DECOMPRESSION SICKNESS (DCS)

See Arterial Gas Embolism and Decompression Illness (DCI)

Classification

DCS I - Skin/Joints DCS II - CNS/Respiratory
Joints ('the bends')
  • Arthralgia

(relieved with BP cuff inflated to 150-200mgHg)

Skin

  • Pruritis
  • Erythema
  • Marbling (esp. trunk)
Spinal
  • Limb weakness/paraesthesia/prickliness
  • Low back pain/abdominal pain
  • Bladder/bowel involvement
    (symptoms advance proximally)

Brain

  • Headache
  • Blurred vision
  • Diplopia
  • Dysarthria
  • Fatigue
  • Behavioural change/Derealism

Inner ear ('the staggers')

  • Nausea
  • Dizziness
  • Vertigo
  • Nystagmus

Lung ('the chokes')

  • Cough/SOB
  • Chest pain
  • ECG - Right heart strain
  • Elevated CVP
  • Decrease ETCO2

MANAGEMENT

See Decompression Illness (DCI)

POST-TREATMENT ADVICE

No flying or diving for at least 4 weeks and possibly indefinitely (obtain further advice from Hyberbaric specialist)

Prevention

Dr. David Teubner MBBS FACEM