Nitrogen narcosis - Revision history

Rossdonaldson1: /* Background */

2020-07-18T13:14:51Z

Background

← Older revision		Revision as of 13:14, 18 July 2020
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	*Risk factors = exertion during dive, cold conditions, alcohol intoxication before dive<ref name="Grover" />		*Risk factors = exertion during dive, cold conditions, alcohol intoxication before dive<ref name="Grover" />
	*Other inert gases cause similar symptoms at depth - severity based on lipid solubility of the gas<ref>Bove AA. Diving medicine. Am J Respir Crit Care Med. 2014 Jun 15;189(12):1479-86.</ref>		*Other inert gases cause similar symptoms at depth - severity based on lipid solubility of the gas<ref>Bove AA. Diving medicine. Am J Respir Crit Care Med. 2014 Jun 15;189(12):1479-86.</ref>

			{{Diving Physiology}}

	==Clinical Features==		==Clinical Features==

ClaireLewis: /* Clinical Features */

2019-09-28T21:29:51Z

Clinical Features

← Older revision		Revision as of 21:29, 28 September 2019
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	==Clinical Features==		==Clinical Features==
	*Insidious onset of symptoms similar to alcohol intoxication (or nitrous oxide inhalation)<ref name="Grover" /><ref name="Levett" />		*Insidious onset of symptoms similar to [[alcohol intoxication]] (or nitrous oxide inhalation)<ref name="Grover" /><ref name="Levett" />
	**Early stage: Euphoria, false sense of security, impaired judgement, diminished reaction times		**Early stage: Euphoria, false sense of security, impaired judgement, diminished reaction times
	**Later stage: Impaired concentration and memory, paresthesias, hallucinations		**Later stage: Impaired concentration and memory, [[paresthesias]], [[hallucinations]]
	**Final stage: [Occurs at depths of at least 10-13ATM (333-429 feet)], lethargy and loss of consciousness		**Final stage: [Occurs at depths of at least 10-13ATM (333-429 feet)], [[lethargy]] and [[loss of consciousness]]
	*Causes high risk of making bad decisions at depth, i.e. impairs diver's judgment therefore leading to drowning accidents (cause of up to 9% of diving deaths)<ref name="Grover" /><ref name="Levett" />		*Causes high risk of making bad decisions at depth, i.e. impairs diver's judgment therefore leading to drowning accidents (cause of up to 9% of diving deaths)<ref name="Grover" /><ref name="Levett" />

Hkm91450: /* Clinical Features */

2018-09-28T11:33:25Z

Clinical Features

← Older revision		Revision as of 11:33, 28 September 2018
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	**Later stage: Impaired concentration and memory, paresthesias, hallucinations		**Later stage: Impaired concentration and memory, paresthesias, hallucinations
	**Final stage: [Occurs at depths of at least 10-13ATM (333-429 feet)], lethargy and loss of consciousness		**Final stage: [Occurs at depths of at least 10-13ATM (333-429 feet)], lethargy and loss of consciousness
	*Causes high risk of making bad decisions at depth (cause of up to 9% of diving deaths)<ref name="Grover" /><ref name="Levett" />		*Causes high risk of making bad decisions at depth, i.e. impairs diver's judgment therefore leading to drowning accidents (cause of up to 9% of diving deaths)<ref name="Grover" /><ref name="Levett" />

	==Differential Diagnosis==		==Differential Diagnosis==

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-24T23:20:00Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Older revision		Revision as of 23:20, 24 July 2016
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	{{Scuba diving DDX}}		{{Scuba diving DDX}}

	==~~Diagnosis~~==		==Evaluation==
	*Clinical diagnosis		*Clinical diagnosis

Ostermayer: Text replacement - "Category:Environ" to "Category:Environmental"

2016-03-22T14:47:01Z

Text replacement - "Category:Environ" to "Category:Environmental"

← Older revision		Revision as of 14:47, 22 March 2016
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	<references/>		<references/>

