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Emergency: requires immediate attention
Decompression sickness
Other Resources UpToDate PubMed
Emergency: requires immediate attention

Decompression sickness

Contributors: Casey Silver MD, Mary Anne Morgan MD, Michael W. Winter MD
Other Resources UpToDate PubMed

Synopsis

Decompression sickness is the formation of nitrogen bubbles in body tissue and circulating blood that results from sudden decompression when a submerged person is elevated too quickly to the surface. It is seen most often in deep-sea divers and tunnel laborers.

Level 1 decompression sickness presents with joint pain, typically in the shoulders and elbows, with onset usually within an hour of surfacing and intensifying over the next 2 days. Other signs include 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.

Codes

ICD10CM:
T70.3XXA – Caisson disease [decompression sickness], initial encounter

SNOMEDCT:
89684003 – Bends

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

The differential is broad and differs based on presenting symptoms. Common conditions that share signs and symptoms with decompression sickness include:

Best Tests

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Management Pearls

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Therapy

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References

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Last Reviewed:04/24/2019
Last Updated:05/13/2019
Copyright © 2021 VisualDx®. All rights reserved.
Emergency: requires immediate attention
Decompression sickness
Decompression sickness (Level 1) : Fatigue, Headache, Cyanosis, Elbow pain, Erythema, Lymphadenopathy, Shoulder pain, Anorexia, Arthralgia, Pruritus, Scuba diving, Miner
Copyright © 2021 VisualDx®. All rights reserved.