Saturday, August 8, 2015

Q: 32 year old male is admitted to ICU after he was brought to ER from beach after his SCUBA diving. Patient was found to be hallucinating, short of breath and just don't look too well. Patient recovered after getting 100% oxygen and IVF in ER, which was continued in ICU. Patient wants to sign AMA as he has flight from Miami to Seattle in next 4 hours. What would be your suggestion?


Answer: Avoid Air travel.

Complications of SCUBA  include hypothermia, trauma, decompression sickness, and nitrogen narcosis. Decompression sickness occurs when a diver returns to the surface and gas tensions in the tissue exceeds the ambient pressure, leading to the liberation of free gas from the tissues in the form of bubbles. It may cause various nonspecific systemic symptoms and may be life-threatening with pneumothorax or involvement of CNS. Patient should avoid air travel for 12 hours after uneventful SCUBA diving and 48 hours or may be more in case of symptomatic air travel.



References:

1. Freiberger JJ, Denoble PJ, Pieper CF, et al. The relative risk of decompression sickness during and after air travel following diving. Aviat Space Environ Med 2002; 73:980.

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