1. Diving accident นต . คมสัน วุฒิประเสริฐ รน . กองเวชศาสตร์ใต้น้ำและการบิน กรมแพทย์ทหารเรือ

7. Middle ear barotrauma

14. Grade 0 - Symptoms without signs Grade 1 - Injection of the TM (especially along the handle of the malleus)

15. Grade 2 - Injection plus slight haemorrhage within TM Grade 3 - Gross haemorrhage within the TM

16. Grade 4 - Free blood in the middle ear Grade 5 - Perforation/Rupture of the TM

17. Inner Ear Barotrauma (Perilymph Fistula)

20. Sinus Barotrauma

24. mask squeeze/ facial barotrauma

27. Pulmonary barotrauma

33. 1 atm 2 atm 3 atm

34. Pathology - Bubble form first in tissue and then in venous blood - The lung are usually an effective filter for bubble ( pulmonary arterioles )

35. Pathology - The ability of lung to filter the bubble which then resolve by gas diffusion to the alveoli - Bubble can also be bypassed through anatomical defect  patent foramen ovale ( PFO)

37. Extravasations of fluid Increased hemoglobin concentration Progressive worsening of blood flow

38. Decompression sickness Type 1 - limb or joint pain ( bends ) Type 2 - sign or symptom ,cause by involvement of CNS , cardiopulmonary system Type 3 - DCS + AGE

41. DCS type 1 Bend Limb and joint pain only Skin rash

45. First Aid.

46. First Aid.

47. First Aid.

48. First Aid.

49. First Aid.

50. First Aid.

51. First Aid.

52. First Aid.

58. Flying after diving

64. Emergency air evacuation -Aircraft pressurized 1 ATA ( if possible) -Un-pressurized aircraft - no more than 1000 feet -Have the patient breath 100% oxygen during transport

66. THANK YOU