Hart A J, White S A, Conboy P J, Bodiwala G, Quinton D
Department of Accident and Emergency Medicine, Leicester Royal Infirmary.
J Accid Emerg Med. 1999 May;16(3):198-200. doi: 10.1136/emj.16.3.198.
The aim of this study was to determine the incidence, type, outcome, and possible risk factors of diving accidents in each year of a five year period presenting from one dive centre to a large teaching hospital accident and emergency (A&E) department.
All patients included in this study presented to the A&E department at a local teaching hospital in close proximity to the largest inland diving centre in the UK. Our main outcome measures were: presenting symptoms, administration of recompression treatment, mortality, and postmortem examination report where applicable.
Overall, 25 patients experienced a serious open water diving accident at the centre between 1992 and 1996 inclusive. The percentage of survivors (n = 18) with symptoms of decompression sickness receiving recompression treatment was 52%. All surviving patients received medical treatment for at least 24 hours before discharge. The median depth of diving accidents was 24 metres (m) (range 7-36 m). During the study period, 1992-96, the number of accidents increased from one to 10 and the incidence of diving accidents increased from four per 100,000 to 15.4 per 100,000. Over the same time period the number of deaths increased threefold.
The aetiology of the increase in the incidence of accidents is multifactorial. Important risk factors were thought to be: rapid ascent (in 48% of patients), cold water, poor visibility, the number of dives per diver, and the experience of the diver. It is concluded that there needs to be an increased awareness of the management of diving injuries in an A&E department in close proximity to an inland diving centre.
本研究旨在确定在五年期间内,每年从一个潜水中心送至一家大型教学医院急诊部的潜水事故的发生率、类型、结果及可能的风险因素。
本研究纳入的所有患者均送至英国最大内陆潜水中心附近的一家当地教学医院的急诊部。我们的主要结局指标为:出现的症状、加压治疗的实施情况、死亡率以及适用时的尸检报告。
总体而言,在1992年至1996年(含)期间,有25名患者在该中心发生了严重的开放水域潜水事故。有减压病症状且接受加压治疗的幸存者(n = 18)比例为52%。所有存活患者在出院前均接受了至少24小时的治疗。潜水事故的中位深度为24米(范围7 - 36米)。在1992 - 1996年的研究期间,事故数量从1起增至10起,潜水事故发生率从每10万人4起增至每10万人15.4起。在同一时期,死亡人数增加了两倍。
事故发生率上升的病因是多因素的。重要的风险因素被认为是:快速上升(48%的患者)、冷水、能见度差、每个潜水者的潜水次数以及潜水者的经验。得出的结论是,在内陆潜水中心附近的急诊部,需要提高对潜水损伤管理的认识。