Wednesday, July 27, 2016

Things that Sting and How to Avoid Them - Part 2 - Fire coral & Stingrays


Disclaimer - I am NOT a doctor.  I am just a scuba instructor who has been around for a while and has seen (and been stung by) a lot of things.  This is not meant to replace professional medical advice or replace visiting your doctor or calling the professionals at Diver's Alert Network for advice.  If any of your symptoms are severe or are affecting your breathing or pulse, please get yourself to a hospital immediately!  

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FIRE CORAL

Image by Nhobgood Nick Hobgood via Wikipedia

FIRE CORALS - They come in many shapes and sizes, but their brownish orange color helps distinguish them from the other corals.  Fire corals are not true corals.  They secrete a hard skeleton and add structure to the reef like other corals, but they are more closely related to jellyfish.  Among the more commonly seen types of fire coral are branching fire corals and encrusting fire corals.  

Image by Nhobgood Nick Hobgood via Wikipedia

Image by Derek Keats via Wikipedia
Branching fire corals often have white coloration near their tips.  Encrusting fire corals can form on anything that has been underwater for an extended period of time.  Fire corals can encrust on mooring lines, dock pillars, rocks, shipwrecks, sea weed, and even other corals.

Image by Public.Resource.Org via Wikipedia

If you look very closely you can see tiny white hairs or bristles coming from the fire coral.  Each of these fine hairs contains a "nematocyst" that is barbed and contains a toxin.  Fire corals use their barbed toxic nematocysts by shooting them out to paralyze their prey (plankton) as well as to defend themselves against potential predators when they get too close.  It's these almost microscopic nematocysts that stick in your skin and cause you extreme pain when you touch fire coral.  

Image by Steel Worker 2nd Class Metro Sayre via Wikipedia
Image by Amy Kelley

To avoid getting stung, cover your skin with a rash guard or a wetsuit and keep a safe distance from the reef.  If there is a lot of surge, give an even wider cushion of safety.  Divers should practice good buoyancy control, and consider taking PADI's Peak Performance Buoyancy course to improve their control in the water.  Be aware that fire coral can encrust on any underwater surface, so avoid touching, brushing into, or grabbing onto anything underwater.  It is important not to touch things underwater for conservation purposes too - you don't want to harm any underwater organisms!  If you find it necessary to hold onto a mooring line and you are not wearing gloves, look at the line carefully before deciding where to grab it.  Avoid the parts of the line that seem to be covered in hydroids or fire coral.  Instead of grabbing the line with your whole hand use what I like to call "shrimp claws."  That means grabbing the line delicately with just two fingers.

Image by Derek Keats via Flickr

In saying that, I have been stung by fire coral numerous times.  I can tell you from personal experience that it does feel like fire.  It is not pleasant at all.  For me, the pain is usually very intense and gives me a head rush because it triggers endorphins to help my body cope with the pain.  I am usually with students or guiding divers when it happens, so I do my best to suck it up and pretend like nothing happened.  It most often occurs when there is significant surge and I am focused on helping another diver rather than paying attention to my own position in the water.

Image by Razvan Marescu via Flickr

If you do touch fire coral you will know it.  You will feel a painful, hot, fiery sting, and will probably see a welt or a rash soon after you accidentally brush up against the fire coral.  Avoid the temptation of rubbing the sting, as you will spread the toxic nematocysts around and end up getting stung even more.  Flush seawater over your sting, and when you get out of the water rinse it with vinegar.  Acids have been proven to stop the nematocysts from continuing to fire.  Later on, the sting location may begin to itch severely.  Try to avoid scratching it.  Instead, apply anti-itch medication and take Benadryl if the itching is unbearable.  Tylenol or Ibuprofen can be used to reduce the pain.  If the sting is so bad that it affects your breathing or pulse, seek emergency medical care immediately.


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STINGRAYS

Image by Barry Peters via Wikipedia
Image by Richard Giles via Flickr

STINGRAYS - Despite their reputation as man-killers after the untimely death of Steve Irwin, the Crocodile Hunter, stingrays are actually very gentle creatures.  They are by no means "out to get you."  However, people can get stung by stingrays when they feel threatened.  Every creature needs a defense mechanism to survive, and the stingray defends itself by arching its tail forward and plunging its venomous sharp barb into whatever threatens it.  Stingrays only sting out of self-defense.  In Steve Irwin's case, the stingray felt threatened because Steve hovered too closely and directly above it.  In most cases when someone is injured by a stingray, they accidentally step on one.

