1/53. Hyperbaric chamber-related decompression illness in a patient with asymptomatic pulmonary sarcoidosis.An asymptomatic 46-yr-old male sustained an acute neurologic insult, appearing during the decompression phase of a 50-m dry hyperbaric chamber dive. The right hemisyndrome was most probably related to diving, since symptoms responded rapidly to the early commenced recompression therapy. Further diagnostics revealed a previously unknown pulmonary sarcoidosis with bilateral pulmonary opacities and pleural adhesions that might have predisposed to arterial gas embolism secondary to pulmonary barotrauma. This case may illustrate a potential risk of decompression illness even during dry chamber dives in patients suffering from asymptomatic pleuro-parenchymal pulmonary disease. The value of chest X-ray in the medical assessment of fitness to dive is therefore emphasized.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
2/53. Cerebral arterial gas embolism in air force ground maintenance crew--a report of two cases.Two cases of cerebral arterial gas embolism (CAGE) occurred after a decompression incident involving five maintenance crew during a cabin leakage system test of a Hercules C-130 aircraft. During the incident, the cabin pressure increased to 8 in Hg (203.2 mm Hg, 27 kPa) above atmospheric pressure causing intense pain in the ears of all the crew inside. The system was rapidly depressurized to ground level. After the incident, one of the crew reported chest discomfort and fatigue. The next morning, he developed a sensation of numbness in the left hand, with persistence of the earlier symptoms. A second crewmember, who only experienced earache and heaviness in the head after the incident, developed retrosternal chest discomfort, restlessness, fatigue and numbness in his left hand the next morning. Both were subsequently referred to a recompression facility 4 d after the incident. Examination by the diving Medical Officer on duty recorded left-sided hemianesthesia and Grade II middle ear barotrauma as the only abnormalities in both cases. Chest x-rays did not reveal any extra-alveolar gas. Diagnoses of Static Neurological Decompression Illness were made and both patients recompressed on a RN 62 table. The first case recovered fully after two treatments, and the second case after one treatment. magnetic resonance imaging (MRI) of the brain and bubble contrast echocardiography performed on the first case 6 mo after the incident were reported to be normal. The second case was lost to follow-up. Decompression illness (DCI) generally occurs in occupational groups such as compressed air workers, divers, aviators, and astronauts. This is believed to be the first report of DCI occurring among aircraft's ground maintenance crew.- - - - - - - - - - ranking = 433.9632387108keywords = discomfort, pain, chest (Clic here for more details about this article) |
3/53. Infraorbital hypesthesia after maxillary sinus barotrauma.We report a case of a diver who suffered an episode of maxillary sinus barotrauma that presented with decreased sensation over the cutaneous distribution of the infraorbital nerve after an ascent which produced facial pain and crepitus. This case illustrates a potential confusion between a decompression sickness etiology and a barotraumatic etiology for the observed sensory deficit. The clinical features of this case were most consistent with a barotraumatic etiology for the findings noted. The anatomy of the trigeminal nerve and previous reports of cranial nerve deficits following barotrauma are reviewed.- - - - - - - - - - ranking = 14.115119224386keywords = pain (Clic here for more details about this article) |
4/53. Pulmonary cyst and cerebral arterial gas embolism in a hypobaric chamber: a case report.This is a report of an aircrew member who suffered a serious physiological incident in the form of pulmonary barotrauma and cerebral arterial gas embolism during hypobaric chamber training, and who subsequently was shown to have a cyst in the upper lobe of the left lung. The likely origin of the cyst is discussed, as well as the aeromedical disposition following thoracotomy and apical segmentectomy to remove the cyst.- - - - - - - - - - ranking = 0.28677526421522keywords = upper (Clic here for more details about this article) |
5/53. Test and evaluation of exercise-enhanced preoxygenation in U-2 operations.BACKGROUND: Preoxygenation to prevent decompression sickness (DCS) during U-2 reconnaissance flights requires considerable time and occasionally does not provide adequate protection. Increasing preoxygenation within a practical period of time provides marginally increased protection and is not always operationally feasible. Including exercise during preoxygenation to increase muscle tissue perfusion, cardiac output, and ventilation can improve the quality of the denitrogenation. methods: A pilot, who reported two cases of DCS during his first 25 U-2 high flights involving cabin altitudes of 29,000-30,000 ft, volunteered to test exercise-enhanced preoxygenation. He performed 10 min of strenuous upper and lower body exercise at the beginning of preoxygenation prior to subsequent high flights without increasing total preoxygenation time. RESULTS: The exercise was performed at 75% of maximal oxygen uptake based on the estimated maximal oxygen uptake determined during an Air Force aerobic fitness test and heart rate. The pilot's next 36 high flights, using exercise-enhanced preoxygenation, were completed with no reports of DCS. CONCLUSIONS: This statistically significant operational test reinforced the laboratory studies. Implementation of this procedure for reducing DCS in susceptible U-2 pilots and collecting additional data from the U-2 pilot population is recommended.- - - - - - - - - - ranking = 0.28677526421522keywords = upper (Clic here for more details about this article) |
