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Type II altitude decompression sickness (DCS): U.S. Air Force experience with 133 cases.
S A Wirjosemito1, J E Touhey, W T Workman
1Hyperbaric Medicine Division, United States Air Force School of Aerospace Medicine, Brooks Air Force Base, Texas.
Aviation, Space, and Environmental Medicine
|March 1, 1989
Summary
Type II altitude decompression sickness (DCS) is challenging to diagnose, but hyperbaric oxygen treatment is highly effective. Understanding symptoms and predisposing factors aids diagnosis and prevention for aviators.
Area of Science:
- Aerospace Medicine
- Hyperbaric Medicine
- Diving and Aviation Physiology
Background:
- Type II altitude decompression sickness (DCS) presents a diverse symptomology complicating diagnosis.
- Misdiagnosis can lead to unnecessary grounding of aviators.
- A review of 133 Type II altitude DCS cases from USAF Hyperbaric Medicine Division was conducted.
Observation:
- Most cases (94.7%) occurred after altitude chamber training.
- Common symptoms include joint pain (43.6%), headache (42.1%), visual disturbances (30.1%), and limb paresthesia (27.8%).
- Less frequent symptoms comprised mental confusion (24.8%), limb numbness (16.5%), and fatigue (10.5%).
Findings:
- Severe DCS manifestations like spinal cord involvement, chokes, and unconsciousness were infrequent.
- Hyperbaric oxygen therapy demonstrated a high success rate (97.7%) with minimal residual deficits (2.3%).
- No fatalities were reported in the reviewed cases.
Implications:
- Accurate diagnosis and prevention of DCS in aviation environments require knowledge of differential diagnoses and risk factors.
- A classification system for symptom severity is proposed to support recommendations for aviator waiver considerations.
- Effective treatment protocols underscore the importance of timely hyperbaric oxygen intervention for Type II altitude DCS.