Image by Marek Jakubowski via Wikipedia

Image by Adamantiaf via Wikipedia
Stingrays eat mollusks, shrimp, crabs, and small fish.  They can be found along the reef, in sea grass beds, and in the sand.  They shuffle through the sand, using mostly their sense of smell and electroreceptors to find their prey.  While resting, stingrays often partially bury themselves in the sand.  Stingrays are quite incredible to watch.  They use their spiracles, the openings behind their eyes, to take in water and to expel the undigestible bits as they filter through the sand for food.  Next time you are snorkeling or diving and find a stingray, take some time to observe it, but give it plenty of space. 

Image by Tomas Willems via Wikipedia

Image by Jlwelsh via Flickr
To avoid any negative encounters with stingrays while diving or snorkeling, do not touch them or corner them.  Especially avoid hovering above them, as that is their strike zone if they feel threatened.  While hanging out at the beach, shuffle your feet through the sand so you don't accidentally surprise a stingray hiding in the sand.  

Image by Andrew Beckwith via YouTube

I cannot say firsthand how badly a stingray sting hurts, since I have never been stung by one.  However, I am certain that it is an extremely unpleasant and very painful experience.  It would be like being stabbed with a serrated knife, plus the effects of the venom.  

Image by Freebin via Wikipedia

If you get stung by a stingray, stay calm.  Remove the stinger (unless it is in a vital organ, such as with Steve Irwin).  Apply pressure to stop the bleeding.  Evaluate the severity of the symptoms, and determine whether or not emergency medical care is necessary.  Typical symptoms include pain, swelling, bleeding, and muscle cramps.  If bleeding is severe and uncontrollable or breathing or circulation are affected, consider it a medical emergency and get to a hospital immediately.  If it's not an emergency, soak the wound in hot water (but don't burn yourself!) for 30-90 minutes to deactivate the venom and relieve the pain.  You can take a painkiller such as Tylenol or Ibuprofen to ease the pain, and an antihistamine such as Benadryl to relieve itching and swelling.  Keep the wound clean and monitor it for signs of infection.    

Image by Symac via Wikipedia

Diver's Alert Network, also known as "DAN," is the dive industry's number one dive safety resource.  Every diver should have their phone number, since they are the best resource for dive safety.  They have a 24 hour emergency hotline, as well as an information line for non-emergency medical questions.  Even non-members can get free advice.  I highly recommend becoming a DAN member, since they provide affordable and high quality dive insurance, travel insurance, a monthly magazine called "Alert Diver," and a wide variety of dive safety educational resources.  

DAN Non-emergency medical information line
+1-919-684-2948
Mon-Fri 8:30am to 5:00pm EST.
+1-800-446-2671

A big "Thank You!" to our local diver John F. for suggesting this blog topic!  I look forward to hearing everyone's ideas and suggestions for future blog topics.  Feel free to leave comments on this blog or on our Aqua Action Divers Facebook page.


Wednesday, July 20, 2016

Things that Sting and How to Avoid Them - Part 1 - Urchins and Hydroids

Disclaimer - I am NOT a doctor.  I am just a scuba instructor who has been around for a while and has seen (and been stung by) a lot of things.  This is not meant to replace professional medical advice or replace visiting your doctor or calling the professionals at Diver's Alert Network for advice.  If any of your symptoms are severe or are affecting your breathing or pulse, please get yourself to a hospital immediately!  

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SEA URCHINS 

Image by Nick Hobgood via Wikipedia

SEA URCHINS - Often looked at by snorkelers and divers as an evil enemy, sea urchins are very underappreciated.  If you take a moment to observe them you will see and hear that they are magnificent creatures. 


