Decompression sickness (DCS) can result from the growth of bubbles in tissues and blood during or after a reduction in ambient pressure, for example in scuba divers, compressed air workers or astronauts. In scuba diving research, post-dive bubbles are detectable in the venous circulation using ultrasound. These venous gas emboli (VGE) are a marker of decompression stress, and larger amounts of VGE are associated with an increased probability of DCS. VGE are often observed for hours post-dive and differences in their evolution over time have been reported between individuals, but also for the same individual, undergoing a same controlled exposure. Thus, there is a need for small, portable devices with long battery lives to obtain more ultrasonic data in the field to better assess this inter- and intra-subject variability. We compared two new handheld ultrasound devices against a standard device that is currently used to monitor post-dive VGE in the field. We conclude that neither device is currently an adequate replacement for research studies where precise VGE grading is necessary.
Introduction: Closed-circuit rebreathers (CCRs) are designed to be watertight. Ingressing water may react with carbon-dioxide absorbent in the CCR, which may produce alkaline soda with a pH of 12-14, popularly referred to by CCR divers as a ‘caustic cocktail’. This study aimed to explore divers’ responses to caustic cocktail events and to investigate if CCR diving experience is associated with experiencing a caustic cocktail. Methods: An online survey instrument was developed and an invitation to participate was extended to certified CCR divers aged ≥ 18 years. Relationships between number of caustic cocktail events and potential risk factors: age; hours of rebreather diving experience; and number of rebreather dives were explored. Results: Of the 413 respondents, 394 (95%) identified as male, mean age was 46 years and median length of CCR certification was six years. Fifty-seven percent (n = 237) of respondents reported having experienced a caustic cocktail. The probability of self-reporting none, one, or more caustic cocktail events increased with experience. Divers reported a variety of first aid treatments for caustic cocktails, with ~80% citing their CCR instructor as a source of information. Conclusions: The more hours or dives a CCR diver accrues, the more likely they will self-report having experienced one or more caustic cocktail events. The majority of CCR divers responded to a caustic cocktail by rinsing the oral cavity with water. A proportion of divers, however, responded by ingesting soda, dairy, juice, or a mildly acidic solution such as a mixture of vinegar and water. The recommendation to immediately flush with water needs reinforcing among rebreather divers.
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