Decompression sickness and arterial gas embolism, collectively known as decompression illness (DCI), are rare but serious afflictions that can result from compressed gas diving exposures. Risk is primarily determined by the pressure-time profile but is influenced by several factors. DCI can present idiosyncratically but with a wide range of neurologic symptoms. Examination is critical for assessment in the absence of diagnostic indicators. Many conditions must be considered in the differential diagnosis. High-fraction oxygen breathing provides first aid but definitive treatment of DCI is hyperbaric oxygen.
Key points
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Decompression sickness (DCS) is a disease resulting from an ascent profile not allowing the orderly elimination of excess gas that was accumulated in tissues during exposure to elevated pressure.
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Decompression sickness (DCS) can present idiosyncratically, affecting a wide range of systems with a variable degree of insult. Masking of important symptoms by chief complaint is possible.
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Arterial gas embolism (AGE) is a disease of frank gas in the arterial systemic circulation following a reduction of ambient pressure so rapid that expanding gases cause pulmonary tissue rupture.
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The first aid for decompression illness (collectively, DCS and AGE) is high fraction oxygen; the definitive treatment is hyperbaric oxygen therapy.
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There are currently no diagnostic tests to confirm decompression sickness.
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