- Also known as “caisson disease” or “the bends”
- Occurs most often in self-contained underwater breathing apparatus (SCUBA) diving, free diving, high-altitude flying, and aerospace events
- Rapid decrease in environmental pressure causing inert gases (usually nitrogen) to form bubbles in tissues or to obstruct small blood vessels, causing symptoms
- Type I (mild):
- Musculoskeletal (70–85%): Mild joint pain that increases with time; most commonly shoulder or elbow pain
- Cutaneous (10–15%): Rash, pruritus, edema
- Type II (severe):
- Neurologic (10–15%): Headache, visual disturbance, paresthesias, paresis, paralysis, bladder or bowel incontinence, vertigo, memory loss, ataxia, seizures
- Pulmonary (2–5%): Nonproductive cough, wheezing, pharyngeal irritation, chest discomfort on inspiration, respiratory distress
- The fetus may be affected and at greater risk for arterial gas emboli.
- Diving should be avoided in pregnancy due to potential risk to fetus if decompression sickness occurs.
- No restrictions on flying in otherwise healthy patients, but airlines may place restriction after 36 weeks' gestation
- No contraindication to recompression therapy during pregnancy
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