Image by Jon Bondy via YouTube

When they move their spines around in the glistening sunlight it is like they are dancing.  Some urchins have beautiful coloration if you look closely (reds, purples, blues).  The crackling sound of the urchins scraping algae off the reef sounds like an underwater orchestra.  Without the urchins, the reef could get overrun with algae and the many creatures that depend on urchins for food could be in trouble. 

Image by LadyCopperhead via YouTube

Image by Sasquatch via Wikimedia

Image by Brocken Inaglory via Wikipedia

Among the creatures that eat urchins are birds, fish, crabs, lobster, octopus, and sea stars.  A snorkeler or diver who pays attention to small details will notice that sea urchins are often home to fish fry (newly hatched tiny baby fish) and little shrimp.  They use the urchin's spines for protection so they don't become an easy meal for another creature on the reef. 

Image by Ingvar-fed via Wikipedia

Every creature needs a way to protect itself, or it would never survive.  The sea urchin's way of protection is through it's spines.  Many species have long, sharp, sometimes venomous brittle spines that can puncture and break off in your skin.  Sea urchins are found in relatively shallow areas where there is algae growth because algae is an important food source for urchins.  Avoid shallow rocky areas, because there are likely sea urchins there!  

Image by Amy Kelley - Only stand in the sand

To avoid stepping on urchins, ONLY STAND IN THE SAND!  When snorkeling or diving, be aware of your surroundings and give plenty of distance between yourself and the urchins.

Image by Derek Keats via Flickr

I will admit that once upon a time I was pretty dumb and thought that if I picked up a very small long spine sea urchin very very carefully, I could avoid getting stung.  I was surprised to find that these creatures are incredibly talented at defending themselves.  The little urchin pointed its spines in the direction of my hand and actually dug one of its spines into my skin.  Ouch!  The long spine sea urchin is one of the urchins that is venomous, and even though I only got one little spine in my hand it was a deep, throbbing pain and I definitely learned my lesson!  


Image by Michael (a.k.a. moik) McCullough

Image by Michael (a.k.a. moik) McCullough via Flickr
Image by Graceie via Pixabay

If you accidentally get urchin spines in your skin you should remove any large spines that are sticking out with tweezers, then soak it in water as hot as you can tolerate without burning yourself for at least 30 minutes.  Trying to dig the spines out is not a good idea.  You will see that they just disintegrate into a million little pieces and digging will likely lead to infection.  Apply an antibiotic ointment and take acetaminophen or ibuprofen to relieve the pain.
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HYDROIDS

Image by Bernard Picton via Wikipedia

HYDROIDS - Look like tiny underwater ferns or feathers, but are actually colonies of tiny animals related to jellyfish.  They are often overlooked because they are so small, but they are one of the most abundant creatures in the sea.  Hydroids can be found on almost anything that has been underwater for any length of time: sea weed, mooring lines, the underside of boats, docks, sea grass, rocks, the reef, conch shells...you name it!  Next time you are in the ocean, you are sure to see hydroids now that you know about them.  If disturbed, individual hydroids break off from the colony and float freely in the water.  Each one of these little hydroids can sting you.  Hydroids sting both as a way of protecting themselves and as a way of capturing prey.  If you have ever felt something sting you in the ocean but didn't see anything, there is a good chance that it was a hydroid.

Image by NPS Photo - Larry Basch via Wikipedia
How badly you will react to a hydroid sting depends on how sensitive your skin is.  People with tough skin might just feel the initial sting and a burning sensation, and then have no further reaction.  People with more sensitive skin could end up with a rash, welts, or blisters that could show up immediately or hours later.  I have very sensitive skin and tend to react severely to stinging things.  For me, it hurts pretty intensely, but usually for just a few seconds.  The worst of it is the itching that usually happens hours later and sometimes lasts over a week.  For some reason it's usually relatively tolerable for me during the day, but I find myself waking up in the middle of the night scratching uncontrollably and losing sleep. 

Image by Jonathan Wilkins via Wikipedia
Image by Amy Kelley - My whole body looked like this! :(

The worst was just over a year ago when the Caribbean had a huge influx of Sargasso sea weed.  It was so thick in one bay I was snorkeling in that I had to push my way through it to get back to the boat.  I was only wearing a bikini, no wetsuit or rash guard, so I got stung from head to toe.  At that time I didn't think about all of the hydroids that were likely growing all over the sea weed.  That night I broke out in a full body rash that was so itchy it practically drove me to the point of insanity.  It lasted a week, and was so bad I had to miss work.  I spent that week in a state of misery, doped up on benadryl and ibuprofen.  After experimenting with various topical anti-itch treatments I found that Bactine gave me the most relief because it desensitized my skin.         

