Hyperbaric emergencies and decompression illness

Abstract

Decompression illness (DCI) is the most important emergency resulting from exposure to hyperbaric environments. Immediate diagnosis and management mostly allow for complete recovery without sequelae. Emergency and critical care physicians need to be aware of the possible symptoms, since there are no DCI-specific symptoms, and the clinical presentation can simulate a variety of other pathologies. Initial treatment of choice is the administration of pure oxygen together with adjunctive measures such as fluid expansion and eventually symptomatic medication, followed by hyperbaric oxygen (HBO) treatment. Patient management under hyperbaric conditions requires taking into account the physics of hyperbarism to avoid any procedure-related pitfalls.