Scuba diving emergencies - Revision history

DMartinPAC: /* Differential Diagnosis */

2026-02-04T19:57:07Z

Differential Diagnosis

← Older revision		Revision as of 19:57, 4 February 2026
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	* Vary based on the specific dive injury.		* Vary based on the specific dive injury.

	==Differential Diagnosis==		==Evaluation and Differential Diagnosis==
	*Facial/Ear/Eye Pain:		*Facial/Ear/Eye Pain:
	**[[Sinusitis]]		**[[Sinusitis]]

DMartinPAC: /* Barotrauma of Ascent */

2026-01-27T16:55:33Z

Barotrauma of Ascent

← Older revision		Revision as of 16:55, 27 January 2026
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	**[[Arterial gas embolism]] is the most dreaded complication of diving. It can manifest in many ways depending on where the emboli travel (i.e. [[stroke]], [[seizure]], [[acute myocardial infarction]], or [[arrythmia]]. The treatment is immediate hyperbaric oxygen therapy.		**[[Arterial gas embolism]] is the most dreaded complication of diving. It can manifest in many ways depending on where the emboli travel (i.e. [[stroke]], [[seizure]], [[acute myocardial infarction]], or [[arrythmia]]. The treatment is immediate hyperbaric oxygen therapy.
	**[[Decompression sickness]] (aka the bends) is due to the gas (usually nitrogen) coming out of solution in the blood and tissues secondary to too rapid of an ascent/depressurization. It can present with a myriad of findings, but the most common systems affected are neurologic and musculoskeletal. Those suspected to have this condition should be referred for urgent hyperbaric therapy.		**[[Decompression sickness]] (aka the bends) is due to the gas (usually nitrogen) coming out of solution in the blood and tissues secondary to too rapid of an ascent/depressurization. It can present with a myriad of findings, but the most common systems affected are neurologic and musculoskeletal. Those suspected to have this condition should be referred for urgent hyperbaric therapy.
			***Though the same constraints may not be present for recreational divers, a commercial diver who is deemed to have ever suffered untreated decompression sickness may be barred from medical clearance to work, making untreated DCS a career-ending injury.

	===At Depth Injuries===		===At Depth Injuries===

DMartinPAC: /* Barotrauma of Ascent */

2026-01-27T16:53:51Z

Barotrauma of Ascent

← Older revision		Revision as of 16:53, 27 January 2026
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	*[[Pulmonary barotrauma]] may manifest in many ways<ref>Diving Medicine, Karen B. Van Hoesen and Michael A. Lang, Auerbach's Wilderness Medicine, Chapter 71, 1583-1618.e6</ref>		*[[Pulmonary barotrauma]] may manifest in many ways<ref>Diving Medicine, Karen B. Van Hoesen and Michael A. Lang, Auerbach's Wilderness Medicine, Chapter 71, 1583-1618.e6</ref>
	**Local pulmonary injury and [[pneumomediastinum]] require supportive care only		**Local pulmonary injury and [[pneumomediastinum]] require supportive care only
	**Treat [[Pneumothorax]] according to severity, does not require recompression on its own		**Treat [[Pneumothorax]] according to severity, does not require recompression on its own. Untreated pneumothorax is an '''absolute''' contraindication to hyperbaric recompression.
	**If any of the above conditions present with [[altered mental status]], presume [[arterial gas embolism]] and recompress the patient		**If any of the above conditions present with [[altered mental status]], presume [[arterial gas embolism]] and recompress the patient
	**[[Arterial gas embolism]] is the most dreaded complication of diving. It can manifest in many ways depending on where the emboli travel (i.e. [[stroke]], [[seizure]], [[acute myocardial infarction]], or [[arrythmia]]. The treatment is immediate hyperbaric oxygen therapy.		**[[Arterial gas embolism]] is the most dreaded complication of diving. It can manifest in many ways depending on where the emboli travel (i.e. [[stroke]], [[seizure]], [[acute myocardial infarction]], or [[arrythmia]]. The treatment is immediate hyperbaric oxygen therapy.

