untreated minor hits

[Dr Deco]

Dear Readers:

Minor DCS pain

There is little question that this is a difficult issue when it comes to recognition and treatment. DAN figures indicate that neurological DCS is approximately as frequent as pain-only DCS. That is, the incidence is one to one for "bends" and neurological problems.

Since neurological DCS is extremely seldom seen in the laboratory trials, this can mean only one of two things. Either SCUBA divers are doing something that makes them prone to neurological DCS or there are is a considerable number of cases of joint-pain DCS that are unrecognized.

Gary (above) indicated some reasons: embarrassment, naiveté, cost issues, fear of medical “grounding”, and spontaneous resolution. Another possibility I have encountered is the belief the “if you have DCS, you will know it.” There is the belief that you will be writhing in pain on the ground. This is simply not correct. A definitive diagnosis of DCS can sometimes be difficult and, even with a “test of pressure,” is not unambiguous.

Temporizing

When a diver delays treatment, there is the possibility that a simple gas phase problem can change into a permanent one that results from edema formation. Edema is not pressure reversible and is difficult to treat. In addition, there is the definite possibility that nerves may have their blood supply blocked. They are starved for oxygen and could die. This should result in permanent neurological loss.

You definitely do not want this as a souvenir of your dive trip. :tree: :upset:

Dr Deco :doctor:

Readers, please note the next class in Decompression Physiology :grad:
http://wrigley.usc.edu/hyperbaric/advdeco.htm

 

[Saturation]

Some clarifications.

Since DCI is not the same disease, one needs to qualify what type of untreated DCI we are discussing. Recent nomenclature changes for DCI prefers we label them as they are: joint decompression illness, neurologic DCI, skin DCI etc.,

Untreated joint DCI increases one's risk for dysbaric osteonecrosis of the joint in question. It often manifests years after the injury. Data comes from saturation divers, so it remains only a risk element for non-saturation decompression-stop divers.

Untreated neurologic DCI leads to permanent neurologic deficit. The rewiring cannot be guaranteed. Luck of the draw, you can recover 100% functionality, or none at all, recovery can be aided by physical therapy. Neurologic DCI includes spinal bends or CAGE.

Untreated middle ear DCI, leads to permanent deficits ranging from dizziness to deafness. Recovery is luck of the draw.

Untreated skin DCI has no known sequelae unless its cutis marmorata, which is a risk factor for a possible impending neurologic DCI.

Pain from bubbles is thought to be due to reduced 02 supply caused by the bubbles blocking of circulation, stimulating pain receptors or both. If it proceeds long enough, the surrounding tissues die, and causes an inflammatory reaction to clear away the debris. The bubble and its immediate area are then filled with this debris, and often blood. The dead tissue, its volume, location and function, determine the ultimate deficits sustained by the patient.