International maritime health
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Acute heart diseases are the most frequent causes for fatalities on merchant vessels. Presently there is no sufficient therapy available to treat ventricular fibrillation. The aim of this study was to test whether common automated external defibrillators [AED] may be appropriate for the use aboard merchant vessels. ⋯ All subjects handled the AED correctly. The AED received a total amount of points in the range between 2125 to 2241 (of 2400 possible). The subjects preferred AED with coloured as well as light marked buttons which gave a feedback (e.g. audible tones) when they were pressed. All AED were able to register an ECG in the vibrating ambient. Due to interface problems it was only possible to extract three ECG files, and only two files (data < 300 kB) could be sent as e-mail attachment via satellite to the German TMAS. In noisy areas the AED must guide the user, e.g. by screen massages and/or pictograms. Displays should provide additional data to help assess resuscitation effectiveness. A special procedure is necessary to ensure that ships and TMAS own the same software to read the transmitted ECG files, which are not allowed to exceed a size of 300 kB.
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The basic treatment of diver with bubble related illness consists of recompression in medical hyperbaric facility. However transportation of injured diver to hyperbaric chamber can last for several hours. During that time the process induced by gas bubbles spread out and finally result in activation of many pathophysiological events. ⋯ The review of available bibliography presented in this paper leads to conclusion that recommendations of the Second European Consensus Conference on Hyperbaric Medicine "The Treatment of Decompression Accidents in Recreational Diving" published in 1996 in Marseille, France for fluid replacement and drug therapy for decompression accidents are still valid. This protocol includes the fluid treatment, normobaric oxygen and intensive therapy. Other drugs (aspirin, lidocaine, heparin, steroids, calcium channel blockers, antioxidants) should still be treated as an option considered by clinician, but without strong evidences from clinical studies.