PFO CONCERNS IN DIVE INJURY TREATMENT
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
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
Categories
2022
January
February
UNCERTAINTY AFTER DIVING: Case Report and Recommendations #1.UNCERTAINTY AFTER DIVING: Case Report and Recommendations #2UNCERTAINTY AFTER DIVING: Case Report and Recommendations #3UNCERTAINTY AFTER DIVING: Case Report and Recommendations #4DIVERS LOSING ACCESS TO EMERGENCY CAREPreventing Breathing gas Contamination
March
When Should the Rescue Begin?Celebrating Young and Old in Turks and CaicosScuba Cylinder RundownChasing WeedsUnderwater Smartphone PhotographyAir and a SpareUnderwater Photographer: Fred BuyleBuilding Better BalanceLow-Visibility DivingMore Than a Sore ShoulderNot Only for DivingLaryngospasm and AnxietyPulmonary Hypertension and DivingTitan Meets TitanicPool Operation: Know Before you GoThe Argonaut Octopus and the jellyfishShort but Beautiful Lives
April
A Sense of PurposeMexico’s Sardine RunHigh-Pressure Hose injuriesA Hole in My HeartGoing UpConcussion and Return to DivingMarfan Syndrome Recommendations.South African Sardine Run by Walter BernardisSouth African Sardine Run By ProdiveSardine Run Port Elizabeth by ProDiveSardine Run Port St Johns by ProDiveScuba Diving In MauritiusScuba Diving in TanzaniaScuba Diving in the SeychellesScuba Diving in Nosy BeScuba Diving in MalawiScuba Diving in KenyaScuba Diving in South AfricaScuba Diving in Mozambique
May
June
July
Destination AntarticaUnconscious DiverA Little DetailDive Boat SafetyBlenny Watching 101Bonaire Inspires Hope for the Future of CoralThe Secret to Deep Freediving: Tips from 3 Female World Record HoldersEnsuring Safety in Freediving CompetitionsFour Tips For Staying Warm While Cold Water DivingAnd They Dived Happily Ever AfterFreediving Is About To Enter A New Era If Oxama Has Its SayGET BENT!The Joys and Challenges of the DeepUnderstanding The Secrets of Deep Freediving: Tips from Three National Record Holders
August
Pushing the Envelope: New Research into the Physiology of Deep Rebreather DivingFin Foot or DCS?Stop Smoking!Good AirEmergency Oxygen and Oxygen ToxicityFreedive with Psoriatic arthritisRebreather MythsShooter: David DoubiletDiving With My DadWhen History Seemingly Repeats Itself: DIADEMA SEA URCHIN LOSSPreserving History: Leslie LeaneyFreediving: Seeking and Finding Our Limits
September
The Edge of ExtinctionDiving Into an Ocean Climate action planSweet Spot in TimeNot in DenialThe Ocean Less TraveledBlue Heron BridgeMistakes and Bad DecisionsCuba’s Golden FishDiving with a Cold soreMatty Smith: In Two WorldsA victory for the cenotes: keeping up with the Mayan Train projectSAVE THE CENOTES