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
2024
February
March
April
May
2023
January
March
Terrific Freedive ModeKaboom!....The Big Oxygen Safety IssueScuba Nudi ClothingThe Benefits of Being BaldDive into Freedive InstructionCape Marine Research and Diver DevelopmentThe Inhaca Ocean Alliance.“LIGHTS, Film, Action!”Demo DiversSpecial Forces DiverWhat Dive Computers Don\'t Know | PART 2Toughing It Out Is Dangerous
April
July
August
September
Mismatched Scuba Valves to Cylinder OutletsUnderwater Crime Scene InvestigatorsDive Boat Etiquette – From Yachts to rubber ducksTravel Smarter: Personal Safety While TravelingLiability in ContextLearning from Success. Learning from MistakeDive in the Fast Lane with DPVsKwaZulu Natal shipwrecks: The ProduceAvoid Diving With EarplugsThe Parting ShotWeight loss for diversPredive Warm-UpTara Panton's Cape NudibranchsMonitoring Cardiac Health in Scuba DiversRESEARCHER PROFILE: Petar Denoble: Solving practical issues for divers
October
2022
January
February
UNCERTAINTY AFTER DIVING: Case Report and Recommendations #1.UNCERTAINTY AFTER DIVING: Case Report and Recommendations #2DIVERS LOSING ACCESS TO EMERGENCY CAREUNCERTAINTY AFTER DIVING: Case Report and Recommendations #3UNCERTAINTY AFTER DIVING: Case Report and Recommendations #4Preventing Breathing gas Contamination