Under Pressure: A Case Report of a Diver's Close Encounter With the Bends

Generalized barotrauma, also referred to as decompression sickness (DCS), is a condition that occurs when there is a sudden shift in atmospheric pressure. While typically associated with underwater excursions or deep-sea dive encounters, this process can also occur during sudden changes in high altitude or unpressurized air travel. Sudden shifts in atmospheric pressure trigger the formation of nitrogen gas bubbles in the bloodstream that fail to clear from the blood and instead accumulate, leading to an obstruction in circulation. Symptoms of DCS may range from joint and musculoskeletal pain to headaches and even stroke-like symptoms, including visual impairment and altered sensorium. The optimal treatment approach for DCS involves hyperbaric oxygen therapy (HBOT) to allow for the dissolution of nitrogen. However, despite the benefits of HBOT, it is not always readily accessible due to the limited availability of hyperbaric chambers. We present the case of a 50-year-old man diagnosed with acute DCS successfully treated using only high-flow oxygen supplementation.