	[[Category:~~Environ~~]]		[[Category:Environmental]]

Mholtz at 02:49, 6 March 2016

2016-03-06T02:49:23Z

← Older revision		Revision as of 02:49, 6 March 2016
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	==Clinical Features==		==Clinical Features==
	*Insidious onset of symptoms similar to alcohol intoxication (or nitrous oxide inhalation)<ref name="Grover" /><ref name="Levett" />		*Insidious onset of symptoms similar to alcohol intoxication (or nitrous oxide inhalation)<ref name="Grover" /><ref name="Levett" />
	**Early stage: Euphoria, false sense of security, impaired judgement		**Early stage: Euphoria, false sense of security, impaired judgement, diminished reaction times
	**Later stage: Impaired concentration and memory, paresthesias, hallucinations		**Later stage: Impaired concentration and memory, paresthesias, hallucinations
	**Final stage: [Occurs at depths of at least 10-13ATM (333-429 feet)], lethargy and loss of consciousness		**Final stage: [Occurs at depths of at least 10-13ATM (333-429 feet)], lethargy and loss of consciousness

Mholtz at 02:44, 6 March 2016

2016-03-06T02:44:59Z

Mholtz at 02:36, 6 March 2016

2016-03-06T02:36:15Z

← Older revision		Revision as of 02:36, 6 March 2016
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	==Background==		==Background==
	*~~A reversible alteration in consciousness that occurs~~ while ~~diving~~ at depth		*Toxic effects of breathing nitrogen-containing gases while at depth
	*~~Caused by~~ the ~~anesthetic effect~~ of nitrogen ~~at high pressure~~		*Called the "rapture of the deep"
	*~~Does not usually become noticeable~~ at depths less than 30 meters (100 ft), unless breathing non-standard air mixtures		*Develops between 3-4ATM (99-132 feet)<ref name="Grover">Grover CA, Grover DH. Albert Behnke: nitrogen narcosis. J Emerg Med. 2014 Feb;46(2):225-7.</ref>
	*~~May cause scuba diving accidents at depth~~ or ~~in a hyperbaric chamber~~, ~~but stops once the patient is at normal pressure~~		**Rare at depths less than 30 meters (100 ft) unless breathing non-standard air mixtures
			**Similar to alcohol, frequent divers can develop tolerance to the effects of nitrogen narcosis<ref name="Grover" />
			*Can be prevented by using nitrogen-free gas mixture (e.g. heliox), or mixtures with reduced nitrogen content (e.g. helium-nitrogen-oxygen)<ref name="Grover" />
			*Risk factors = exertion during dive, cold conditions, alcohol intoxication before dive<ref name="Grover" />

	==Clinical Features==		==Clinical Features==
	*~~Produces a state~~ similar alcohol intoxication (or nitrous oxide inhalation), ~~only while~~ at ~~depth~~		*Insidious onset of symptoms similar to alcohol intoxication (or nitrous oxide inhalation)<ref name="Grover" />
	*~~Completely reversed in a few minutes by ascending~~ to ~~a shallower depth, with no long-term effect~~		**Early stage: Euphoria, false sense of security, impaired judgement
			**Later stage: Impaired concentration and memory, paresthesias, hallucinations
			**Final stage: [Occurs at depths of at least 10-13ATM (333-429 feet)], lethargy and loss of consciousness
			*Causes high risk of making bad decisions at depth (cause of up to 9% of diving deaths)<ref name="Grover" />

	==Differential Diagnosis==		==Differential Diagnosis==
	{{Scuba diving DDX}}		{{Scuba diving DDX}}

	==~~Workup~~==		==Diagnosis==
	*Clinical diagnosis		*Clinical diagnosis

	==Management==		==Management==
	*Ascent		*Ascent - symptoms completely reversed within minutes by ascending to a shallower depth, with no long-term effect
			**Therefore, consider other causes in patients with continued symptoms after ascent

