Tag Archives: Health

Scuba Diving Safety Tips

Fotografía hecha en Playa del Carmen, México, ...

(Photo credit: Wikipedia)

Whether you are a seasoned diver or you are just learning how to dive, there’s a lot to learn and remember when it comes to diving. I am going to go over some handy tips that will help to keep you safe on your next dive.

  1. Get Certified – First and foremost, NEVER scuba dive unless you have been properly trained and are certified as a scuba diver by a recognized scuba training agency. Such training will make you aware of the more common problems you will face underwater, and how to reduce the likelihood of these problems occurring.
  2. Get A Checkup – Some medical conditions are not compatible with safe diving, while other conditions may allow you to dive safely with caution. Only a physician knowledgeable with scuba diving will be able to properly advise you as to your medical situation regarding scuba diving. Scuba diving requires a lot of strenuous physical activity and can be demanding on the body. A dive physical can help you identify any problems that you may not have even known about beforehand. Studies have shown that about ¼ to ⅓ of all scuba diving fatalities are from heart and/or circulatory problems.
  3. Relax – Being relaxed and comfortable underwater is key to a successful dive. If something happens:
    1. Stop
    2. Breathe
    3. Think
    4. Act

    The worst thing that you could do is to panic, it could make a manageable situation unmanageable very quickly.

  4. Never Hold Your Breath – Never holding your breath while scuba diving is the cardinal rule of diving. Always breathe as normally as possible to avoid the potential of lung over-expansion injuries. Delaying exhaling while ascending can cause damage to the alveoli in your lungs, and can therefore cause severe lung injury, and in extreme cases, death. Also remember to exchange carbon dioxide for good clean air by breathing deeply and slowly.
  5. Have Good Buoyancy and Secure Gear – Be sure your buoyancy skills are well honed before you go diving in any fragile environments. Coral takes hundreds of years to form and thrive, only growing about one inch each decade. Fragile sea fans and corals can be destroyed with the kick of a fin. Please make sure your feet are up and that you are always aware of your surroundings and your own placement in the water. Clip gauges, spare regulators, and other dangling equipment to your BC or secure it in pockets, so that you help save the environment and also to keep you from becoming entangled in fishing line or other objects underwater.
  6. Be Conservative – Dive tables or computer limits do not necessarily constitute a boundary between “bends” or “no-bends” and cannot guarantee that you will not suffer from Decompression Illness. The diving decisions you make should be based upon current suggested safety guidelines for diving and your own unique circumstances while diving.
  7. Keep to the limits — Stay well within the guidelines of the table or computer you’re using, and allow an appropriate surface interval between dives.
  8. Be Flexible – Be prepared to modify your dive plan for unanticipated factors such as exertion, cold or depth and personal physiological factors affected by your activities before, during and after diving.
  9. Be Prepared to Dive — Make sure you’re rested, healthy, well hydrated and well-nourished prior to your diving activities.
  10. Avoid Alcohol – Never drink alcohol before or between dives. Along with the inebriating effects that alcohol can cause including slowing down reaction times, it can also make the body dehydrated which can cause serious problems while diving.
  11. Equalize — Begin equalizing before your head submerges and continue to equalize frequently during descent.
  12. Descend feet first — This slows your descent some and makes it easier to equalize your ears.
  13. Ascend slowly — Always ascend at the rate of 30 feet / 9.1 meters per minute or slower.
  14. Make a safety stop — for three to five minutes at 10-15 feet / 3-4.5 meters on all dives.

Stingray Sting Treatment

Hawaiian Stingray

Hawaiian Stingray

A distant cousin of the shark, Stingrays and other rays like skates, electric rays, guitarfishes and sawfishes are classified as Batoidea, a type of cartilaginous fish and have around 500 species in thirteen families.

They are pretty widespread and can be found in seas on the floor, across the world in both temperate and cold-water. The manta is an exception living in open waters and a few fresh water species living in brackish bays and estuaries.

