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PFO CONCERNS IN DIVE INJURY TREATMENT

November 19th, 2021
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Question: I recently took DAN’s online Basic Life Support: CPR and First Aid and emergency Oxygen for Scuba Diving Injuries courses. I’ve heard it is best to put an injured diver in the recovery position on their left side because of the possibility of a patent foramen ovale (PFO). Is this true, and what would be the benefit?

Answer: A PFO is undoubtedly a concern with diving because about 25 percent of the population has one. The recovery position supports and maintains an open airway in an
unconscious person or injured diver. The left-side preference was based on anatomy, not PFO concern. Blood from the venous system returns to the right atrium via the superior and
inferior vena cava, so the idea of putting a diver on the left side was to alleviate unnecessary weight that might compress these large vessels and impede circulation.

Recent studies and recommendations from the International Liaison Committee on Resuscitation (ILCOR), however, suggest there is no benefit to placing someone on their left side
instead of their right side when using the recovery position. In the case of suspected decompression sickness (DCS), place the injured diver in a position of comfort, or if they are
unconscious, one that allows you to monitor them as necessary. PFO concern is not a factor
in this case. If the diver is symptomatic and you are rendering care, then you need to treat the
symptoms. Give them the highest concentration of oxygen available, and get them to definitive health care and treatment. Remember that many conditions show symptoms that may mimic DCS. Just because someone was diving does not mean they have a dive-related illness.

When creating your emergency action plan, note the location of the nearest emergency room or where and how to access local emergency services.
— Robert Soncini, NR-P, DMT
Posted in Alert Diver Fall Editions, Alert Diver Winter Editions, Dive Fitness, First Aid Training, Return To Diving
Tagged with First Aid, First Aid Equipment, First Aid Kit, First Aid Training, Oxygen providers, PFO, Patent foramen ovale, BLS, Basic Life Support

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