Decompression sickness

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Decompression sickness

  1. 1. SYNONIMS CAISSON DISEASE BENDS STAGGERS CHOKES AND AEROEMBOLISM DECOMPRESSION SICKNESS
  2. 2. Penyakit yang disebabkan pelepasan dan mengembangnya gelembung-gelembung gas dari fase larut dalam darah atau jaringan akibat penurunan tekanan disekitarnya. DEFINISI
  3. 3. PENTING DIKETAHUI Gas yang terlarut berbanding lurus dengan tekanan parsial gas tersebut
  4. 4. PENTING DIKETAHUI SUPERSATURASI
  5. 5. PENTING DIKETAHUI Jaringan cepat-jaringan lambat <ul><li>Daya larut nitrogen dalam jaringan </li></ul><ul><li>Aliran darah </li></ul><ul><li>Darah Lemak </li></ul><ul><li>Otak </li></ul><ul><li>Tulang rawan </li></ul>
  6. 6. PENTING DIKETAHUI <ul><li>Penyelaman </li></ul><ul><li>singkat dan dalam : </li></ul><ul><li>Jaringan cepat </li></ul><ul><li>Bublle dlm darah </li></ul><ul><li>Chokes, neurologis </li></ul><ul><li>Penyelaman </li></ul><ul><li>lama dan dangkal : </li></ul><ul><li>Jaringan lambat </li></ul><ul><li>Bublle dlm jaringan </li></ul><ul><li>Bends </li></ul>vs
  7. 7. ETIOLOGY AND PATHOPHYSIOLOGY Decompression sickness is a disease of protean clinical manifestations which is produced by excessively rapid lowering ambient pressure. This reduction causes inert gas dissolved in tissue to come out of physical solution and enter the gas phase. The result is the formation of gas bubbles in the tissue, and in arterial and the venous blood. DECOMPRESSION SICKNESS
  8. 8. TIPE I <ul><li>Classification for identification, prognosis, and therapy. </li></ul><ul><li>Not well defined or applied appropriately </li></ul><ul><li>Pain only bends </li></ul><ul><li>Skin manifestations </li></ul><ul><li>Devined (US Navy Diving) : </li></ul><ul><li>Pain only, skin rash or lymphatic disease, with </li></ul><ul><li>A normal neurological examination before treatment and </li></ul><ul><li>Symptoms resolved within 10 minutes at 2.8 ATA on oxygen </li></ul>
  9. 9. MUSCULOSKELETAL <ul><li>Rasa tidak enak, kaku, yang enak bila digerakkan </li></ul><ul><li>>>> Nyeri tumpul, fluktuasi, kadang berdenyut dan tajam, nyeri gerak </li></ul><ul><li>Usually no sign of joint inflammation </li></ul><ul><li>1/3 shoulder in diver; knee in caisson, aviator </li></ul><ul><li>Rarely symmetrical, if 2 joint are involved and adjoining </li></ul>
  10. 10. Cutaneus <ul><ul><li>Local >>> general </li></ul></ul><ul><ul><li>Pruritus </li></ul></ul><ul><ul><li>lengan bawah, pergelangan tangan, tangan, paha </li></ul></ul><ul><ul><li>Bubbles in dermis, epidermis, kel sebacea </li></ul></ul><ul><ul><li>Segera </li></ul></ul><ul><ul><li>Scarnatinatiorm rash </li></ul></ul><ul><ul><li>Stimulasi piloerector, pelepasan histamin </li></ul></ul><ul><ul><li>Red punctate rash </li></ul></ul><ul><ul><li>Distribusi : Chest, shoulder, back, upper abdomen, thigh </li></ul></ul><ul><ul><li>Beberapa jam </li></ul></ul>
  11. 11. Cutaneus <ul><ul><li>Erysipeloid rash </li></ul></ul><ul><ul><li>Gas in venous drainage </li></ul></ul><ul><ul><li>Systemic DCS </li></ul></ul><ul><ul><li>Papules with flat and firm borders </li></ul></ul><ul><ul><li>Cutis marmorata marbling </li></ul></ul><ul><ul><li>Small pale area, cyanotic mottling, spread peripherally, </li></ul></ul><ul><ul><li>Becoming erythematous, extension cyanotic mottling </li></ul></ul><ul><ul><li>Serious sign of DCS, reliefable </li></ul></ul>
  12. 12. Cutaneus <ul><ul><li>Subcutaneous emphysema </li></ul></ul><ul><ul><li>Dx : Tanda krepitus, localized, along tendon sheats, radiologis </li></ul></ul><ul><ul><li>DD : Barotrauma pulmoner </li></ul></ul><ul><ul><li>Lymphatic obstruction </li></ul></ul><ul><ul><li>Localized swelling. </li></ul></ul><ul><ul><li>Involves hair follicles, a peau d’orange or pigskin appereance with brawny oedema. </li></ul></ul><ul><ul><li>The trunk, but it is also seen over the head and neck </li></ul></ul>

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