Page 202 - PJ MED OPS Handbook 8th Ed

CAUTION: If CO2 toxicity is suspected the dive should be aborted even if symptoms dissipate
at the surface. The decrease in symptoms may be a result of the reduction of partial pressure
of CO2 as the diver ascends and will reappear upon return to depth.

Hypoxia
Caused by the partial pressure O2 being too low to meet metabolic needs. In closed circuit diving,
cause is too much nitrogen in the circuit due to an inadequate purge.
Signs and Symptoms:
1. Frequently no warnings signs prior to loss of consciousness.
2. Other symptoms include confusion, agitation, incoordination, dizziness and convulsions.

NOTE: If symptoms of unconsciousness or convulsions occur at the beginning of a closed
circuit dive, hypoxia, not O2 toxicity, is the most likely cause.

Treatment:
Remove mouthpiece, allow diver to breathe fresh air. If unconscious, check breathing and circula-
tion, maintain open airway, provide 100% O2.

Chemical Injury
The introduction of a caustic alkaline solution into the upper airway is the result of water leaking
into the canister and coming in contact with CO2 absorbent (“caustic cocktail”). Generally occurs
when diver is in a horizontal or head down position.

Signs and Symptoms:
1. Rapid breathing or headache related to buildup of CO2.
2. Choking, gagging, foul taste, and burning of the mouth and throat, will begin immediately.
Treatment:
Rinse mouth out several times with fresh water. Several mouthfuls should then be swallowed. If
only seawater is available, rinse mouth, do not swallow.

NOTE: Do not use acid solutions or induce vomiting. Uncontrolled ascent common. Monitor
for AGE.

Neurologic Exam:
This examination is designed to detect CNS problems and serves as a method to monitor for changes
in neurological function resulting from DCS or POI. The exam should be conducted on any diver who
experiences pain, discomfort, alteration in sensation or body function, or any other symptom within
24 hours of completion of a dive. The exam should be repeated every 30-45 minutes or more fre-
quently if the diver’s condition is deteriorating.

200 n Pararescue Medical Operations Handbook / 8th Edition