Sinus squeeze or worse

[andy lewin]

Whilst instructing on a recent Sport Diver course I had a student who surfaced 3 times with blood in his mask. The first time I wasn't quite sure if I saw blood however the 2nd two dives confirmed my thoughts.

When I asked the student about the blood and informed him he probably experiencing sinus squeeze he said it always happened and there was nothing to worry about, I was not happy with this.

I suggested he see a doctor to confirm he was "fit to dive" and refrained from instructing him further until a decision was made by his GP. This caused a great deal of disturbance within our direct diving circle... What would you guys have done.

Thanks in advance.

Andy

[Mike Halligan]

What would you guys have done.

Andy,

I am not medically qualified. Unless the student was an ENT specialist, I would do the same as you. If the student was an ENT expert, I would still suspend training, recommend a quick 'phone chat between student and referee and discussed with my DO. Then, I would ask him/her to re-write the manual and marshall it through its pre-publication checks.

HTH

Mike
(OWI and TO)

[edward haynes]

Andy

Medical Question 1 on the SDMF asks if the applicant "Have you suffered at any time from diseases of the heart and circulation including high blood pressure, angina, chest pains and palpitations?".

As a layperson on these matters, doesn't blood come under circulation and therefore this individual should have a SDMF signed off by a Diving Medical Referee.

Just my opinion.

Edward

Whilst instructing on a recent Sport Diver course I had a student who surfaced 3 times with blood in his mask. The first time I wasn't quite sure if I saw blood however the 2nd two dives confirmed my thoughts.

When I asked the student about the blood and informed him he probably experiencing sinus squeeze he said it always happened and there was nothing to worry about, I was not happy with this.

I suggested he see a doctor to confirm he was "fit to dive" and refrained from instructing him further until a decision was made by his GP. This caused a great deal of disturbance within our direct diving circle... What would you guys have done.

Thanks in advance.

Andy

[Mike Halligan]

Andy

Medical Question 1 on the SDMF asks if the applicant "Have you suffered at any time from diseases of the heart and circulation including high blood pressure, angina, chest pains and palpitations?".

As a layperson on these matters, doesn't blood come under circulation and therefore this individual should have a SDMF signed off by a Diving Medical Referee.

Just my opinion.

Edward

Aw, now fair do's. You could be right, and a nose-bleed can be symptomatic of many things. However, no layman will be persuaded that it ranks alongside angina, chest pains and palpitations. I can see them now.

"Nosebleed:ITU admission, what's the difference?" Andy's in enough treacle already without antagonising his audience.

Mike :-)

[iainmsmith]

:=Andy
:=
:=Medical Question 1 on the SDMF asks if the applicant "Have you suffered at any time from diseases of the heart and circulation including high blood pressure, angina, chest pains and palpitations?".
:=
:=As a layperson on these matters, doesn't blood come under circulation and therefore this individual should have a SDMF signed off by a Diving Medical Referee.

Aw, now fair do's. You could be right, and a nose-bleed can be symptomatic of many things. However, no layman will be persuaded that it ranks alongside angina, chest pains and palpitations. I can see them now.

"Nosebleed:ITU admission, what's the difference?" Andy's in enough treacle already without antagonising his audience.

Actually, the response I initially posted was:

"
>> Have you suffered at any time from diseases of...circulation

> Doesn't blood come under circulation and therefore this
> individual should have a SDMF signed off by a Diving Medical
> Referee.

Edward, have you ever cut yourself? Can I assume that you therefore have an SDMF signed by a referee?"

However, I deleted it because it would be worth making completely sure that the nosebleed _is_ the consequence of sinus squeeze (ie is there faulty technique and once this is corrected, is the problem solved) before laughing it off completely.

Iain

[edward haynes]

Mike/Iain

I agree with you both that it?s a tenuous link, but in the original post it was reported the nosebleed every time this individual went diving.

OK. I've had students with nosebleeds, but not on every dive.

I think Andy is right to ask for medical confirmation about the condition - If the student wont get it (speculation, I don?t know whether this is true or not) then, as Andy has done, I would refuse to continue to dive with them.

This is one of the dilemmas we, as instructors, have to occasionally face with Self-Declaration. If this individual had an incident and it transpired there was a problem, the student's relatives could make a claim against the instructor(s). Claiming their John/Joan always had nosebleeds, but the instructors had never said there could be something wrong.

Am I going over the top, possibly?

The only one who can really make the decision whether to carry on or not is the instructor facing the situation - they get my full sympathy.

Edward

[keith snell]

Whilst instructing on a recent Sport Diver course I had a student who surfaced 3 times with blood in his mask. The first time I wasn't quite sure if I saw blood however the 2nd two dives confirmed my thoughts.

When I asked the student about the blood and informed him he probably experiencing sinus squeeze he said it always happened and there was nothing to worry about, I was not happy with this.

I suggested he see a doctor to confirm he was "fit to dive" and refrained from instructing him further until a decision was made by his GP. This caused a great deal of disturbance within our direct diving circle... What would you guys have done.

Thanks in advance.

Andy
I cannot see any problem with your actions if your immediate group thimk otherwise, then get round a pint and discuss it, always best to be safe in this day and age, the SDMF is open to many dubious answers and relys on the applicant being trueful, we have all been there, you could get the student to sign some form of disclaimer saying the problem is his responsibility.