Image by Rob Zwissler
The best way to avoid being stung by hydroids is to cover your skin by wearing a rash guard or wetsuit and avoiding contact with things that may have hydroids growing on them!  If you do get stung, avoid the temptation to rub your skin!  This will spread the stinging cells around and make it worse!  Instead, flush sea water over the sting to get rid of any remaining hydroids.  Next, get out of the water and rinse the sting with vinegar to neutralize the stinging cells.  Keep the area clean to avoid infection, and apply anti-itch medication. Consider taking Benadryl if the itching is too much to handle, and of course immediately seek professional medical help if the reaction affects your breathing or pulse.  

Diver's Alert Network, also known as "DAN," is the dive industry's number one dive safety resource.  Every diver should have their phone number, since they are the best resource for dive safety.  They have a 24 hour emergency hotline, as well as an information line for non-emergency medical questions.  I highly recommend becoming a DAN member, since they provide affordable and high quality dive insurance, travel insurance, a monthly magazine called "Alert Diver," and a wide variety of dive safety educational resources.  

DAN Non-emergency medical information line
+1-919-684-2948
Mon-Fri 8:30am to 5:00pm EST.
+1-800-446-2671

A big "Thank You!" to our local diver John F. for suggesting this blog topic!  I look forward to hearing everyone's ideas and suggestions for future blog topics.  Feel free to leave comments on this blog or on our Aqua Action Divers Facebook page.

Keep following the Aqua Action Blog to see "Things that Sting and How to Avoid Them - Part 2"


Wednesday, July 13, 2016

Skills Every Diver Should Practice

Image by Ahmad Faiz Mustafa via Wikipedia

How long has it been since you took your scuba certification course?  Months?  Or has it been years?  Many divers become complacent because they have been diving for "so long."  But being a safe diver has nothing to do with how long you have been diving.  The big question is, how sharp are your skills?  Are you comfortable enough that you know you can handle any problem that may occur underwater and confident that nothing will cause you to panic?  Do you remember and understand basic dive theory to keep you safe from injury and decompression sickness?  

Download the ReActivate program and do it anywhere!  ©PADI 2016

If you cannot answer "YES!" with confidence, it's time to consider Re-Activating your certification and doing a refresher course.  PADI's "ReActivate" program is a way for PADI divers to update their skills and knowledge before getting back into the water.  It's quick and easy, and personalized for you.  You download a program that goes over concepts you learned in your scuba training in a prescriptive way, so you can focus on the things you forgot.  You can do it anytime, anywhere!  Contact Aqua Action Divers or your local dive shop to get your code to download your ReActivate program and get started!  You get to keep the program forever so you can review your knowledge and skills again and again! 
 
Refresh your skills with a PADI Instructor ©PADI 2016

After you complete the digital portion of the ReActivate program you can sign up for a refresher course to practice your in-water skills with a PADI instructor.  If you complete both the digital and the in-water portions of the ReActivate course, you get a replacement certification card that says "ReActivated" on it.  Contact Aqua Action Dive Center to schedule your in-water practice time with one of our instructors!

At the absolute minimum, you should review your dive theory and practice your skills in a pool or in calm shallow water.  Here are a few of the skills that you should practice regularly because they are essential to your safety :

Image by TauchSport_Steininger via Wikipedia
No mask breathing - You must be comfortable with water around your face.  It is not uncommon for masks to leak a little bit on a dive.  Although less likely, your mask strap could break or you could lose your mask during a dive.  You must be able to stay cool, calm, and collected and avoid panicking if this were to ever happen to you. 

Image by Peter Southwood via Wikimedia Commons

Cramp release - The muscles you use when you are swimming with fins are muscles you may not use much in your everyday life.  Cramps can happen from dehydration or working a muscle more than you're used to.  Knowing how to deal with cramps in your feet or legs is important to avoid panic during a dive.  You should be able to calmly signal to your buddy, grab your fin tip, and stretch until the muscle has relaxed.

