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INTERIM REPORT FOR ROUND FOUR GRANTS

Australasian Hyperbaric & Diving Medicine
Research Trust Grant Application
2012 Round 4 Interim Report


1a. Project Title:

What Is The Incidence of Middle Ear Barotrauma in Novice SCUBA Divers
and Can It Be Reduced?

1b.Investigators and Institutional Affiliations:

Dr Denise Faye Blake BN, MD, FRCPC, FACEM, PG Dip Med Sci (Diving and
Hyperbaric Medicine)
Staff Specialist, Emergency Department, The Townsville Hospital
Adjunct Senior Lecturer, School of Marine and Tropical Biology, James Cook
University, Townsville, QLD

Dr Katherine H Commons MBChB
Registrar, Hyperbaric Medicine Unit, The Townsville Hospital

Dr Clinton R Gibbs MBBS, FACEM, Dip DHM (SPUMS), PGCertAME
Staff Specialist, Emergency Department, The Townsville Hospital

Dr Catherine A Meehan MBBS, PG DIP Med Sci (Diving and Hyperbaric
Medicine, Dip DHM (SPUMS)
General Practitioner, McLeod Street Medical, Cairns, Queensland

Lawrence H Brown PhD, MPH&TM
Senior Principal Research Officer
School of Public Health, Tropical Medicine and Rehabilitation Services
James Cook University

1d. Institutions/sites where research will be conducted:

Prodive, Cairns dive training centre, pool and dive boats
Deep Sea Divers Den Cairns dive training centre, pool and dive boats

1e. Administering Institution/Deductible gift recipient status:

James Cook University Research Services
Division of Finance and Resource Planning
Room 224, Ken Black Chancellery Building
James Cook University
Angus Smith Drive, Douglas, Queensland, 4811
Phone: 07 4781 4314

1f. Principal Investigator:

Dr Denise Blake
Emergency Department
The Townsville Hospital
100 Angus Smith Drive, Douglas, QLD, Australia, 4814
Mobile: 0427 158 788
Fax: 07 4796 2901
Denise_blake@health.qld.gov.au

2. Hypothesis and Aims:

The aim of this study is to assess the hypothesis that education about ear
equalization techniques using video otoscopy in open water Self Contained
Underwater Breathing Apparatus (SCUBA) diver candidates will decrease the
incidence of middle ear barotrauma.

This study will test two null hypotheses:

HØ1: There is no difference in the frequency of grade 2 or greater post-dive
barotrauma in PADI open water dive candidates who participate in an extra
educational session on ear equalization techniques compared with dive
candidates who are not exposed to the extra educational session.

HØ2: There is no difference in the severity of post-dive barotrauma in PADI
open water dive candidates who participate in an extra educational session on
ear equalization techniques compared with dive candidates who are not
exposed to the extra educational session.

3. Summary Of Progress:

We have completed 3 dive trips and are half way through collecting the
control group data. All dive trips have been with Prodive in Cairns. Student
numbers have been increasing. Interim analysis below:

6 (21.4%) with middle ear barotraumas (MEBT) after 1st pool dive; 1 (3.5%) bilateral
14 (50%) with MEBT after 2nd pool dive; 6 (21.4%) bilateral
11 (39.3%) with MEBT after 1st ocean dive; 8 (28.6%) bilateral
16 (57.1%) with MEBT after 2nd ocean dive; 10 (35.7%) bilateral

Only 9 individuals (32.1%) without MEBT at any point

No relationship between whether instructed in primary language and MEBT:
Instructed in primary language, MEBT = 11/15 (73.3%)
Not instructed in primary language, MEBT = 8/13 (61.5%)
Fisher's exact test, p = 0.689

There have been no changes to the project. We have purchased a second
otoscope handle and a pelican case to house our equipment for use on the
dive boat.

Time to travel to Cairns has been difficult due to work and exam
commitments. We are unsure how the new legislation surrounding
recreational dive medicals will affect our ongoing research. We are hoping
that our ear assessment will still be seen as valuable.

The first version of our ear barotrauma book has been completed and printed
on Mac book. We have started preparing the presentation for the intervention
group. Interest from DAN America has been raised to formally design an ear
assessment program along the lines of their neurological assessment course.













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