emDocs - Septiember 23, 2019 - By Humphrey T., Cirone M
Edited by: Koyfman A and Long B
"Key Points
- Conditions related to descent are generally treated with symptomatic management.
- Pulmonary barotrauma of ascent can lead to local pulmonary injury, pneumomediastinum, pneumothorax, or AGE.
- A chest x-ray should be obtained in all cases of suspected pulmonary barotrauma or AGE.
- Any neurological symptoms or loss of consciousness upon surfacing is considered AGE until proven otherwise. Treatment is supplemental O2, IV fluids, and most importantly, a hyperbaric chamber.
- Decompression sickness is more appropriately categorized by the organ system affected, as even minor manifestations can progress to more serious forms.
- While AGE and neurological DCS may be clinically indistinguishable, both are managed similarly with supplemental oxygen, IV fluids, and hyperbaric oxygen therapy.
- In general, AGE and DCS are clinical diagnoses. Labs and imaging should not delay transfer to a hyperbaric facility.
- Consultation with Diver’s Alert Network (919-684-9111; https://www.diversalertnetwork.org) should be performed early in cases of diving emergencies."