Most species of rays have flat bodies that facilitate them to effectively conceal themselves in their environment which is the sea bed. Their disc like shape (in most ray species) have five ventral slot-like body openings called gill slits that lead from the gills and their mouths on the undersides. Because their eyes are on top of their bodies they cannot see their prey and use smell and electro-receptors similar to those of sharks.

There are nine known species of rays found in Hawaiian waters, divided into three distinct categories, Manta, Eagle, and Stingray. The most common stingray in Hawaii is the broad stingray, sometimes referred to as the Hawaiian, brown or whip-tail stingray pictured above.

The Hawaiian stingray has a diamond-shaped body similar to the diamond stingray. The Hawaiian stingray can grow to over 5 feet wide, but few of this size are rarely seen any more. Their tails are twice as long as their body length and are equipped with venomous spines similar to a serrated-edged knife which it uses for defense.

The most common injury from a stingray comes from accidentally stepping on one which will cause its tail to whip around and being driven into the victims leg or foot.

To avoid being stung by a stingray, use care when wading in sandy-bottomed shallow water. A good preventive measure is to do the “stingray shuffle.” Slowly slide or shuffle your feet in the sand. Any stingrays in the area are likely to retreat as fast as possible.

To treat a Stingray sting follow these simple steps:

  1. Immediately wash the area with fresh water.
  2. DO NOT remove any visible spines from the wound, leave this for trained medical personnel as the spines are barbed and may cause more damage to flesh when being removed.
  3. Use direct pressure with gauze pads to control bleeding.
  4. Soak the affected area in warm water (110°F to 113°F) for 30 to 90 minutes to denature the toxins.
  5. Administration of analgesia (never use aspirin in conjunction with hot water treatments).
  6. Watch for signs of systemic symptoms and be ready to perform CPR if necessary or treatment for anaphylactic shock.
  7. Transport to the hospital for evaluation and wound debridement and care.

Devil Scorpionfish Sting Treatment

DevilScorpionfish

Devil Scorpionfish

In the Hawaiian language, scorpionfish are known as nohu, which is the same name used for stonefish in Tahiti.

A close relative of and often mistaken for the stonefish, the Devil Scorpionfish pictured to the right was photographed at Sharks Cove on Oahu’s North Shore.

There are approximately 350 known species of scorpionfish around the world, approximately 25 of which can be found in Hawaii waters. Lionfish and turkeyfish are also in the scorpionfish family, but generally have longer fins.

Like the stonefish, the Devil Scorpionfish is also a master of disguise in both body shape, and coloration. It is very often mistaken for a common rock. Most stings occur when someone mistakingly steps on a Devil Scorpionfish in shallow water near the shore, where there oftentimes are a lot of other rocks, or along the reef. The Devil Scorpionfish is able to blend in with the other rocks and stay motionless, thereby virtually disappearing from view.

If a person is stung, that person will experience intense throbbing, sharp pain. There may be severe bleeding and a whitened color of the area around the site of the sting and the color of the area changes as the amount of oxygen supplying the area decreases. The victim may experience intense abdominal pain, nausea, vomiting, and diarrhea, delirium, fainting, fever, headache, muscle twitching, seizures, paralysis. difficulty breathing, changes in blood pressure, heart failure, pulmonary edema, and loss of consciousness.

Immediate emergency medical treatment is advised as some people are more susceptible to the venom than others. The sting of the stonefish can be extremely deadly.

To treat a Stonefish sting follow these simple steps:

  1. Immediately wash the area with fresh water.
  2. Carefully remove any visible spines from the wound.
  3. Use direct pressure with gauze pads to control bleeding.
  4. Soak the affected area in warm water (110°F to 113°F) for 30 to 90 minutes to denature the toxins.
  5. Administration of analgesia (never use aspirin in conjunction with hot water treatments).
  6. Watch for signs of systemic symptoms and be ready to perform CPR if necessary or treatment for anaphylactic shock.
  7. Transport to the hospital for evaluation and wound debridement and care, and anti-venom administration where available.

Recovery usually takes about 24 – 48 hours but can take several months.

