Spums j 10/4

It seems only feasible to assess every case blood pressure to avoid over infusion.
least 250ml of fluid every 45 minutes.
Skin infections known as ‘sea ulcers’ are a major problem for fishermen in northern Australia.
Prawn fishermen in particular suffer from these Treatment of decompression accidents in a They might begin as apparently insignificant cuts or scratches, but soon flare into weeping sores that just refuse to heal. They may last weeks, even months, and, when eventually they do clear up, ugly purple scars and sensitive skin remain. From personal experience I know how painful and annoying these ulcers are.
Sometimes even the irritation of a pair of shorts or rubber boots is enough to give entry to bacteria and commence the cycle of infection. In fact many fishermen, when standing knee-deep in the sorting tray shovelling prawns, refuse to wear (6.b.i.) to (6.b.ix.) as prescribed.
rubber boots or any other form of footwear - despite the fact that the sorting tray might also hold sea snakes or stonefish hidden amongst the prawns. They prefer to risk the slight possibility of a fatal bite or painful sting, rather than the almost certain ulcers that follow irritation of Fishermen working in the Gulf of Carpentaria and other remote areas have few opportunities to see a doctor, but even medical treatment often has little effect on the ulcers. Some fishermen are The specific points mentioned by Dr Khan: forced to spend weeks ashore - away from salt water and away from their livelihood - before the ulcers The same IV infusion regime as per appendix Sea ulcers thus represent a serious problem for individual fishermen and the industry in diving accident. The rationale being that his cerebral symptom were caused by cerebral Therefore everyone involved in the fishing L a s i x i s u s e d p r e s e n t l y d u e t o industry, particularly in northern Australia, should read the following article. It has been disseminated intravascular coagulation.
written by Dr John L Reichelt, a microbiologist with the drug company Roche Products Pty Ltd, who This point is well taken. It will be noted is studying various types of marine bacteria. He that our treatment regime has been altered explains probable causes and possible cures for A list of ‘dos and dont’s’ can be compiled from the article, but basically he suggests neurological system, has not been spelled fishermen should keep their skin clean of marine disinfectants, used regularly, probably after each session at the sorting tray. Arms and legs should be washed. A tub or sink could be provided twelve weeks after the accident we declare somewhere between the back deck and the accommodation the person as unfit to dive again. It may and filled with disinfectant solution each day.
however be too dogmatic in a diver with eg, Some disinfectants are better than others in level of salt in the bacteriological media.
killing these marine bacteria. Dr Reichelt suggests one marketed as “Hibiclens” which incidentally, is not a Roche product).
grow over a temperature range of 10° to 40°C and,at the higher temperatures, growth is extremely For doctors, he points out that the ointment rapid. In fact cell division times of 10 to 15 “Neosporin” is effective, as well as the antibiotics minutes under optimal conditions make these tetracycline and erythromycin (although other bacteria some of the fastest-growing living detailed information to individual fishermen, derived infections are observed to be more severe fishing companies, medical practitioners or anyone in tropical areas, while in temperate areas most else interested in the problem. To assist cases occur during the summer months. In tropical treatment he will also arrange identification of areas the rapid growth rates of these marine bacteria cultures prepared by doctors. The bacteria confer the ability to establish infection ulcer-forming marine bacteria occur as a significant proportion of the total bacterial flora of coastal seawater in most parts of the world. Increased numbers are observed in the summer months in temperate waters and larger numbers of these marine bacteria are found in coastal waters than infections with simply daily care, then individual fishermen, skippers or boat owners should ensure that it is done: sea ulcers have been allowed to found to occur in marine sediments and in association with marine animals, the numbers observed are not significantly enhanced over those REPRINTED BY KIND PERMISSION OF THE EDITOR FROM “AUSTRALIAN FISHERIES”. 1980; 39(5) May.
forming bacteria have shown the infecting organism to belong to at least three closely related species. The most common species causes ear infections and infections of wounds. Another relatively common species is generally associated with gastroenteritis from seafood, but is occasionally associated with wound infections.
The third species, which is much less commonly observed, has a greater tendency to cause blood poisoning. (These bacteria are most often obtained for identification from blood samples.) BACTERIA INVOLVED IN MARINE-DERIVED WOUND Prevention and cure of marine bacterial ulcers wounds is completely false in this case. Because the ulcer-forming marine bacteria are present in seawater, rinsing wounds in seawater may lead to areas are familiar with the fact that minor wounds from coral or other marine animals frequently become infected, forming persistent ulcers. In In many marine industries frequent exposure some marine industries, marine-derived ulcers are of minor wounds to seawater is unavoidable. Under these circumstances preventive measures must take microbiology laboratories have shown that these into account the extremely rapid growth rate of the ulcers are most frequently due to a small group of marine ulcer-forming bacteria. An effective disinfectant should be applied within two to three hours, rather than at the end of the day.
Properties of the ulcer-forming marine bacteria Chlorohexidine gluconate (its trade name is “Hibiclens” and it is marketed by ICI) is an The bacteria isolated from marine derived example of an inexpensive, readily-available ulcers gave been found to be uniquely marine disinfectant which is effective on these marine bacteria, needing salt to survive. Because of this bacteria while being safe to apply frequently; it salt requirement, these marine bacteria do not is widely used in hospitals as a daily skin- occur outside of the marine environment, but human tissues contain sufficient salt for their growth.
Where a marine-derived infection has become A second consequence of the salt requirement established, a doctor should be consulted. Two is that conventional medical procedures have frequently failed to isolate the causative organism from marine-derived ulcers because of an inadequate

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