Decompression sickness: Difference between revisions
| Line 10: | Line 10: | ||
**Ascending paralysis | **Ascending paralysis | ||
**Signs often cannot be traced to single location in the cord (may have skip lesions) | **Signs often cannot be traced to single location in the cord (may have skip lesions) | ||
***Limb weakness, paresthesias, or paralysis | |||
***Urinary retention, fecal incontinence, or priapism | |||
*Vestibular ("staggers") involvment | *Vestibular ("staggers") involvment | ||
**Vertigo, hearing loss, tinnitus | **Vertigo, hearing loss, tinnitus | ||
| Line 15: | Line 17: | ||
*Pulmonary "chokes" | *Pulmonary "chokes" | ||
**Cough, hemoptysis, dyspnea, substernal chest pain | **Cough, hemoptysis, dyspnea, substernal chest pain | ||
===Type III (Type II + gas embolism)=== | ===Type III (Type II + gas embolism)=== | ||
*Variety of stroke symptoms/signs | *Variety of stroke symptoms/signs | ||
Revision as of 15:32, 24 February 2015
Background
- Dissolved inert gases (e.g. Nitrogen) 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)
- Limb weakness, paresthesias, or paralysis
- Urinary retention, fecal incontinence, or priapism
- 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