Gradual Ascent, avoidance of<unk>  deeper if experiencing pain
Decongestants for sinus pain
Antibiotic ear drops for TM rupture (choose a formulation such as ofloxacin suspension that is safe in the middle ear)
Gradual ascent, safety stops imperative
Pulmonary barotrauma may manifest in many ways
Local pulmonary injury and pneumomediastinum require supportive care only
Treat Pneumothorax according to severity, does not require recompression on its own
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<unk> . 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.
Local pulmonary injury and pneumomediastinum require supportive care only
Treat Pneumothorax according to severity, does not require recompression on its own
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<unk> . 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.
Oxygen Toxicity usually results from high FiO2 at several atmospheres of pressure. It can cause pulmonary injury manifesting as chest pain, pleurisy, or even pulmonary edema/hemorrhage. It can also cause CNS pathology manifesting as nausea, auditory changes, convulsions, sweating, twitching, or tunnel vision. Treatment for any of these injuries is ascent and inhalation of lower FiO2 at decreased pressure. More severe presentations of pulmonary injury may require intubation.
Nitrogen Narcosis results from inhaling nitrogen containing gas mixtures at high pressures (specialized gas mixtures exist for work at depth that have decreased amounts of nitrogen). It manifests as altered mental status. Treatment is gradual ascent.
Hypothermia: re-warm
Carbon Monoxide Toxicity: see main section; oxygen, consider hyperbaric therapy
Caustic Cocktail: supportive
Scuba diving emergencies
Facial/Ear/Eye Pain:
Heat stroke
Sinusitis
Electrical storm
Otitis Media and Otitis Externa
Environmental heat diagnoses
Subconjunctival Hemorrhage