“The Treatment of Decompression Sickness During COVID-19: A Case of At-Home Recompression.” Landrum B., Ray K., Badam M., Hardy S., Siegel M., Legros T. LSU Undersea and Hyperbaric Medicine Fellowship 2021 LSU Internal Medicine Research Conference, New Orleans Louisiana

BACKGROUND: Decompression sickness (DCS), commonly known as the bends, is a potentially fatal injury precipitated by bubble formation within tissues and blood when total dissolved gas pressures exceed ambient pressure. The treatment for DCS is hyperbaric oxygen therapy

(HBO2). This case reviews a delay in treatment for DCS due to COVID-19.

CASE PRESENTATION: Diagram 1: Dangers of Reverse Profile Dives A 58-year-old man presented to the ED with bilateral hip pain and a headache. Six days prior he completed 5 dives in a reverse profile pattern. This diving pattern is dangerous and provocative for DCS injury (Diagram 1). Thirty minutes following his last dive, he became symptomatic. He was off-balance, achy, with a headache and fatigued. Later that night he developed bilateral hip pain. The patient called Divers Alert Network (DAN) who directed him to the ED for evaluation. Photograph 1: Swimming Pool Scuba Diver The patient deferred this advice, as he lost his health Diagram 2: Decompression Sickness Warning Poster insurance during the COVID-19 pandemic. Instead, he DISCUSSION & CONCLUSIONS: attempted at-home recompression. He performed a COVID-19 has been catastrophic for many REFERENCES: 100% O2 dive in a 6 ft pool for 30 minutes the day prior patients and their employers, often 1. McInnes, S., Edmonds, C., & Bennett, M. (2005). to ED presentation (Photograph 1). The relative safety of forward and reverse diving resulting in job and health insurance loss. profiles. Undersea & Hyperbaric Medicine, 32(6), 421. He was admitted to the ED with c/o of headache, hip Fortunately, even with the patients delayed presentation, appropriate HBO 2. Edmonds, C., McInnes, S., & Bennett, M. (2005). pain, headache, and dizziness that was worsened 2 Reverse dive profiles: the making of a myth. SPUMS following at-home recompression. He was fully therapy may be successful in ameliorating JOURNAL, 35(3), 139. the multiple inflammatory cascades, evaluated, diagnosed with Type 2 DCS (Diagram 2), 3. Ranapurwala, S. I., Bird, N., Vaithiyanathan, P., & and treated with HBO (USN TT6). All symptoms edema, and tissue hypoxia caused by the Denoble, P. J. (2014). Scuba diving injuries among 2 air bubble formations. Divers Alert Network members 2010–2011. Diving resolved following HBO2. Hyperb Med, 44(2), 79-85.