Stonefish Sting Treatment

Stonefish

Stonefish

Although the stonefish is not found in Hawaiian waters, I thought it was necessary to include it because divers travel, and I want you to be prepared incase you ever encounter one of these nasty looking creatures while diving in the Indo-Pacific region where the stonefish calls home.

The stonefish is a master of disguise in both body shape, and coloration. It is very often mistaken for a common rock, which is why it is so dangerous.

Most stonefish stings occur when someone mistakingly steps on a stonefish in shallow water near the shore, where there oftentimes are a lot of other rocks. The stonefish is able to blend in with the other rocks and stay motionless, thereby virtually disappearing from view.

If a person is stung, that person will experience intense throbbing, sharp pain. There may be severe bleeding and a whitened color of the area around the site of the sting and the color of the area changes as the amount of oxygen supplying the area decreases. The victim may experience intense abdominal pain, nausea, vomiting, and diarrhea, delirium, fainting, fever, headache, muscle twitching, seizures, paralysis. difficulty breathing, changes in blood pressure, heart failure, pulmonary edema, and loss of consciousness.

Immediate emergency medical treatment is advised as some people are more susceptible to the venom than others. The sting of the stonefish can be extremely deadly.

To treat a Stonefish sting follow these simple steps:

  1. Immediately wash the area with fresh water.
  2. Carefully remove any visible spines from the wound.
  3. Use direct pressure with gauze pads to control bleeding.
  4. Soak the affected area in warm water (110°F to 113°F) for 30 to 90 minutes to denature the toxins.
  5. Administration of analgesia (never use aspirin in conjunction with hot water treatments).
  6. Watch for signs of systemic symptoms and be ready to perform CPR if necessary or treatment for anaphylactic shock.
  7. Transport to the hospital for evaluation and wound debridement and care, and anti-venom administration where available.

Recovery usually takes about 24 – 48 hours but can take several months.

Benched From Diving – Update

This is an update to an earlier post. Click here to read the original post.

It has now been two full weeks since the infection started and my ear still will not equalize so I went back to the doctor today to have my ear checked again.

Apparently the Augmentin (Amoxicillin/clavulanic acid) antibiotics and the antibiotic ear drops that the doctor put me on two weeks ago did not clear up the infection in my ear. The infection in my ear canal has cleared up, but the infection in my middle and inner ear seems to be antibiotic-resistant. There is also fluid still being retained behind the membrane (ear drum), which they say may take weeks to dry up.

This is the second ear infection that I have had so far this year. Because of my past issues with ear infections, and my eustachian tubes being so tiny, they are referring me to an Ear, Nose & Throat specialist to have it checked. They also want to send me for a hearing test on that ear.

They are still worried about the possibility of there being a tiny hole in the membrane, but I don’t think there is because it is not draining fluid. It seems as if there were a hole there that it would drain and relieve the pressure behind it.

I will have to wait for the ENT specialist to call me to set up the appointments to find out what exactly is going on in there. So in the meantime they have put me on stronger intravenous antibiotics and I now have a portable pump that I wear in a shoulder pouch for the next ten days.

I hate getting IV’s. When I get my really bad migraines I have to get them for pain medication and hydration, now I have to wear one 24-hours a day for the next week and a half. This really sucks. I will see how it goes, you know they say that medics and doctors are the worst possible patients.

It’s been two full weeks since I have been able to dive, and it looks like it will be at least another two weeks before I can even begin to think about it again. My gills are going to dry up!

Beach Safety eBook

eBookCoverWith summer finally upon us, many families will be heading out to the beach more often.

Before you head out to the beach, download this complimentary Beach Safety eBook from Oahu CPR Training.

It contains valuable safety tips to help keep your families safe at the beach this summer.

BeachSafetyEbook

What is “Surfers Ear”?

SurfersEar

Image: Surf Transworld

Unlike “swimmers ear” or otitis externa, “surfers ear” also called exostosis is a buildup of abnormal bony growth in the form of lumps inside the ear canal.

