DIVE LOG Australasia

Know Your Neuro

A s the waves crashed over the reef ahead, the small dive boat anchored nearby careened at their mercy — despite being anchored in a relatively sheltered spot. No one’s ladder exits were pretty that day, but the third diver in the group really struggled to get back onboard. Once the divemaster and captain assisted him onto the deck and helped him out of his gear, he was breathing hard and fiercely gripping the bench on which he sat. In an attempt to comfort the diver, the divemaster asked him if he needed some water. He clearly and coherently replied, “Yes, thanks.” When the divemaster returned with his water, the man seemed suddenly unsure why the divemaster was giving him water and when he began to try and speak he was slurring his words.

At first the divemaster was stumped by the diver’s condition so he looped in the boat captain to try and gain more insight. “Could this guy have DCS after a 30-minute dive to 7.5 metres? We came up so slowly …. He seems disoriented. AGE maybe?” “Presenting with symptoms immediately after a dive doesn’t necessarily mean this guy has a diving injury. Let’s do a neuro.” After conducting a quick neurological exam, the

captain discovered that the diver was unable to lift his right arm and has persistent slurred speech. She called emergency services from the boat and arranged for an ambulance to meet them at the dock because she suspected he might be having a stroke. She noted

the time of symptom onset and made haste back toward shore. Fifteen minutes later, the diver was transported by ambulance to the local emergency room for treatment. The attentiveness of the crew, quick action on part of the boat captain and their proximity to shore had saved this diver’s life, and all they had to do was act FAST. Face, Arms, Speech, Time – FAST is the mnemonic you use to recall how to properly conduct a neurological exam. Check for facial droop and inability to move or raise an arm, determine slurred, mumbled or nonsensical speech, and

remember to note the time symptoms began. If you detect any of these symptoms, call emergency medical services immediately. Using FAST to begin your neurological examination is an effective way to determine if a neurological injury is present — whether from a stroke, trauma or a diving injury. Quick and correct response to a neurological injury can make a life-or-death difference; the faster a victim of AGE or stroke reaches advanced medical care, the greater their likelihood of avoiding a life-altering disability or further injury. Diving Health and Safety Resources The DAN World website contains an extensive range of health & medicine as well as safety & prevention resources and reference materials that are freely available to all divers, as part of DAN’s mission to enhance diving safety.

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DIVE LOG Australasia #408 - October ‘24

www.divelog.net.au