Acute Confusion: Diving

Caisson disease. In acute confusion, stupor, neurological problems or shock occurring after diving, one should consider decompression problems or caisson disease resulting from too rapid ascent to the surface (often occurs in panic situations).

Rupture of the lung with pneumothorax can occur due to rapid ascent to the surface without adequate expiration. For example, the pressure amounts to 3 atmospheres at a depth of 20 metres while on the water surface it is only one atmosphere so that the lungs’ volume would have to increase threefold. The air in the lungs expands as the pressure falls.

Envenomation by certain marine animals can have hyperacute and very serious consequences. The sea wasp [Chironex fleckeri] is a small, translucent, but extremely venomous jellyfish that is found in Australasian seawater. Coneshells [Conus sp] can likewise deliver a highly venomous sting (nerve toxin). The bite of the so called “blue ringed octopus” [Hapalochlaena lunulata and H. maculosa], a name given to two related species of small cephalopods (15 cm) found in the seas between Northern Australia to Japan, is likewise notorious. Acute confusion and stupor are among the clinical symptoms. Irukandji syndrome occurs in North Australia following stings by Carukia barnesi, a small box jellyfish.

Category: Neurology notes , Psychiatry Notes