Atlanta recreational or professional scuba divers can prepare for their next scuba excursion with an extensive dive physical at HyOx, the official dive physical facility of Atlanta’s Georgia Aquarium. Our hyperbaric medicine doctors understand the mechanisms of scuba diving and also treat the following scuba-related conditions:

Air or Gas Embolism and Hyperbaric Oxygen Therapy

Air or gas embolism is the presence of gas bubbles in the bloodstream that obstruct circulation. It may occur with decompression from increased pressure — typically occurring in ascending divers who have been breathing compressed air. If a diver does not fully exhale upon ascent, the air in the lungs expands as the pressure decreases, over-inflating the lungs and forcing bubbles of gas (emboli) into the bloodstream. When the moving bubbles reach the arteries to the brain, the blood blockage causes unconsciousness. Gas embolism is second only to drowning as a cause of death among divers. Gas embolism may also result from trauma or medical procedures such as catheterization and open-heart surgery that allows air into the circulatory system.

The primary symptom of gas embolism is immediate loss of consciousness. It may or may not be accompanied by convulsions. Any unconscious diver should be assumed to be the victim of gas embolism, regardless of whether consciousness was lost during or promptly after ascent. A doctor may also find pockets of air in the chest around the lungs and sometimes a collapsed lung from over-inflation and rupture. Coughing up blood or a bloody froth around the mouth are visible signs of lung injury.

Scuba divers benefit from hyperbaric oxygen therapy to treat air or gas embolism by its ability to:

• Deflate the gas bubbles in the bloodstream, so blood flow is restored to the brain and other organs

• Help to force out other gases so bubbles don’t reform

• Decrease swelling in the injured area

Decompression Illness (“The Bends”) and Hyperbaric Oxygen Therapy

Treatment for decompression sickness, or “The Bends,” was one of the original indications for hyperbaric oxygen therapy. Decompression illness is caused by pressure changing too quickly (rapid decompression) and nitrogen gas bubbles forming in the blood vessels and tissues of the diver which disrupts blood flow.

During a dive, the body’s tissues absorb nitrogen from the breathing gas in proportion to the surrounding pressure. As long as the diver remains at pressure, the gas presents no problem. However, if the pressure is reduced too quickly the nitrogen comes out of solution and forms bubbles in the tissues and bloodstream. The volume of bubbles interfere with pulmonary, circulatory and organ function and can be life-threatening.   Commons signs and symptoms include pain in joints, numbness, dizziness, confusion, personality changes, and muscle weakness.

Symptoms include joint and muscle pain, swelling, skin lesions, respiratory problems, and abdominal pain. Onset of symptoms usually occurs within 30 minutes after a dive but can take up to 12 hours.

Scuba divers benefit from hyperbaric oxygen therapy by its ability to:

• Reduce the bubble size until the inert gas is eliminated while tissues are saturated with 100 percent oxygen

• Increase the diffusion gradient for inert gas from the bubble into the surrounding tissue

• Oxygenize ischemic tissue

• Reduce swelling in the central nervous system

WHEN TO REFER TO HYOX:

As both air or gas embolism and decompression illness are emergent conditions, please medical care immediately and ask to be referred for hyperbaric oxygen therapy as soon as possible. Avoid air flight. If you have any questions about scuba-related conditions or to schedule a dive physical, please contact HyOx at 678.303.3200.