The Journal of the Florida Medical Association
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Decompression sickness and cerebral gas embolism can present as dramatic and profound sudden onset injuries in patients engaged in tunnel work and compressed gas diving, including scuba. The history and management of these illnesses span centuries. ⋯ Gas embolism results from the direct transit of molecular gas from a pulmonary or intravascular origin into the arterial circulation causing occlusion of a distal locus. Treatment relates to increasing hydrostatic pressure, thus maximizing the gradient for gas reabsorption and dissolution and subsequently gas excretion via the lungs.
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Decompression illness, which includes decompression sickness and arterial gas embolism, can be a complex and difficult diagnostic dilemma. The signs and symptoms are not well known and mimic other illnesses which often results in delay when seeking medical evaluation. Additionally, most physicians are not exposed to diving medicine and may not recognize a decompression illness injury. ⋯ Divers Alert Network also publishes the national annual report on scuba diving morbidity and mortality. Services provided without charge are sponsored by the DAN membership. This article introduces the physician to decompression illness and the basic care and treatment of the injured scuba diver.
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Diving accidents include air embolism and decompression sickness. Both require early stabilization and initiation of therapy before transfer to a definitive medical center for recompression therapy. Initial treatment consists of hydration, oxygen therapy and often steroids and antithrombosis therapy. Symptoms must be separated from other related conditions including myocardial infarction.
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All physicians must be educated in treating injuries incurred when a diver comes into contact with any dangerous marine life. Stinging invertebrates are the most commonly encountered dangerous marine animals. ⋯ Sharks pose the greatest danger to divers. However, bites from other marine animals can be painful, become infected and require extensive medical treatment.