6/53. Delayed onset pulmonary barotrauma or decompression sickness? A case report of decompression-related disorder.A-24-yr-old male professional diver began to complain of substernal pain 3 h after a controlled ascent from a dive of less than 40 ft of sea water (fsw). The diving master who supervised his dive and the physicians who examined him on presentation suspected pulmonary barotrauma rather than decompression sickness (DCS) because he had only descended to a depth of 32 fsw. Hyperbaric oxygen therapy (HBO) by U.S. Navy treatment Table VI was implemented because of his progressively worsening pain. HBO was apparently effective and a relapse was not seen. The author cannot label his condition based on the conventional classification categories, such as decompression sickness (DCS), barotrauma or even decompression illness. This case report is offered as a topic for consideration in the controversy over decompression-related disorders.- - - - - - - - - - ranking = 28.230238448773keywords = pain (Clic here for more details about this article) |
7/53. Cases from the aerospace medicine Resident's teaching File: unsuspected pulmonary barotrauma.A USAF pararescue specialist developed chest pain during scuba diving duty. Initial evaluations considered decompression sickness and musculoskeletal etiologies. Pulmonary barotrauma was not contemplated because of the relatively mild presentation. Later, a very significant pneumothorax was discovered and successfully treated without sequelae. decompression sickness is briefly discussed followed by a more in-depth examination of the presentation, diagnosis, treatment, and aeromedical aspects of spontaneous and "deserved" pneumothoraces.- - - - - - - - - - ranking = 15.115119224386keywords = pain, chest (Clic here for more details about this article) |
8/53. Diver with decompression injury, elevation of serum transaminase levels, and rhabdomyolysis.A 43-year-old female recreational scuba diver presented to the emergency department 1 hour after a rapid, uncontrolled ascent. Her presentation included progressing confusion, slow and slurred speech, and complaints of headache and hypesthesia over her forearms and anterior thighs bilaterally. Differential diagnosis included arterial gas embolism and decompression sickness. She underwent recompression therapy with US Navy Table 6 within 120 minutes of her ascent. After recompression therapy, the patient had signs and symptoms consistent with severe rhabdomyolysis, including creatine kinase levels of 36,000 U/L and myoglobinuria.- - - - - - - - - - ranking = 3.1266171718054keywords = headache (Clic here for more details about this article) |
9/53. central nervous system involvement following type I aviator's bends complicated by complacency.A false sense of security surrounds the possibility of post-flight complications resulting from "aviator's bends." The accepted clinical clue that a patient is at risk for serious complications is the presence of some form of dysbarism at altitude. This principle has been inappropriately extended to imply that serious post-flight complications of the evolved gas syndrome only follow serious in-flight symptoms. This paper, in addition to reporting the occurrence of post-flight neurologic signs in a patient after Type I pain-only bends during an altitude chamber flight, also identifies a broader subtle complacency in the professional community that routinely deals with hypobarics.- - - - - - - - - - ranking = 14.115119224386keywords = pain (Clic here for more details about this article) |
10/53. The monoplace hyperbaric chamber and management of decompression illness.Three cases of decompression illness are reported. Two patients presented with joint pain and skin signs, while one patient presented with joint pain and neurological signs and symptoms. The patients received emergency recompression therapy in a hong kong clinic, using a monoplace hyperbaric chamber. All three patients were treated successfully and no residual signs or symptoms were evident on review at 90 days' post-treatment. Issues concerning the use of monoplace and multiplace hyperbaric chambers are also discussed, along with additional clinical applications of the monoplace hyperbaric chamber.- - - - - - - - - - ranking = 28.230238448773keywords = pain (Clic here for more details about this article) |
| | Next -> |