Decompression sickness: Difference between revisions
(Created page with "==Background== *Dissolved inert gases come out of solution and form bubbles in blood and tissue ==Clinical Features== ===Types=== ====Type I (Pain only DCS)==== *Involves th...") |
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==Clinical Features== | ==Clinical Features== | ||
===Type I (Pain only DCS)=== | |||
*Involves the joints, extremities, and skin ("cutis marmorata") | *Involves the joints, extremities, and skin ("cutis marmorata") | ||
*Usually only single joint is involved | *Usually only single joint is involved | ||
===Type II (Serious DCS)=== | |||
*Spinal cord involvement | *Spinal cord involvement | ||
**Ascending paralysis | **Ascending paralysis | ||
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*Pulmonary "chokes" | *Pulmonary "chokes" | ||
**Cough, hemoptysis, dyspnea, substernal chest pain | **Cough, hemoptysis, dyspnea, substernal chest pain | ||
===Type III (Type II + gas embolism)=== | |||
*Variety of stroke symptoms/signs | *Variety of stroke symptoms/signs | ||
**May spontaneously resolve | **May spontaneously resolve | ||
Revision as of 23:25, 10 February 2015
Background
- Dissolved inert gases come out of solution and form bubbles in blood and tissue
Clinical Features
Type I (Pain only DCS)
- Involves the joints, extremities, and skin ("cutis marmorata")
- Usually only single joint is involved
Type II (Serious DCS)
- Spinal cord involvement
- Ascending paralysis
- Signs often cannot be traced to single location in the cord (may have skip lesions)
- Vestibular ("staggers") involvment
- Vertigo, hearing loss, tinnitus
- Differentiated from inner ear barotrauma which usually occurs on descent
- Vertigo, hearing loss, tinnitus
- Pulmonary "chokes"
- Cough, hemoptysis, dyspnea, substernal chest pain
Type III (Type II + gas embolism)
- Variety of stroke symptoms/signs
- May spontaneously resolve
Differential Diagnosis
Diving Emergencies
- Barotrauma of descent
- Otic barotrauma
- Pulmonary barotrauma
- Sinus barotrauma
- Mask squeeze
- Barodentalgia (trapped dental air causing squeeze)
- Barotrauma of ascent
- Pulmonary barotrauma (pulmonary overpressurization syndrome)
- Decompression sickness (DCS)
- Arterial gas embolism
- Alternobaric vertigo
- Facial baroparesis (Bells Palsy)
- At depth injuries
- Oxygen toxicity
- Nitrogen narcosis
- Hypothermia
- Contaminated gas mixture (e.g. CO toxicity)
- Caustic cocktail from rebreathing circuit