Aviat Space Envir Md
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Aviat Space Envir Md · Nov 2012
Clothing buoyancy and underwater horizontal swim distance after exiting a submersed vehicle simulator.
Winter road workers, who drive heavy vehicles over ice-covered waterways, are at risk for ice failure, vehicle submersion, and subsequent drowning in frigid water. Although some jurisdictions require these workers to wear flotation clothing, there are concerns that, following an underwater exit in fast-moving water, increased clothing buoyancy may reduce ability to swim against the current to safely return to the ice opening. ⋯ Flotation clothing (either Jackets or Overalls) is recommended for vehicle travel on ice because they do not impede underwater exit from a vehicle and allow significant horizontal underwater swim distance. An inflatable vest is not recommended because inappropriate premature inflation could increase exit impedance and decreased underwater swim distance.
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Aviat Space Envir Md · Nov 2012
ReviewAcute neurological symptoms during hypobaric exposure: consider cerebral air embolism.
Cerebral arterial gas embolism (CAGE) is well known as a complication of invasive medical procedures and as a risk in diving and submarine escape. In the underwater environment, CAGE is caused by trapped air, which expands and leads to lung vessel rupture when ambient pressure decreases during ascent. Pressure decrease also occurs during hypobaric activities such as flying and, therefore, CAGE may theoretically be a risk in hypobaric exposure. ⋯ We recommend considering CAGE in all patients presenting with acute central neurological injury during or shortly after pressure decrease such as flying. A CT scan of head and chest should be performed in these patients. Treatment with hyperbaric oxygen therapy should be initiated as soon as possible in cases of proven or probable CAGE.