Remember that just because you
were diving you are not necessarily
suffering from a diving-specific
medical problem. Many medical
conditions can mimic the symptoms
of DCI, which further complicates the
process of making a diagnosis. Other
possible explanations of symptoms that
commonly occur after diving include
food-borne illnesses like ciguatera,
infectious diseases including viral
and parasitic syndromes and, perhaps
most notably, exertion or trauma that
leads to muscle strains or joint pain.
But don’t be too quick to decide your
symptoms are the result of something
other than DCI; leave that decision to
the doctor.
Other Tests
When you arrive at the ER, the
nurses will check your vital signs:
heart rate, blood pressure, respiratory
rate, temperature, pulse oximetry
(
which measures oxygen saturation of
hemoglobin) and level of pain.
If your symptoms are serious, a nurse
will obtain intravenous (IV) access by
inserting a needle into a peripheral
vein, usually in your arm or hand.
Blood will be taken and sent to the
lab for testing, and a tiny plastic tube
through which fluids and medications
can be administered will be placed into
the vein. Common blood tests that
may be conducted include a complete
blood count (which checks blood
cells), a metabolic panel (which checks
electrolytes, kidney function, blood
sugar and liver function) and cardiac
and other biomarkers (which check for
heart and muscle damage).
Your doctor may also order a chest
X-ray to check for problems with
your lungs, including such conditions
as pneumothorax (a collection of air
in the space around the lungs) or
evidence that air has leaked outside
the lung into other areas such as the
mediastinum (the area around the
heart) or in subcutaneous (under the
skin) spaces. In addition, a chest X-ray
can identify fluid in the lungs that may
suggest cardiac problems, immersion
pulmonary edema or water aspiration.
Your doctor may also ask for an
electrocardiogram (ECG or EKG).
This test involves placing electrodes
on your chest, arms and legs to
collect information about your heart’s
electrical system. It can identify an
abnormal heart rhythm and reveal
evidence of a recent heart attack.
If you had a loss of consciousness
or are experiencing neurological
symptoms, it is likely the doctor will
order a computed tomography (CT)
scan of your head. During this test
you will lie on a table that moves you
through a circular, donut-shaped X-ray
machine. This machine will rapidly
take a series of pictures of your head
and brain as you pass through and will
display a detailed three-dimensional
image. The doctor will review this
image for brain abnormalities such as
evidence of AGE, bleeding or a stroke.
If a lung injury (i.e., pulmonary
barotrauma) cannot be ruled out, the
doctor may also order a CT scan of
your chest. This can allow detection
of a small pneumothorax or small
collections of gas in the chest that may
not be visible on the chest X-ray. A CT
scan performed in conjunction with
the injection of a contrast dye through
your IV can help identify blockages in
arterial blood flow from blood clots or
gas bubbles.
The doctor, if concerned about your
heart, may order an echocardiogram.
This test uses ultrasound to create a
video of your heart in action. It involves
the placement of gel and a probe on
your chest. Echocardiography checks
for problems with the heart muscle,
heart valves or the flow of blood
through the heart.
What About Treatment?
If DCS or AGE is suspected, high-flow
oxygen should be administered through
a mask. In addition, unless you have an
underlying cardiac problem, you will
probably be given fluids through your
IV to help address possible dehydration.
If you are experiencing pain, the doctor
may offer you pain medication either
88
|
fall 2012
A thorough
neurological
exam may include
(
clockwise from
left): patellar
reflex, finger-to-
nose, sharpened
Romberg and eye-
movement tests.