SYNONIMS CAISSON DISEASE BENDS STAGGERS CHOKES AND AEROEMBOLISM DECOMPRESSION SICKNESS

Penyakit yang disebabkan pelepasan dan mengembangnya gelembung-gelembung gas dari fase larut dalam darah atau jaringan akibat penurunan tekanan disekitarnya. DEFINISI

PENTING DIKETAHUI Gas yang terlarut berbanding lurus dengan tekanan parsial gas tersebut

PENTING DIKETAHUI SUPERSATURASI

PENTING DIKETAHUI Jaringan cepat-jaringan lambat Daya larut nitrogen dalam jaringan Aliran darah Darah Lemak Otak Tulang rawan

Daya larut nitrogen dalam jaringan

Aliran darah

Darah Lemak

Otak

Tulang rawan

PENTING DIKETAHUI Penyelaman singkat dan dalam : Jaringan cepat Bublle dlm darah Chokes, neurologis Penyelaman lama dan dangkal : Jaringan lambat Bublle dlm jaringan Bends vs

Penyelaman

singkat dan dalam :

Jaringan cepat

Bublle dlm darah

Chokes, neurologis

Penyelaman

lama dan dangkal :

Jaringan lambat

Bublle dlm jaringan

Bends

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

TIPE I Classification for identification, prognosis, and therapy. Not well defined or applied appropriately Pain only bends Skin manifestations Devined (US Navy Diving) : Pain only, skin rash or lymphatic disease, with A normal neurological examination before treatment and Symptoms resolved within 10 minutes at 2.8 ATA on oxygen

Classification for identification, prognosis, and therapy.

Not well defined or applied appropriately

Pain only bends

Skin manifestations

Devined (US Navy Diving) :

Pain only, skin rash or lymphatic disease, with

A normal neurological examination before treatment and

Symptoms resolved within 10 minutes at 2.8 ATA on oxygen

MUSCULOSKELETAL Rasa tidak enak, kaku, yang enak bila digerakkan >>> Nyeri tumpul, fluktuasi, kadang berdenyut dan tajam, nyeri gerak Usually no sign of joint inflammation 1/3 shoulder in diver; knee in caisson, aviator Rarely symmetrical, if 2 joint are involved and adjoining

Rasa tidak enak, kaku, yang enak bila digerakkan

>>> Nyeri tumpul, fluktuasi, kadang berdenyut dan tajam, nyeri gerak

Usually no sign of joint inflammation

1/3 shoulder in diver; knee in caisson, aviator

Rarely symmetrical, if 2 joint are involved and adjoining

Cutaneus Local >>> general Pruritus lengan bawah, pergelangan tangan, tangan, paha Bubbles in dermis, epidermis, kel sebacea Segera Scarnatinatiorm rash Stimulasi piloerector, pelepasan histamin Red punctate rash Distribusi : Chest, shoulder, back, upper abdomen, thigh Beberapa jam

Local >>> general

Pruritus

lengan bawah, pergelangan tangan, tangan, paha

Bubbles in dermis, epidermis, kel sebacea

Segera

Scarnatinatiorm rash

Stimulasi piloerector, pelepasan histamin

Red punctate rash

Distribusi : Chest, shoulder, back, upper abdomen, thigh

Beberapa jam

Cutaneus Erysipeloid rash Gas in venous drainage Systemic DCS Papules with flat and firm borders Cutis marmorata marbling Small pale area, cyanotic mottling, spread peripherally, Becoming erythematous, extension cyanotic mottling Serious sign of DCS, reliefable

Erysipeloid rash

Gas in venous drainage

Systemic DCS

Papules with flat and firm borders

Cutis marmorata marbling

Small pale area, cyanotic mottling, spread peripherally,

Becoming erythematous, extension cyanotic mottling

Serious sign of DCS, reliefable

Cutaneus Subcutaneous emphysema Dx : Tanda krepitus, localized, along tendon sheats, radiologis DD : Barotrauma pulmoner Lymphatic obstruction Localized swelling. Involves hair follicles, a peau d’orange or pigskin appereance with brawny oedema. The trunk, but it is also seen over the head and neck

Subcutaneous emphysema

Dx : Tanda krepitus, localized, along tendon sheats, radiologis

DD : Barotrauma pulmoner

Lymphatic obstruction

Localized swelling.

Involves hair follicles, a peau d’orange or pigskin appereance with brawny oedema.

The trunk, but it is also seen over the head and neck