Cold injury to a diver's hand after a 90-min dive in 6 degrees C water

We present here a case of non-freezing cold injury (NFCI) in a sport scuba diver. There are similarities between the presenting symptoms of NFCI and decompression sickness, e.g., pain and/or altered sensation in an extremity, often reported as numbness. In both conditions patients have been known to describe their lower limbs or feet as feeling woolly. Both conditions are the result of environmental exposure. Additionally, there are no good (high sensitivity and specificity) diagnostic tests for either condition. Diagnosis is made based on patient history, clinical presentation, and examination. NFCI is most frequently seen in military personnel, explorers, and the homeless. When affecting the feet of soldiers it is often referred to as "trench foot." Historically, NFCI has been and continues to be of critical importance in infantry warfare in cold and wet environments. A high priority should be given to prevention of NFCI during military operational planning. With the advent of so-called "technical diving" characterized by going deeper for longer (often in cold water) and adventure tourism, this extremely painful condition is likely to increase in prevalence. NFCI is treated symptomatically.