S16C208 - Dysbarism

Question 1

DCS type 1

Answer 1

• pain only
• pain in joints, extremities, skin (cutis marmorata), lyphedema
• from ascent
• usually occurs w/in mins/hrs (can take days)
• commonly knees/shoulders
• caused by bubbles in joints/tendons

Question 2

Type II DCS (decompression syndrome)

Answer 2

• neurologic, involves CNS, ascending paralysis
• vestibular (staggers)
• cardiopulmonary
• caused by bubbles in CNS
• classically: sensation of truncal constriction or girdle-like pain, ascending paralysis, tendency towards lower cervical/thoracic regions
• presents similar to transverse myelitis, rapid, may have autonomic/sexual/incontinence dysfxn

Question 3

CAGE

Answer 3

• cerebral arterial gas embolism
• symptoms of stroke
• complication of ascent
• can be from pulmonary trauma or a venous embolus through a shunt
• may cause immediate death
• Sz: LOC, Sz, blindness, disorientation, hemiplegia
• may spontaneously improve, may cause an inflammatory process

Question 4

How long to wait b/w dive and flying?

Answer 4

24h

Question 5

Pulmonary DCS

Answer 5

• pulmonary artery bubbles
• cough, hemopytsis, dyspnea, chest pain
• rarely, an embolism from pulmonary barotrauma can cause immediate apnea and cardiac arrest

Question 6

Tx of DCS and CAGE

Answer 6

• 100% O2

- HBO (hyperbaric chamber)

Question 7

Nitrogen Narcosis

Answer 7

• Sx: loss of fine motor skills and high-order mental processes
• may increase likelihood of diver performing a dangerous activity
• unconsciousness may occur
• helium added to mixtures to reduce risk

Question 8

Oxygen toxicity

Answer 8

• pulmonary O2 toxicity (rare in diving)

- cerebral O2 toxicity: twitching, nausea, paresthesias, dizziness, Sz