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In Case of Emergency – The Five Minute Neuro Exam.

October 6, 2009 By Shannon

Michael and I have been diving for years without incurring or observing any serious accidents taking place.  We follow all the rules, as we have a strong aversion to the possibility of getting a case of the bends.   Even when obeying EVERY rule, however, a person may be physiologically susceptible to, or just be plain unlucky enough, to develop symptoms caused by breathing air at depth.  If there is a diver who surfaces, or exits the water with complaints that lead you to believe he may have suffered a dive related incident, or if you notice someone acting strangely, be sure to incorporate The Five Minute Neuro Examination as learned in your Stress and Rescue course while awaiting the input of medical personnel.  Components of the test are as follows:

  1. Do an orientation check.   Ask the diver his/her name, the date, and to explain what happened on their dive.  Answers to these questions may demonstrate the diver has some confusion.  Even if answers to these questions are correct, make sure general conversation is making sense.
  2. Eye test-  With the head held still, have the diver follow your hand while it moves in upwards/downwards, and in side to side directions.   Your hand should be placed approximately 18 inches from the person's face.   The eyes should track smoothly in every direction and should not exhibit any jumping/bouncing around while tracking.   Look at their peripheral vision - when are they able to see an object coming around from behind their head?  Is it symmetrical on both sides?  Shine a flash light in their eyes.  Do their pupils get smaller, then larger again when the light is removed?
  3. Forehead -  With the divers eye's closed, lightly touch their forehead and face.   Are they able to feel your touch and is it the same on both sides of the face?  Check strength by trying to open the divers eyes (from above their brow)  after they have shut them tightly.  Ask them to furrow their brow.   Is there a difference between right and left brows?
  4. Observe the divers face.  Is the diver able to pucker his lips to whistle?  Is the diver able to smile?  Have them clench their jaw and  have the examiner feel if both sides of the jaw are exhibiting equal strength.  Is sensation present?
  5. Check the ears.  With the divers eyes closed, ask them if their hearing seems normal.  Hold your hands 2 feet from the divers ear.  Rub your finger and thumb together, and gradually  move closer until the diver is able to hear you.
  6. Check the gag reflex.  Does the diver's "Adam's apple" move up  and down when you ask him to swallow?
  7. Have the diver stick their tongue out.    Make a note whether the tongue comes straight out or moves to one side or the other.
  8. Check the shoulder strength.   With your hands firmly positioned on the divers shoulders, ask them to shrug their shoulders.  Is one side stronger than the other?  Do the shoulders have any sensation here?
  9. Check arm strength.  Ask the diver to squeeze your fingers.  Is one hand stronger than the other?  Have them raise their arms to chest level straight in front of them.  Push down gently, then pull on elbows with the diver attempting to  resist the motion.  Is one side stronger than the other?  Are they able to feel both their arms?
  10. With the diver's eyes closed, check sensation their chest.
  11. With diver lying flat, have diver raise and lower their legs with resistance.  Note if there differences in strength between sides.  In standing, check balance and coordination by asking them to walk in a heel-toe fashion.   Guard closely, as falls should be avoided.  Is sensation in the legs present?

If the diver is unable to complete one of these tests, indicate which test was omitted and why.

Repeat the tests every hour.  Make sure results are documented and present them to medical personnel.

Notice how the exam moves in a head to toe direction.  The body parts are highlighted, and work their way from mind/brain to the feet.  These two things may help you remember the steps of a complete exam.  Hopefully this tool is one you'll never have to utilize, but as a responsible diver, you should review and practice it frequently so that if you find a diver in need, you'll be able to step up and help.

-- Shannon

Filed Under: Dive Tips, Safety Tagged With: ,

Avoiding a Ruptured Eardrum – Tips For a Safe Injury-Free Dive

September 23, 2009 By Mike

By Katie Plotner

Suffering a ruptured eardrum is an unfortunate and unnecessary complication of scuba diving. If you understand a couple facts about your eardrum and about scuba diving, it's actually quite easy to avoid.

What is the Eardrum?

The eardrum (also known as the tympanic membrane) is the thin membrane that separates the outer and middle ear. This important structure serves two purposes: It prevents ear infections by serving as a barrier to block bacteria from entering the middle ear, and it also allows you to hear. When sound waves strike the ear drum, it vibrates and creates nerve impulses that travel to the brain, resulting in a hearing sensation.

As you can probably guess, the two main consequences of a ruptured eardrum are possible infection and temporary hearing loss.

How Does an Eardrum Rupture?

Although a ruptured eardrum can be caused by several things, including acoustic trauma, fluid buildup from ear infections, and direct damage from foreign objects, the main concern divers need to be aware of is barotrauma (pressure-induced injury).

