Taravana Syndrome A Threat in Military BreathHold Diving

Taravana Syndrome: A Threat in Military Breath-Hold Diving (Review Article) Personal Photo Authors 1 -Lut Col. Mr Dr Hamze Shahali*: Assistant Professor, MPH & Specialist on Aerospace & Diving Medicine, CME Manager of AJA University of Medical Sciences, Iran, Tehran, hamze. shahali@ajaums. ac. ir, (Coresponding Author). 2 -Mrs Dr Azade Amir. Abadi Frahani: Specialist of Clinical & Anatomical Pathology, Iran Forensic Medical organization, Iran, Tehran, amirabadi. Azadeh @gmail. com 3 - Col. Mr Dr Abolfazl Khademi: Assistant Professor, Specialist on Aerospace & Diving Medicine, AJA University of Medical Sciences, Iran, Tehran, a. khademi@ajaums. ac. ir. 4 - Lut Col. Mr Dr Mahmood Momenzadeh: Assistant Professor, Specialist on Aerospace & Diving Medicine, AJA University of Medical Sciences, Iran, Tehran, mg_mahmood@yahoo. com. 1 Mahsa Asadi- Department of Medical Education, School of Medicine- Aia University of Medical Sciences, Tehran, Iran 13/OCT/10

Introduction Dysbaric accidents(DA) are usually referred to continuous air-supplied dives. Nonetheless diving accidents are known to occur also among breath-hold (BH) divers. BH diving accidents include the rare Taravana syndrome(TS) which firstly described by Cross in 1965. He reported professional BH pearl divers in the Tuamoto Archipelago, in the South Pacific. Paulev also Found TS in Danish military personnel previously exposed to pressure during submarine escape training. In the same year, using the U. S Navy nodecompression limits Lanphier calculated the likelihood of developing decompression sickness after repetitive breath-hold dives using specific parameters such as average diving time, depth and surface intervals. Methods: This article is a review Article, According to all articles, text books, guidelines and documentations about Challenges in Military Breath-Hold Diving. 2 Mahsa Asadi- Department of Medical Education, School of Medicine- Aia University of Medical Sciences, Tehran, Iran 13/OCT/10

Method This article is a review Article, According to all articles, text books, guidelines and documentations about Challenges in Military Breath-Hold Diving. 3 Mahsa Asadi- Department of Medical Education, School of Medicine- Aia University of Medical Sciences, Tehran, Iran 13/OCT/10

Discussion 4 Mahsa Asadi- Department of Medical Education, School of Medicine- Aia University of Medical Sciences, Tehran, Iran 13/OCT/10

Result col Col_1 Col_2 Col_3 Col_4 Row_1 11 12 13 14 Row_2 21 22 23 24 Row_3 31 32 33 34 row 5 Often called “Taravana” it presents as a complex clinical picture characterized by different combinations of complete or partial neurological disorders as nausea, euphoria, hemiparesis, visual problems, hearing impairment, dysarthria, crossed sensory numbness and minor symptoms such as nausea, dizziness, vertigo, headache and unconsciousness, and even sudden death, after repetitive BH dives with short surface intervals. In some cases the symptoms were sudden, occurring as the divers left the water, whereas in other cases they appeared 1 -2 h later, depending on the dive profile. Its predisposing factors are unclear. Although some cases have been reported in the literature, the pathophysiology and the predisposing factors of this syndrome are still unclear. Even if the genesis of these particular TS cases is still doubtful, inert gas accumulation cannot be excluded. Hyperbaric Oxygen Therapy is the choice treatment for TS. Mahsa Asadi- Department of Medical Education, School of Medicine- Aia University of Medical Sciences, Tehran, Iran 13/OCT/10

Conclusion TS is critical threat in military BH divers with repetitive shallow water diving during Marine environment conflicts. So, having enough information and skills for prevention, approach and treatment of TS is mandatory in military divers, military and civil medical crew. 6 Mahsa Asadi- Department of Medical Education, School of Medicine- Aia University of Medical Sciences, Tehran, Iran 13/OCT/10

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Final Questions • What is already known about the subject? • What could be added to the current knowledge by this study? 9 Mahsa Asadi- Department of Medical Education, School of Medicine- Aia University of Medical Sciences, Tehran, Iran 13/OCT/10