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
2023
January
March
Demo DiversCape Marine Research and Diver DevelopmentKaboom!....The Big Oxygen Safety IssueTerrific Freedive Mode“LIGHTS, Film, Action!”Scuba Nudi ClothingDive into Freedive InstructionThe Benefits of Being BaldThe Inhaca Ocean Alliance.Special Forces DiverToughing It Out Is DangerousWhat Dive Computers Don\'t Know | PART 2
April
July
August
September
Avoid Diving With EarplugsKwaZulu Natal shipwrecks: The ProduceDive in the Fast Lane with DPVsLearning from Success. Learning from MistakeLiability in ContextUnderwater Crime Scene InvestigatorsTravel Smarter: Personal Safety While TravelingDive Boat Etiquette – From Yachts to rubber ducksThe Parting ShotMismatched Scuba Valves to Cylinder OutletsPredive Warm-UpWeight loss for diversTara Panton's Cape NudibranchsRESEARCHER PROFILE: Petar Denoble: Solving practical issues for diversMonitoring Cardiac Health in Scuba Divers
October
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 Titanic