DMartinPAC: /* Differential Diagnosis */

2026-01-27T16:52:44Z

Differential Diagnosis

← Older revision		Revision as of 16:52, 27 January 2026
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	**Pulmonary overinflation syndrome		**Pulmonary overinflation syndrome
	*[[Altered Mental Status]]:		*[[Altered Mental Status]]:
			**Arterial Gas Embolism
			**Decompression sickness
	**[[Stroke]]		**[[Stroke]]
	**[[Meningitis]] or [[Encephalitis]]		**[[Meningitis]] or [[Encephalitis]]

DMartinPAC: /* Differential Diagnosis */

2026-01-27T16:52:05Z

Differential Diagnosis

← Older revision		Revision as of 16:52, 27 January 2026
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	**[[Pericarditis]]		**[[Pericarditis]]
	**[[GERD]]		**[[GERD]]
			**Pulmonary overinflation syndrome
	*[[Altered Mental Status]]:		*[[Altered Mental Status]]:
	**[[Stroke]]		**[[Stroke]]

DMartinPAC: /* Evaluation */

2026-01-27T16:48:45Z

Evaluation

← Older revision		Revision as of 16:48, 27 January 2026
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	*** Ear pain from reverse ear squeezes - ask about symptoms on descent		*** Ear pain from reverse ear squeezes - ask about symptoms on descent
	*** Facial pain or epistaxis from reverse sinus squeezes - ask about symptoms during descent		*** Facial pain or epistaxis from reverse sinus squeezes - ask about symptoms during descent
			*** Chest burning/pain from pulmonary overinflation syndrome
	*** Decompression sickness		*** Decompression sickness
	** Symptoms noted at the surface within 10 minutes of surfacing		** Symptoms noted at the surface within 10 minutes of surfacing

DMartinPAC: /* Evaluation */

2026-01-27T16:47:32Z

Evaluation

← Older revision		Revision as of 16:47, 27 January 2026
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	*** Limb or skin pains likely represent trauma from contact with surfaces or sea life		*** Limb or skin pains likely represent trauma from contact with surfaces or sea life
	** Symptoms began during ascent		** Symptoms began during ascent
	*** ~~Reverse~~ ear squeezes		*** Ear pain from reverse ear squeezes - ask about symptoms on descent
	*** ~~Reverse~~ sinus squeezes		*** Facial pain or epistaxis from reverse sinus squeezes - ask about symptoms during descent
	*** Decompression sickness		*** Decompression sickness
	** Symptoms noted at the surface within 10 minutes of surfacing		** Symptoms noted at the surface within 10 minutes of surfacing

DMartinPAC: /* Evaluation */

2026-01-27T16:45:45Z

Evaluation

← Older revision		Revision as of 16:45, 27 January 2026
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	==Evaluation==		==Evaluation==
			* Establish timing of symptom onset
			** Symptoms began on descent
			*** Facial pain could be sinus squeeze, mask squeeze
			*** Tooth pain from poor dental work with trapped air bubbles
			*** Ear pain is inner ear squeeze
			*** Breathing difficulties likely represented regulator problems or dry suit squeeze
			** Symptoms began at the bottom
			*** Hypothermia, hyperthermia
			*** Respiratory difficulties could represent pulmonary oxygen toxicity or pressure-related pulmonary edema
			*** Ear pain could represent oxygen-related inner ear squeeze aka Draeger Ear
			*** Limb or skin pains likely represent trauma from contact with surfaces or sea life
			** Symptoms began during ascent
			*** Reverse ear squeezes
			*** Reverse sinus squeezes
			*** Decompression sickness
			** Symptoms noted at the surface within 10 minutes of surfacing
			*** Neurologic, stroke-like, seizure-like, or LOC are suspicious for arterial gas embolism
			** Symptoms noted at the surface more than 10 minutes but likely within 24hrs of surfacing
			*** Rash, extreme fatigue, vague systemic illness, cutis marmorata (marbling/mottling skin rash), neurologic deficits in cognition, abdominal pains or parasthesias, extremity weakness / pain / parasthesias, sensory deficits even limited to a single dermatome are all suspicious for decompression sickness

	==Management==		==Management==

DMartinPAC: /* Clinical Features */

2026-01-27T16:36:46Z

Clinical Features

← Older revision		Revision as of 16:36, 27 January 2026
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	==Clinical Features==		==Clinical Features==
	- Vary based on the specific dive injury.		* Vary based on the specific dive injury.

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

DMartinPAC: /* Clinical Features */

2026-01-27T16:36:11Z

Clinical Features

← Older revision		Revision as of 16:36, 27 January 2026
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	==Clinical Features==		==Clinical Features==
			- Vary based on the specific dive injury.

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