Dive Injury and Jellyfish Sting Case Study.

Introduction: Wildlife exposure is a risk that trained divers are fully aware of. Examples of hazardous wildlife that divers may encounter include, but are not limited to, sharks, coral, sponges, eels, and jellyfish. Encountering wildlife can lead to a diver panicking or being forced to surface rapidly or in an uncontrolled manner due to panic or avoidance of the hazard. This may increase the risk of decompression illness (DCI), mainly pulmonary overinflation syndrome (POIS). Injuries caused by hazardous aquatic wildlife can also be distracting, leading dive supervisors and/or medical personnel to overlook unrelated injuries, such as DCI. If this occurs, the affected diver may suffer a grave outcome that could otherwise have been prevented. Case Report: A 23-year-old Army Engineer diver developed sharp chest pain shortly after a 70-foot SCUBA dive complicated by suspected Portuguese man-of-war envenomation. He had painful tentacle contact on both hands/arms and neck, treated immediately with oxygen, vinegar, and seawater irrigation. In the ED, he was stable with normal oxygenation, ECG, labs, venous blood gas, and troponin. His chest pain resolved within 90 minutes, and skin findings improved with topical steroids and antihistamine therapy. He was diagnosed with jellyfish envenomation and atypical chest pain rather than a diving-related injury. At one-month follow-up, he was asymptomatic with normal chest radiographs and was cleared to return to diving. Discussion: It is of the utmost importance to be aware of all possible injuries or maladies that could have occurred to a diver, and for medical personnel to avoid becoming hyper-focused on a single injury, such as wildlife exposure or trauma.