Latham Emi, van Hoesen Karen, Grover Ian
Department of Emergency Medicine, Division of Hyperbaric Medicine, University of California, San Diego, San Diego, California 92103-8676, USA.
J Emerg Med. 2011 Nov;41(5):486-8. doi: 10.1016/j.jemermed.2008.04.015. Epub 2008 Nov 7.
Scuba diving is a very popular and safe sport. Occasionally divers will suffer an injury from barotrauma, decompression sickness or an arterial gas embolism. The history and physical examination are important when determining the etiology of the injury and its subsequent treatment.
This article will help readers identify key components of the history and physical examination in a patient to help differentiate between and injury caused by barotrauma or arterial gas embolism.
This is a case of a diver that was initially felt to have an arterial gas embolism after scuba diving. After obtaining further history and performing a detailed physical exam it was determined that his diplopia was due to barotrauma from his mask. This was confirmed by an orbital computed tomography (CT) scan.
Scuba diving is a very safe sport. When injuries occur it is important to obtain a careful history and physical examination to determine the exact cause of the injury because treatments vary according to the type of injury. In this case, the history and physical examination showed that the only neurologic sign the patient had was diplopia, which is not consistent with a diagnosis of arterial gas embolism. The CT scan helped with the diagnosis because it proved the patient had an orbital hematoma causing his proptosis and double vision.
水肺潜水是一项非常受欢迎且安全的运动。偶尔潜水者会因气压伤、减压病或动脉气体栓塞而受伤。在确定损伤的病因及其后续治疗时，病史和体格检查很重要。
本文将帮助读者识别患者病史和体格检查的关键组成部分，以帮助区分气压伤或动脉气体栓塞所致的损伤。
这是一例潜水者在水肺潜水后最初被认为患有动脉气体栓塞的病例。在获取进一步病史并进行详细体格检查后，确定其复视是由面罩引起的气压伤所致。眼眶计算机断层扫描（CT）证实了这一点。
水肺潜水是一项非常安全的运动。受伤时，仔细询问病史并进行体格检查以确定损伤的确切原因很重要，因为治疗方法因损伤类型而异。在本病例中，病史和体格检查显示患者唯一的神经学体征是复视，这与动脉气体栓塞的诊断不符。CT扫描有助于诊断，因为它证实患者有眼眶血肿导致眼球突出和复视。
