DCS type 1 Bend Limb and joint pain only Skin rash
DCS type 2
- Cardiopulmonary system
- “ choke ”
- “ spinal cord hit ”
- spinal cord DCS
Spinal cord DCS
Venous infarction of cord
- Venous gas embolism block the pulmonary arterioles
- Rise in intra-thoracic pressure
( pulmonary hypertension )
- Interferes drainage of venous system
( spinovertebral-azygos system )
- Spinal cord is relatively poor perfusion when compare to the brain
Remove from water
oral /IV fluid
Air (Helo/ Air Ambulance)
- ascent, at depth and descent.
- contributing factors
- exclusion of alternate potential causes
- onset of symptoms
- neurological assessment
Hyperbaric Oxygen Therapy.
Mechanical compression of bubbles.
Washout of inert gas (N2).
Stabilization of cell membranes.
Combats inflammatory response.
avoid dive - 4 weeks
avoid fly 2-4 weeks
Review 4 weeks
? Further investigations
Flying after diving
> Flying after a single no-decompression dive : A minimum preflight surface interval of 12 hours is suggested.
> Flying after multiple no-decompression dives in a single day or multiple days of no-decompression diving : A minimum preflight surface interval of 18 hours is suggested.
> Flying after dives requiring decompression stops : There is little experimental or published evidence on which to base a recommendation for decompression dives. A preflight surface interval substantially longer than 18 hours appears prudent.
cabin altitudes of 2,000 to 8,000 feet for divers who do not have symptoms of decompression sickness (DCS).
The recommended preflight surface intervals do not guarantee avoidance of DCS.
Longer surface intervals will reduce DCS risk further .
Emergency air evacuation -Aircraft pressurized 1 ATA ( if possible) -Un-pressurized aircraft - no more than 1000 feet -Have the patient breath 100% oxygen during transport