Because surfers ear causes bony growth to build up in the ear canal, it starts to block the ear canal, making the passageway smaller. This can lead to difficulty hearing, and an increase of ear infections and swimmers ear.

Surfers Ear is caused by our ears having repeated contact with cold water and wind. It is more common in the surfing world – hence the name, but divers that repeatedly dive in cold water can also suffer from this condition.

In surfers it is generally more prevalent on one side (the side facing the prevailing winds when surfing), however with divers it generally occurs on both sides together due to the fact that both ears are in the cold water together.

Surfers ear is a progressive condition, meaning that it will start off slowly and become progressively worse over time with repeated exposure. This is why cold water divers must take preventative measures early on.

“But I only dive in warm tropical waters, I can’t possibly get surfers ear can I?” Even though the temperature of the water is warm, when you surface from the water into the “trade winds” that continually blow across the islands the water in the ear canal evaporates, causing a cooling effect inside the ear canal which could lead to surfers ear.

There are a couple of simple things that a diver can do to avoid getting surfers ear:

  1. Wear Vented Ear Plugs – I know you remember back in your Open Water Diver training that divers should never wear ear plugs because it prevents them from being able to equalize their ears. Vented Ear Plugs on the other hand prevent water from entering the ear canal but have a tiny hole in them to allow air equalization through them, but the hole is too small for water to pass through.
  2. Wear a Wetsuit Hood – Wetsuit hoods will keep our ear canals nice and warm, and prevent them from being chilled by evaporation from the wind.
  3. Wear a Stocking Cap or Beanie – After diving put a stocking cap or beanie on to cover the ears. This will keep you warm while preventing the wind from evaporating the water in your ear canals and cooling them too quickly.

“How can I tell if I already have surfers ear?” There are a few simple things to look for like:

  • Take notice of any pain, popping or crackling that originates in your ear.
  • Tilt your ear toward the ground and shake your head to see if you can hear water trapped in your inner ear.
  • Ask yourself if people are always telling you to turn down the music or the TV, or if they tell you that you talk loudly.
  • Think about whether you’re asking others to speak up, even when they are sitting right next to you.
  • Visit a doctor, preferably an ear specialist, and get a second opinion to verify any diagnosis.

If the condition is left untreated and becomes severe enough surgery may be necessary to alleviate it by drilling and cutting away the abnormal bony growth. This used to be done by making an incision behind the ear as well as going in with a drill through the ear canal.

There is a new process now where they will use chisels to remove the abnormal bony growth through the ear canal instead of making the traditional incision behind the ear. This new process also eliminates most of the use of the drill as well. The new process submits the patient to less noise during surgery that could damage hearing, and speeds healing afterwards.

By utilizing these simple steps outlines above, you can help prevent surfers ear from starting in the first place and the need for painful surgery.

What Causes “Swimmers Ear”?

EarOtitis externa or “Swimmers Ear” as it is commonly referred to is a very common ailment affecting swimmers, divers, surfers, and anyone else who spends a lot of time in water. Otitis externa is the fancy technical term for an external ear infection.

Contrary to popular belief and information posted on many diving websites and forums, bacteria in the water does not cause otitis externa. It is actually caused by bacteria that is already present and lurking inside our ear canals, waiting for an opportunity to strike.

Ear wax is created by sweat glands that have been modified to produce the waxy substance that is present inside our ear canals. This necessary wax acts as a waterproofing layer that coats the canal and prevents water and bacteria from getting into the cells of the canal lining.

When the cells become saturated from frequent immersion in water they swell and pull apart just enough to allow bacteria to slip between them and find a warm moist place to grow and multiply underneath the surface of the skin. Once the bacteria is allowed to multiply and affect surrounding tissues the resulting pain begins to be noticed.

One easy way to determine where the ear is infected is by gently tugging backwards on the  pinna, which is shown in the above photo. You can also gently press on the fleshy lump just in front of the ear canal which is called the tragus, If this hurts, it is an outer ear infection, if not it is a middle or inner ear infection.

