1. Drunkning i samband med apparatdykning - Drowning during scuba diving Hans Örnhagen Förbundsläkare Svenska sportdykarförbundet hans@ornhagen.se www.ornhagen.se www.ssdf.se HLR2014 - Om Drunkning Tylösand 3-4 juni 2014

2. Google gave 7 790 000 hits when seaching for ”drowning while diving” in Mars 2014. After drowning, heart problems constitute the second most common cause of death among divers.

3. Recreational diving, also called sportsdiving or amateur diving, is either -Breathhold diving, also called apnea diving -Or SCUBA (Self Contained Underwater Breathing Apparatus) Sometimes difficult to distinguish in statistics and reports. ”Anyone dressed in black in water is a diver.”

4. HLR2014 - Om Drunkning Tylösand 3-4 juni 2014 How dangerous is it to dive? Data on fatality risks from www.About.comwww.About.com 1 out of every 211,864 dives ends in a fatality (DAN 2010) 1 out of every 126,626 marathon runners died of sudden cardiac arrest while running a marathon between 1975-2003 (National Safety Council) 1 out of every 116,666 skydives ended in a fatality in 2000 (United States Parachuting Association).

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6. Number of fatalities during recreational scuba diving in some Nordic countries 6 HLR2014 - Om Drunkning Tylösand 3-4 juni 2014

7. From Divers Alert Network fatality statistics 2009. A total of 91 coroners reports after scuba diving fatality. HLR2014 - Om Drunkning Tylösand 3-4 juni 2014

8. Diving Fatality Data (www.divingmedicine.info) In the ANZ survey in half the deaths (56%), critical events developed when the diver was either running low or was out-of-air (LOA, OOA). When equipment was tested following death, few victims had an ample air supply remaining. The DAN survey found 41% in this situation. HLR2014 - Om Drunkning Tylösand 3-4 juni 2014

9. 9 The authors conclusion regarding the most important factors contributing to 947 fatalities in recreational diving. (Denoble et al, UHM, dec 2008) Lack of breathing gas41% Separation from buddy57% Cardio vascular illness30% HLR2014 - Om Drunkning Tylösand 3-4 juni 2014

10. 10 Pre existing medical illness in 947 fatalities in recreational diving in USA 1992 -2003 (Denoble et al, UHM, dec 2008) Number% Cardio vascular illness25227 Diabetes 37 4 Astma 29 3 Other lung problem 28 3 Epilepsia 11 1 HLR2014 - Om Drunkning Tylösand 3-4 juni 2014

11. 11 Data från Divers Alert Network USA, DAN 2006 HLR2014 - Om Drunkning Tylösand 3-4 juni 2014

12. Diving Fatality Data (http://www.divingmedicine.info) 90% died with their weight belt on. 56% were alone when they died. 50% did not inflate their buoyancy vest. 25% encountered their difficulty first on the surface, (50% actually died on the surface.) 10% were under training when they died. 10% were advised that they were medically unfit to dive. 5% were cave diving. 1% of “rescuers” became a victim. HLR2014 - Om Drunkning Tylösand 3-4 juni 2014

15. Two types of oxygen equipment for 100% oxygen breathing. Both contain 1000 NL of oxygen and have an outlet for a free-flow mask.

16. HLR2014 - Om Drunkning Tylösand 3-4 juni 2014 From 2010 the European Resuscitation Council recommends ventilation to be started in water. (Soar J et al in Resuscitation. 2010;81:1400-33.) From Diving and Hyperbaric Medicine, June 2013 ”Rescue of drowning victims and divers: is mechanical ventilation possible underwater? A pilot study” The answer is: No The reason is: The breathing valve is not built to deliver the pressure required for inflation of the immersed lung because the exhalation valve opens.

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22. http://www.youtube.com/watch?v=ki2D8j0Dq-Q HLR2014 - Om Drunkning Tylösand 3-4 juni 2014

23. This device will inflate your BCD before you are out of air or if you have not taken a breath in 30 sec. Profylaxis is always better than treatment ”Soon in a dive shop near you” HLR2014 - Om Drunkning Tylösand 3-4 juni 2014 DIVO® by Aventics GmbH Soon in a dive shop near you