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10.1155/2017/7203085

http://scihub22266oqcxt.onion/10.1155/2017/7203085
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suck abstract from ncbi


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pmid29109872
      Case+Rep+Emerg+Med 2017 ; 2017 (ä): 7203085
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  • Severe Decompression Illness: Case Report, Prehospital Recognition, and Regional Transport Considerations #MMPMID29109872
  • Estrada J ; Meurer D ; De Boer K ; Huesgen K
  • Case Rep Emerg Med 2017[]; 2017 (ä): 7203085 PMID29109872 show ga
  • A 46-year-old male presented to our tertiary care emergency department (ED) with shortness of breath and chest pain following an uneventful four-hour SCUBA dive at 100 feet. His prehospital emergency medical services (EMS) assessment revealed transient hypotension and hypoxia. He later developed progressive skin mottling. Serology was significant for acute kidney injury, transaminitis, hemoconcentration, and hypoxia on an arterial blood gas. Computed tomography (CT) angiography demonstrated intravascular gas throughout the mesenteric and pulmonary arteries as well as the portal venous system. No abnormality was seen on head CT and the patient had normal mental status. Prehospital nonrebreather oxygen therapy was changed to continuous positive airway pressure (CPAP) upon ED arrival, and the patient was intubated prior to transfer to a hyperbaric facility. However, within 24 hours the patient was found to have multiorgan failure, diffuse cerebral edema, and brain death despite no further episodes of hypotension or hypoxia. No intracranial gas was seen on repeat head CT. Our case demonstrates the importance of early recognition of decompression illness by EMS personnel, consideration of ground versus flight transportation of these patients to the nearest hyperbaric center, and the possible use of prehospital CPAP as an alternative to enhance oxygenation.
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