The middle ear is an airspace, and all air spaces are affected by changes in pressure. Whenever the pressure outside an airspace is greater than the pressure inside, the outer pressure causes the airspace to compress, unless the imbalance is equalized.

Divers call this compression a squeeze. Another common situation in which you may have felt a squeeze in your ears is being on an airplane. If your ears have ever "popped," it's most likely because of a pressure imbalance.

A squeeze can range from uncomfortable to downright painful. You most likely encounter small changes in pressure everyday; however, you don't need to consciously equalize your ears because of a built-in equalization structure known as the Eustachian tube. This tube connects your middle ear to your throat. When air passes between the middle ear and your throat through this tube, the pressure in both air spaces is equalized. Yawning, chewing, swallowing, and wiggling your jaw can also help with this.

But if this built-in equalization mechanism is so handy, why do divers sometimes run into problems with their ears?

The problem is that the Eustachian tube is an airspace too, so it is subject to changes in pressure just like the ears. As the ambient pressure of the water increases, the tube is compressed or even sealed. Without an open air passage, the middle ear compresses, and the ear drum is sucked inward due to the vacuum effect. If ears aren't equalized and the vacuum effect continues to increase, the ear drum could rupture.

What Can You Do About It?

To avoid perforating your eardrum, you need to equalize your ears often during a dive (about every 5 to 10 vertical feet). You can't yawn, chew, swallow, or wiggle your jaw while you have a regulator in your mouth, but equalizing is still very easy!

Simply pinch your nostrils shut with two fingers while you gently blow through your nose. No air should escape from your nostrils, and you should feel a slight pressure or outward bulging in your ears. Make sure not to do this forcefully, though, or you'll risk blowing your eardrum anyway...exactly what you're trying to avoid!

What To Watch Out For

When you're diving, if you notice any pain, ear ringing or buzzing, or hearing loss, you should end the dive and see a doctor.

A ruptured eardrum takes about 2 to 3 months to heal. After that, you should check with an ear, nose, and throat specialist to see if it is safe to dive again. While your normal doctor would probably use an octoscope to examine your eardrum, the ENT specialist uses a binocular microscope that is capable of detecting much smaller perforations. This is important because higher pressure levels can cause water to jet through even a tiny perforation, so you need to be sure the eardrum is completely healed before you dive again.

If you follow the tips outlined above, you'll probably never have to worry about being sidelined by a ruptured eardrum. Take it slow and follow responsible diving protocols, and you'll enjoy plenty of fun, safe, injury-free diving!

Katie Plotner is the creator and editor of http://www.fun-and-safe-scuba-diving.com a site that specializes in providing new and inexperienced scuba divers with easily-accessible information on scuba diving safety, equipment, certification, and tips for fun diving. A certified diver and lifelong ocean enthusiast, Katie is currently pursuing a degree in marine biology from the University of Rhode Island. She can be contacted at http://www.fun-and-safe-scuba-diving.com/contact.html and welcomes all questions and concerns related to diving.

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Proper Scuba Gear For Your Dive

September 5, 2009 By Mike

By Sydney Garrison

Like any sport, in scuba diving, your equipment is important to your performance. However, unlike sports such as tennis or baseball, scuba diving equipment not only allows you to perform better, it also keeps you safe and sound. When you choose to go scuba diving, you are taking a risk. While it is not one of the most dangerous sports out there, any time that you strap on an air tank and head several hundred feet below the surface, you are putting yourself in a bit of danger. Obviously, while under the water you are susceptible to any of the many creatures the live below the oceans surface.

This can include dangerous fish, eels and sharks. You also have to deal with sharp objects that may be below the surface such as coral or scraps of metal left over from ship wrecks. The biggest danger however is not being able to breathe properly under water or coming up to quickly and creating air bubbles in your lungs. Having the proper equipment and knowing how to use it can protect you from almost all of these things. As for the sharks, just keep your fingers crossed.

The first piece of equipment you will need is a wet suit. Wet suits are made of synthetic rubber and are lined with nylon fabric. A wet suit covers your entire body and will serve two purposes. Firstly, it will keep you warm when you are submerged in cold water, it does this by keeping the moisture away from your body, thus helping to regulate your core temperature. The next protection it will provide is against getting scraped or cut by something. If you brush up against coral, a wet suit will provide a barrier between your skin and the sharp object. Flippers are good to have to in order to swim easier.

The next piece of equipment is the most important. As scuba diving takes you down below the oceans surface for long periods of time, you will need to be able to breathe. The oxygen tank is therefore the most indispensable part of your gear. This tank is strapped to the divers back and pumps oxygen directly into your face and eye mask (which are obviously important as well). Depending on the length of your dive, you can get oxygen tanks with varying amounts of oxygen. You should always have a bit more than you need in case of emergencies.

