DETAILS FOR ROUND FOUR GRANTS
WHAT IS THE INCIDENCE OF MIDDLE EAR BAROTRAUMA IN NOVICE SCUBA DIVERS AND CAN IT BE REDUCED?
THE EFFECT OF HYPERBARIC OXYGEN TREATMENT ON LARGE BONE DEFECT HEALING USING TISSUE ENGINEERED BONE SUBSTITUTES
Dr Denise Blake
The Townsville Hospital
100 Angus Smith Drive, Douglas, QLD, Australia, 4814
Mobile: 0427 158 788
Fax: 07 4796 2901
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 MPH&TM
Principal Research Officer, School of Public Health, Tropical Medicine
and Rehabilitation Services, James Cook University.
Institution at which 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
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:
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.
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.
be a prospective study performed to assess middle ear barotrauma in PADI
open water diver candidates after an education session on ear
equalization techniques. The PADI open water diver candidates will have
completed and passed their dive medicals prior to enrolment in the
study. To decrease the ability of students and instructors to share
knowledge of ear equalization techniques, entire open water classes will
be used as the control and intervention groups. The groups will be
allocated to control and intervention with all controls being completed
before the intervention. The intervention group will have an education
session on basic ear anatomy and physiology and a practical session on
ear equalization techniques with video otoscopy to show them movement of
their tympanic membranes with the Valsalva manoeuvre. Photographs of
their tympanic membranes will be taken and tympanometry completed. The
control group will have photographs taken, otoscopy to visualize
tympanic membrane movement with Valsalva, and tympanometry but with no
formal ear equalization education and no viewing of TM movement. The
candidates will be assessed at the training centre prior to confined
water sessions, after confined water sessions and after open water
dives. Education sessions will take place at the dive training centre.
The frequency of grade 2 or greater barotrauma in the two study groups
will be compared using relative risk; the severity (grade) of
barotraumas in the two study groups will be compared using the Wilcoxon
Outcomes and significances:Divers:
- Potential for reduction in the risk of barotrauma, through initiation of preventative measures:
- Reduction in pain;
- Reduction in further complications of middle ear barotraumas eg. hearing loss
- Potential for reduction in other diving injuries:
more dives can be completed during the initial supervised course,
divers may go on to learns more safe practices before heading out into
the water by themselves;
- new divers able to focus on other aspects of dive safety therefore reducing rapid ascents and buddy separation due to ear pain
enjoyable, less painful diving is more likely to encourage divers back
into the sea and to recommend the activity to friends
- Decrease the number of dives missed by divers due to aural barotrauma
obtained from this research project will be used to develop a formal
training program for SCUBA instructors to teach assessment of ears and
education about ear equalization techniques for open water SCUBA diver