Document Detail


Type II decompression sickness in naval hypobaric chambers: A case of mistaken identity?
MedLine Citation:
PMID:  16173680     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Historically, U.S. Navy clinicians have used the U.S. Navy Dive Manual for guidance in the diagnosis and treatment of injuries incurred during hyper- or hypobaric operations. Based on this manual, paresthesias are considered to be central nervous system manifestations and thus are classified as Type II (severe) decompression sickness (DCS). Yet given the highly successful response to treatment of peripheral nervous system manifestations of DCS in the literature, both the diving and aviation communities have questioned its classification as "severe" DCS. This record review was undertaken to examine U.S. Naval severe cases of altitude DCS with the goal of identifying dissimilarities between hypobaric facilities in classification and incidence. METHODS: Hypobaric exposures and cases were reviewed from quarterly training reports maintained at the Naval Operational Medicine Institute, Pensacola, FL, between January 1993 and April 2004. Cases were analyzed for age, gender, flight profile, symptom complex, type of DCS, and treatment provided. RESULTS: There were 50,355 hypobaric exposures resulting in 97 cases of altitude DCS. Of the 97 cases of diagnosed DCS, 58 were classified as Type II, while 39 were Type I. Of the 58 cases of Type II DCS, 29 were diagnosed as Type II by the sole finding of non-dermatomal paresthesias. DISCUSSION: Type II DCS, a designation traditionally reserved for severe DCS, is frequently diagnosed by the sole finding of non-dermatomal paresthesias in Naval hypobaric training. A review and revision of the U.S. Naval Aviation classification system for altitude DCS should be undertaken with emphasis on severity not symptomatology.
Authors:
G Merrill Rice; Jeffrey L Moore
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Aviation, space, and environmental medicine     Volume:  76     ISSN:  0095-6562     ISO Abbreviation:  Aviat Space Environ Med     Publication Date:  2005 Sep 
Date Detail:
Created Date:  2005-09-21     Completed Date:  2005-11-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7501714     Medline TA:  Aviat Space Environ Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  841-6     Citation Subset:  IM; S    
Affiliation:
Naval Aerospace Medical Research Laboratory, Pensacola, FL, USA. gmrice0622@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Altitude
Central Nervous System Diseases / etiology
Decompression Sickness / classification*,  complications,  diagnosis*,  physiopathology
Humans
Male
Military Medicine*
Oxygen
Paresthesia / etiology
Prospective Studies
Reproducibility of Results
Retrospective Studies
Chemical
Reg. No./Substance:
7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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