Image by Von Thomei08 via Wikipedia

Dealing with a sticky BCD inflator button - If your BCD inflator button sticks while you are on a dive, it could send you shooting to the surface and put you at great risk of decompression sickness if you do not know what to do.  Be familiar with the dump valves on your BCD so you can dump out excess air from your BCD and prevent a runaway ascent.  Practice disconnecting your low pressure inflator hose while under pressure, too, since it would need to be disconnected if you had a sticky inflator button.  To prevent your inflator button from sticking in the first place, wash your gear well after each use to make sure no salt crystals or sand can cause it to stick.  Also, have your gear serviced annually by a qualified technician.

Image by Mark.murphy via Wikipedia

Emergency weight drop - It is essential to know how to quickly get rid of your weights in an emergency.  For example, if you are on the surface and you cannot keep your head above water and your BCD is not inflating you need to drop your weights to get positively buoyant.  Being familiar with your weight system and knowing how to quickly ditch them can save you from drowning.

Image via Pixabay

Buoyancy control - Poor buoyancy control while diving can lead to ear injuries (read "10 Tips to Prevent Ear Injury"), decompression sickness, lung over-expansion injury, rapid air consumption, hyperventilation, injuries resulting from running into sea urchins or coral, and damaging the reef.  Buoyancy control is the skill that takes the most practice to master, but once you master it your dives will be immeasurably more safe, relaxing, and enjoyable.  

Image by Peter Southwood via Wikipedia

Alternate Air source use  - Although running out of air should never be an issue if you pay attention to your air gauge, it is important to practice using your buddy's alternate air source and having your buddy breathe using your alternate air source.  You should also practice swimming together while sharing air, since it is awkward and does takes team work and coordination.  In the unlikely event that you or your buddy do run out of air from a dive, being able to confidently perform this skill could save you or your buddy's life.

Which of this skills do you feel most confident with?  Are there any of these skills you haven't practiced in a while?  What are you going to do to make sure your skills are sharp before your next dive?  What other skills do you think should be on this list?


Wednesday, July 6, 2016

10 Tips to Prevent Ear Injury

The most common injuries in scuba diving are ear injuries.  Pressure increases with depth, and you must be able to "equalize" your body's air spaces to avoid injury.  Equalizing means making the pressure inside your body's air spaces match the surrounding ambient pressure.

HERE ARE 10 TIPS TO PREVENT EAR INJURY

Image by Vera Kratochvil via Public Domain Pictures

1. DO NOT DIVE WHEN CONGESTED - If you have a cold or allergies, mucus fills your body's air spaces, making it difficult or impossible to equalize your ears and sinuses.  Air needs to be able to move freely through your ear and sinus air spaces in order to make the pressure inside of your body's air spaces equal to the surrounding pressure.    

Image by ParentingPatch via Wikimedia

2. ONLY USE MEDICATIONS WITH EXTREME CAUTION -  Some divers like to take a decongestant such as Afrin or Sudafed before a dive.  These medications help to clear up congestion, but if the congestion returns during the dive you may have another problem to contend with - reverse block.  Reverse block can happen if you are ascending and the expanding air cannot be released from your body's air spaces.  Be careful to take decongestants close enough to your dive time so they are effective, but not too early so they do not wear off during your dive.

Image by Mojpe via Pixabay

3. REDUCE MUCUS BEFORE & DURING THE DIVE - As disgusting as these ideas may sound, they work.  Prior to descending, blow your nose to clear the mucus from your sinuses.  "Hock a loogie" to clear your Eustachian tubes of phlegm.  This will make equalizing easier during your descent.  But mucus may re-accumulate, and you may need to get rid of mucus during the dive, too.  I remove my mask while underwater to blow my nose and clear my air spaces of mucus, and it works for me.  I would only recommend this for divers who are very comfortable removing their mask underwater.   


