Decompression illness is primarily a clinical diagnosis and is assessed with a very thorough and detailed history and examination.

In the emergency department, it is vital to ensure there is no pulmonary barotrauma. This is crucial as it helps with the diagnosis and may need to be treated before a patient receives recompression therapy. A thorough examination and chest x-ray are important. If there is any uncertainty after this then a CT chest may be required to determine if there is any pulmonary barotrauma.

If there is any doubt as to the diagnosis, further investigations may be required to rule out other pathologies. For example, cerebral arterial gas embolism presents very similarly to a stroke a CT head would be useful in this case.

Learning Bite

A chest x-ray is often useful to assess for pulmonary barotrauma, although further investigations may be required.

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