during recreational scuba diving in some Nordic countries HLR 2014 - Om Drunkning Tylösand 3 -4 juni 2014 6

From Divers Alert Network fatality statistics 2009. A total of 91 coroners reports after scuba diving fatality. HLR 2014 - Om Drunkning Tylösand 3 -4 juni 2014

Diving Fatality Data (www. divingmedicine. info) • In the ANZ survey in half the deaths (56%), critical events developed when the diver was either running low or was out-of-air (LOA, OOA). • When equipment was tested following death, few victims had an ample air supply remaining. • The DAN survey found 41% in this situation. HLR 2014 - Om Drunkning Tylösand 3 -4 juni 2014

The authors conclusion regarding the most important factors contributing to 947 fatalities in recreational diving. (Denoble et al, UHM, dec 2008) • Lack of breathing gas • Separation from buddy • Cardio vascular illness HLR 2014 - Om Drunkning 41% 57% 30% Tylösand 3 -4 juni 2014 9

Pre existing medical illness in 947 fatalities in recreational diving in USA 1992 -2003 (Denoble et al, UHM, dec 2008) Number • Cardio vascular illness 252 • Diabetes 37 • Astma 29 • Other lung problem 28 • Epilepsia 11 HLR 2014 - Om Drunkning Tylösand 3 -4 juni 2014 % 27 4 3 3 1 10

Data från Divers Alert Network USA, DAN 2006 HLR 2014 - Om Drunkning Tylösand 3 -4 juni 2014 11

Diving Fatality Data (http: //www. divingmedicine. info) • 90% died with their weight belt on. • 56% were alone when they died. • 50% did not inflate their buoyancy vest. • 25% encountered their difficulty first on the surface, (50% actually died on the surface. ) • 10% were under training when they died. • 10% were advised that they were medically unfit to dive. • 5% were cave diving. • 1% of “rescuers” became a victim. HLR 2014 - Om Drunkning Tylösand 3 -4 juni 2014

HLR 2014 - Om Drunkning Tylösand 3 -4 juni 2014

Two types of oxygen equipment for 100% oxygen breathing. Both contain 1000 NL of oxygen and have an outlet for a free-flow mask. HLR 2014 - Om Drunkning Tylösand 3 -4 juni 2014

From 2010 the European Resuscitation Council recommends ventilation to be started in water. (Soar J et al in Resuscitation. 2010; 81: 1400 -33. ) From Diving and Hyperbaric Medicine, June 2013 ”Rescue of drowning victims and divers: is mechanical ventilation possible underwater? A pilot study” The answer is: No The reason is: The breathing valve is not built to deliver the pressure required for inflation of the immersed lung because the exhalation valve opens. HLR 2014 - Om Drunkning Tylösand 3 -4 juni 2014

HLR 2014 - Om Drunkning Tylösand 3 -4 juni 2014

http: //www. youtube. com/watch? v=ki 2 D 8 j 0 Dq-Q HLR 2014 - Om Drunkning Tylösand 3 -4 juni 2014

Profylaxis is always better than treatment DIVO® by Aventics Gmb. H This device will inflate your BCD before you are out of air or if you have not taken a Soon in a dive shop near you breath in 30 sec. HLR 2014 - Om Drunkning ”Soon in a dive shop near you” Tylösand 3 -4 juni 2014