[abstract] THE DIFFERENTIAL DIAGNOSIS OF BLACKOUT ASSOCIATED WITH DIVING

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[abstract] THE DIFFERENTIAL DIAGNOSIS OF BLACKOUT ASSOCIATED WITH DIVING

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Title: [abstract] THE DIFFERENTIAL DIAGNOSIS OF BLACKOUT ASSOCIATED WITH DIVING
Author: Strauss, MB; Aksenov, IV; Strauss, AG; France, EV
Abstract: BACKGROUND: Loss of consciousness in diving is always serious. Without immediate rescue, drowning occurs. Success depends on recognizing the cause of blackout. Differential diagnosis of blackout needs to be done almost instantaneously in order to initiate treatment and prevent irreversible brain damage. A logical classification system makes it possible to achieve this essential requirement. MATERIALS AND METHODS: A Medline search and review of major textbooks and papers and clinical experience disclosed more than 20 causes of blackout. RESULTS: The causes of blackout can be categorized into five groups. 1) Hypoxic Decreased oxygen supply to the brain (breath-holding blackout, distraction blackout, diffusional blackout, dilutional blackout, Valsalvic blackout and tank blackout) 2) Cardiovascular Decreased cardiac output (vasovagal, cardiogenic, arrhythmic, and carotogenic blackouts) 3) Narcotic Drug side effects or abnormal gas concentrations (carbon monoxide poisoning, carbon dioxide poisoning, nitrogen narcosis blackout, oxygen poisoning, drug-induced blackout and hypothermic blackout) 4) Pressure related Unphysiological pressure changes (alternobaric vertigo, pulmonary barotrauma, arterial gas embolism and decompression sickness) 5) Miscellaneous - Marine animal injuries (blood loss, toxins), head injury, co-morbid medical problems such as diabetic hypoglycmia. The problems in each category may be treated differently, but the 5-group approach enables a differential diagnosis of blackout to be made with immediate institution of the appropriate interventions. CONCLUSIONS: Our classification provides a quick identification to the specific causes of blackout associated with diving. This information leads to optimal management and the best chances for good outcomes for diving related blackout conditions.
Description: Undersea and Hyperbaric Medical Society, Inc. (http://www.uhms.org )
URI: http://archive.rubicon-foundation.org/1652
Date: 2005

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  • UHMS Meeting Abstracts
    This is a collection of the published abstracts from the Undersea and Hyperbaric Medical Society (UHMS) annual meetings.

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