Image by H. Zell via Wikimedia
Image by Kruscha via Pixabay
Image via Pexels



















4. AVOID SUBSTANCES THAT CAUSE EXCESSIVE MUCUS PRODUCTION -  Consuming milk products, tobacco, and alcohol cause your body to create more mucus.  If you are someone who tends to have trouble equalizing, avoid drinking milk or having other dairy products before a dive.  Smoking and drinking alcohol should always be avoided before and after diving.  Smoking and drinking cause mucus to form, make it harder to equalize, and increase your risk of decompression sickness.

Image by Waltermera182 via Wikipedia

5. KNOW VARIOUS EQUALIZATION TECHNIQUES - Most divers know the "jaw wiggle" technique, the "swallow" technique, and the "pinch your nose and blow gently" technique.  Relaxing your face and neck muscles while trying to equalize can make a big difference, too.  Relaxing your muscles allows air to move more freely through your air spaces, while tense muscles can prevent equalization from happening.  You can tilt your head to the side to elongate your Eustachian tube, the tube that connects your ears and sinuses to your throat, while trying to equalize.  You can also massage your Eustachian tube to help air pass through for equalization.  This works great if you have one stubborn ear, but can also be used for two stubborn ears if you alternate sides.  You can combine these techniques for even better results.  For more techniques, read Diver Alert Network's The Diver's Complete Guide to the Ear.

Image by Nathanial Kelley

6. ALWAYS DESCEND SLOWLY AND CONTROLLED -  Most divers descend way too quickly, and put themselves at high risk of barotrauma, pressure related injuries.  You should think of your descent like descending a ladder, rung by rung.  Go slowly, equalize every two feet, and be able to stop immediately if your ears do not equalize to the depth of that rung.  If you are having trouble equalizing, go up only two feet (one rung of the ladder).  Going up more than that will cause unnecessary and dramatic pressure changes to your ears that are likely to hurt you.  Many divers are totally unaware of exactly how much they are going up or down.  Looking at your depth gauge, or better yet, your dive computer, can help you make sure you are not going up or down too far or too fast.  

Image by Amy Kelley
 
The best way to assure a slow, controlled descent is to use a descent line and climb up and down that line with your hands while you equalize.  If surface conditions are choppy, remember that you shouldn't let the line jerk you up and down.  Move your arm up and down with the waves, while your body remains at a constant depth.

Image by Amy Kelley

7. DESCEND FEET-FIRST -  That will allow air to rise up your Eustachian tubes and mucus to drain down.  If you descend in an inverted position you will probably need to equalize more forcefully, which can lead to ear damage.  Always equalize gently.

Image by Julie Holmes via Pexels

8. EQUALIZE PROACTIVELY -  Try equalizing before your dive to make sure your ears will cooperate.  Some experts say that if you practice equalizing hours before your dive, it will be easier for you to equalize during your dive.  If you are unable to equalize on the surface, you will not be able to equalize underwater - and you should not dive.  If you gently equalize right before you begin your descent (pre-pressurize) it may help you to equalize past those first few feet which are where the pressure change is the most dramatic.  Equalize before you feel any pain or discomfort and never force an equalization.

Image by Amy Kelley

9. SWIM SLIGHTLY ABOVE THE GROUP -  If you are having a hard time equalizing but the rest of the group is beginning their dive, you can still stay with the group but at a shallower depth.  This way you won't float away into the deep blue by yourself while trying to equalize, and you will not stop the group from beginning the dive.  Be sure to signal to your dive guide that you are having trouble with your ears and that you will swim above the group.  Take your time equalizing and descending, and only descend to a deeper depth when your ears are ready. 

Image via Pixabay

10. GET CONTROL OF YOUR BUOYANCY - Good buoyancy control will help you to be in control under the water.  With good buoyancy control you will have slow descents and ascents, be able to stop at any given depth if necessary, and be able to stay at a constant depth.  Divers with poor buoyancy control tend to accidentally float up and sink down many times during a dive, subjecting their ears to unnecessary pressure changes.  Consider signing up for a Peak Performance Buoyancy course with Aqua Action Dive Center or your local dive shop.


Remember these 10 tips next time you go diving, and enjoy a fun and pain-free dive!  To learn more, read Diver Alert Network's Guide to Avoiding Ear & Sinus Injuries in Scuba Diving

Image by BruceBlaus via Wikipedia