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Case Reports
. 2019 Dec 20;49(4):304-305.
doi: 10.28920/dhm49.4.304-305.

Fatal air embolism in a breath-hold diver

Neil Dg Banham  1   2 , John Lippmann  3
Affiliations
Case Reports

Fatal air embolism in a breath-hold diver

Neil Dg Banham et al. Diving Hyperb Med. .

Abstract

Cerebral arterial gas embolism (CAGE) from breath-holding or inadequate exhalation during ascent is a well-recognised complication of scuba diving. It does not usually occur with breath-hold (BH) diving in those with normal lungs, as the volume of gas in the lungs on surfacing cannot exceed what it was on leaving the surface. However, a BH diver who breathes from a compressed gas supply at depth essentially becomes a scuba diver and is at risk of pulmonary barotrauma (PBt) and CAGE on ascent. In this case, a 26-year-old male experienced BH diver breathed from a scuba set at approximately 10 metres' sea water depth and ascended, sustaining massive PBt and CAGE with a fatal outcome. BH and scuba divers, especially those with less experience, need to be well-informed about this potential risk.

Keywords: Barotrauma; Breath-hold diving; Case reports; Cerebral arterial gas embolism (CAGE); Diving deaths; Pulmonary barotrauma; Scuba.

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Figures

Figure 1
Figure 1
Coronal chest CT scan image performed immediately after cessation of resuscitation attempts showing evidence of massive barotrauma, with bilateral pneumothoraces, pneumopericardium, pneumomediastinum, subcutaneous emphysema and intravascular gas in the liver. Extensive alveolar-interstitial pulmonary opacification is also evident, likely as a result of aspiration of seawater but possibly also from pulmonary haemorrhage. An endo-tracheal tube is in situ
Figure 2
Figure 2
Axial brain CT images showing extensive intracerebral intravascular gas (CAGE)
See this image and copyright information in PMC

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