 If left untreated, the swelling can spread to the nearby lymph nodes and cause enough pain that moving your jaw becomes uncomfortable. At this point, the only treatment is antibiotics, either with pills, and/or ear drops, and diving is definitely out of the question until the infection has cleared up. If the infection becomes extreme, an antibiotic injection may be necessary.

Prevention

It is very easy to prevent otitis externa or swimmers ear, and it will not break the bank to do it, but the following steps need to be done precisely to be effective.

Create a solution of 50% distilled white wine vinegar and 50% isopropyl alcohol, both of which can be obtained from just about any grocery store. The white wine vinegar is approximately 4-6% acetic acid, and has a pH of 3.0, which is perfect to use as a bactericidal to prevent the bacteria from multiplying. The isopropyl alcohol acts as a drying agent to draw excess water out of the cells lining the ear canal.

To administer, lay on one side and drop enough of the mixture into the ear canal to fill the canal. The most important part of the treatment is to remain still and hold the solution in the ear canal for a full five minutes. After the solution has been in contact with the ear canal for a full five minutes, turn over to allow the solution to drain and repeat with the other ear canal.

If the solution does not stay in contact with the ear canal for a full five minutes, it’s effectiveness is greatly reduced. This procedure should be done twice daily, once before the first dive of the day, and then once more after the final dive of the day.

If there is a chance of a ruptured eardrum due to a squeeze, DO NOT place drops into the ear. Doing so may inadvertently flush bacteria into the middle ear causing a worse infection problem.

If the above steps are followed exactly as described, this will prevent you from having to miss a dive because of swimmers ear.

Benched From Diving

Unfortunately I received some bad news today. On Thursday’s dive I noticed that I was having trouble equalizing my left ear and I had to force it a little bit. Apparently I forced it a bit too much, at the time I heard a popping sound but did not think too much about it because my hearing did not change and there was no immediate pain in it. That all changed on Friday though.

When I woke up on Friday I noticed pain in my left ear and my ear was plugged up so that I could hear my heartbeat. Actually hearing my heartbeat is a good thing, that is a good sign that the membrane, or ear drum, was still intact. I stayed home on Friday with a low-grade fever and took ibuprofen for the pain, hoping it would go away.

Today I woke up with the pain even worse, so I went to the hospital to have my ear checked. Even though I know what to look for and have an otoscope here in my emergency kit to see into the ear canal, I can not see into my own ears, so I was forced to rely on someone else’s opinion.

The Emergency Room physician referred me to a specialist because he thought he saw a small hole in the membrane, but he was not sure. The membrane was severely infected along with the ear canal, but he was not sure if the membrane was intact or not. So, for the next few hours I waited to get squeezed into see the specialist, worrying that I may have done permanent damage to the membrane, which could prevent me from diving in the future.

Once I was finally able to be seen by the specialist she examined my ears, noting the infections to both the canal and the membrane. She noticed what the E.R. physician had seen on the membrane but stated that she did not believe it had ruptured. It was basically like a stretch mark which was a sign of over stretching of the membrane when I forced my ears to equalize on Thursday.

Because the infection was both on the inside and on the outside, affecting both the ear canal and membrane, and middle ear she prescribed antibiotics and antibiotic ear drops for the next 15 days and benched me from diving for at least a week. If the infection has completely cleared I can resume diving after June 3rd, but if it has not completely cleared I have to wait another full week before I am cleared to dive again.

I was supposed to be assisting Michelle with another Open Water Diver class today and tomorrow for their open water dives up at Sharks Cove on the North Shore. I had to sit today out dealing with the hospital and doctors, but I will assist her tomorrow morning. I wont be able to dive tomorrow, but at least I can help out with ground support.

This not being able to get in the water for at least a week is really going to get to me. This is going to be a very long week for me. The moral of this story, if you ever have trouble equalizing your ears, DO NOT force it, not even a little bit. You may not be as lucky as I was by only having to stay out of the water for a week.

UPDATE: Click here to read the update post.

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