Level 1 decompression sickness presents with joint pain, typically in shoulders and elbows, with onset usually within an hour of surfacing and intensifying over the next two days. Other signs are pruritus, localized erythema, cyanosis, painful lymphadenopathy, and edema.
Level 2 decompression sickness is serious and may be life-threatening. Movement of bubbles can create severe risk of pulmonary embolism, neurologic damage, venous obstruction, increased heart pressure, and death. Symptoms include weakness, paresthesias, headache, ataxia, visual disturbance, memory loss, personality changes, dyspnea, wheezing, chest pain, and throat irritation.
Management includes oxygen, hydration, Durant's maneuver (put patient in left lateral position), Trendelenburg position, and pharmacologic therapies. Hyperbaric oxygen therapy in a recompression chamber is considered the definitive treatment.
T70.3XXA – Caisson disease [decompression sickness], initial encounter
89684003 – Bends