	==Disposition==		==Disposition==
			*Discharge

	==See Also==		==See Also==
			*[[Scuba diving emergencies]]

	==External Links==		==External Links==

	==~~Sources~~==
			==References==
	<references/>		<references/>

	[[Category:Environ]]		[[Category:Environ]]

Rossdonaldson1: /* Sources */

2015-03-24T19:05:45Z

Sources

← Older revision		Revision as of 19:05, 24 March 2015
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	==Sources==		==Sources==
	<references/>		<references/>

			[[Category:Environ]]

Rossdonaldson1: /* Differential Diagnosis */

2015-03-11T00:04:13Z

Differential Diagnosis

← Older revision		Revision as of 00:04, 11 March 2015
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	==Differential Diagnosis==		==Differential Diagnosis==
			{{Scuba diving DDX}}

	==Workup==		==Workup==

← Older revision		Revision as of 02:44, 6 March 2016
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	*Develops between 3-4ATM (99-132 feet)<ref name="Grover">Grover CA, Grover DH. Albert Behnke: nitrogen narcosis. J Emerg Med. 2014 Feb;46(2):225-7.</ref>		*Develops between 3-4ATM (99-132 feet)<ref name="Grover">Grover CA, Grover DH. Albert Behnke: nitrogen narcosis. J Emerg Med. 2014 Feb;46(2):225-7.</ref>
	**Rare at depths less than 30 meters (100 ft) unless breathing non-standard air mixtures		**Rare at depths less than 30 meters (100 ft) unless breathing non-standard air mixtures
	**Similar to alcohol, frequent divers can develop tolerance to the effects of ~~nitrogen narcosis~~<ref name="Grover" />		**Similar to alcohol, frequent divers can develop subjective "tolerance" to the effects, but impairment remains<ref name="Levett">Levett DZ, Millar IL. Bubble trouble: a review of diving physiology and disease. Postgrad Med J. 2008 Nov;84(997):571-8.</ref><ref name="Grover" />
	*Can be prevented by using nitrogen-free gas mixture (e.g. heliox), or mixtures with reduced nitrogen content (e.g. helium-nitrogen-oxygen)<ref name="Grover" />		*Can be prevented by using nitrogen-free gas mixture (e.g. heliox), or mixtures with reduced nitrogen content (e.g. helium-nitrogen-oxygen)<ref name="Grover" />
	*Risk factors = exertion during dive, cold conditions, alcohol intoxication before dive<ref name="Grover" />		*Risk factors = exertion during dive, cold conditions, alcohol intoxication before dive<ref name="Grover" />
			*Other inert gases cause similar symptoms at depth - severity based on lipid solubility of the gas<ref>Bove AA. Diving medicine. Am J Respir Crit Care Med. 2014 Jun 15;189(12):1479-86.</ref>

	==Clinical Features==		==Clinical Features==
	*Insidious onset of symptoms similar to alcohol intoxication (or nitrous oxide inhalation)<ref name="Grover" />		*Insidious onset of symptoms similar to alcohol intoxication (or nitrous oxide inhalation)<ref name="Grover" /><ref name="Levett" />
	**Early stage: Euphoria, false sense of security, impaired judgement		**Early stage: Euphoria, false sense of security, impaired judgement
	**Later stage: Impaired concentration and memory, paresthesias, hallucinations		**Later stage: Impaired concentration and memory, paresthesias, hallucinations
	**Final stage: [Occurs at depths of at least 10-13ATM (333-429 feet)], lethargy and loss of consciousness		**Final stage: [Occurs at depths of at least 10-13ATM (333-429 feet)], lethargy and loss of consciousness
	*Causes high risk of making bad decisions at depth (cause of up to 9% of diving deaths)<ref name="Grover" />		*Causes high risk of making bad decisions at depth (cause of up to 9% of diving deaths)<ref name="Grover" /><ref name="Levett" />

	==Differential Diagnosis==		==Differential Diagnosis==