Having the correct equipment will keep you safe and ensure that you have a great time exploring the depths of the ocean!

Sydney Garrison is an avid cyclist and sports enthusiast. She is also a partner in an online bike rack store.

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Tips to Be Able to Scuba Dive Safely

April 7, 2009 By Mike

Tips to Be Able to Scuba Dive Safely
By Uzi Ohana

There are many activities that you can do to be able to have some fun. Those who love nature can go hiking in the forest or climb a mountain. But for those who love the water, nothing beats going scuba diving.

Going underwater isn't just putting on a wetsuit and then jumping off the boat. Given that there are some dangers, here are some useful tips that are strictly enforced especially when taking a vacation in a private resort.

1. Those who love to rent the scuba diving equipment should be licensed to do so. This means presenting a plastic card certifying this before being able to proceed with the transaction.

Scuba diving isn't just for experienced divers. Most resorts conduct classes for beginners who can certify a beginner after a few days of training. Most of the lessons will be done in a pool so the progress of the student can be monitored in a controlled environment.

2. Going underwater and seeing the coral reef is different than going for a drive to the mall. This is because the person isn't familiar with the territory, which makes it important to always stay close with the group or the dive master.

3. Before diving from the boat, divers should always check the equipment. There are people who prepare the equipment but you should double check to make sure the oxygen gauge is full, the zippers and the locks on the wetsuit and the fins are working and the goggles aren't foggy.

People who do not check on the equipment will have to surface immediately ahead of the others thus ruining the underwater adventure.

4. Another safety tip is for you to learn the basic signs used underwater. These are usually done using sign language, which is the only way to communicate given that it is difficult to talk with a mouthpiece on.

5. The most important tip for scuba diving especially for beginners and experienced divers is to always go in the water with a partner. Studies have shown going in pairs increases the chances of being rescued in the event of an emergency.

Scuba diving is a lot of fun. By learning the basics, you will be able to enjoy the adventure over and over again in different dive spots across the country to see something different that is better than what Sea World has to offer.

I am Uzi , thank you for reading hope it was informative for you. For receiving another useful information about scuba diving please join my list at : http://www.freescuba-diving-lessons.com and enjoy from qualitative tips on a constant base. You can also visit my web content on: http://www.fun-scubadiving-lessons.com to enrich your knowledge on the subject.

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Scuba Diving Beginner Tips

April 7, 2009 By Mike

Scuba Diving Beginner Tips
By Uzi Ohana

Scuba diving is a very exciting and fun sport for different ages. However, you can't deny that it can also be a dangerous activity especially for beginners. Nevertheless if you know the essentials of scuba diving, you can ensure safety and enjoyment.

Here are some important scuba diving tips for beginners:

1. Never learn scuba diving on your own. Take diving lessons that lead to certification before you attempt scuba diving. There are many professional diving schools that can provide this.

2. Check with your doctor to see if you are fit for scuba diving. Be sure to undergo a swimming test before you take your lessons. As a beginner, you don't need to be a competitive swimmer but should at least know how to swim properly.

3. Dive only in waters which you are certified for. There are special certifications for diving under ice water, in underwater caves, and by shipwrecks. These dangerous forms of diving need special training.

4. Never go scuba diving alone. During your first dives, be sure that you aren't only accompanies by beginners.

5. Follow instruction carefully and listen to the dive group leader.

6. Each time you go scuba diving, check your equipment that everything is functioning properly. Also make sure that everything fits you well.

7. Check the weather conditions in the area where you plan to drive. Check with the local weather bureau if it is safe to dive. If you hear of a storm coming cancel your diving trip. Not only will you get wet on the way, lightning might hit the water and you could get struck.

8. Wear sun block before diving. Even if you are underwater, you can still get sunburned. And you wouldn't notice it because of the cool water.

9. Drink a lot of water whenever you are on the surface. Being surrounded by water doesn't mean that you body will get the water it needs. Many people get dehydrated while scuba diving.

10. Be aware of the symptoms and the signs of conditions such as heat exhaustion and hypothermia. Learn about the first aid treatment for these.

11. While going on the way to the diving site, be sure to protect your eyes by wearing sunglasses because the sunlight can be reflected by the water.

These are just general scuba diving tips for beginners. To know more about scuba diving, consult a licensed diving instructor.

For receiving another useful information about scuba diving please join my list at : http://www.freescuba-diving-lessons.com and enjoy from qualitative tips on a constant base. You can also visit my web content on : http://www.fun-scubadiving-lessons.com to rich your knowledge on the subject , I am uzi thank you for reading hope it was informative for you.

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