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Decompression Sickness S006

Document
Last amended 
29 June 2015
Current RMA Instruments:
Reasonable Hypothesis SOP
13 of 2015
Balance of Probabilities SOP
14 of 2015
Changes from Previous Instruments:

SOP Bulletin 179

 ICD Coding:
  • ICD-9-CM Codes: 993.30
  • ICD-10-AM Codes: T70.30

This is a potentially systemic disorder of the body caused by the expansion of nitrogen bubbles in the blood and tissues around the body caused by the decrease in ambient barometric pressure (decompression). The decrease in ambient barometric pressure can occur as a result of ascending from depth in water or from ascending to altitude.

Normally, the dissolved nitrogen will be slowly expelled through the lungs to the ambient atmosphere, but if the decrease in barometric pressure is achieved too quickly the dissolved nitrogen comes out of solution as gas bubbles which progressively grow in size. It is these growing bubbles that cause pathology by obstructing blood flow causing ischaemia and infarction of supplied organs; or direct tissue damage when the bubble is within a tissue or organ.

Is specific diagnostic evidence required to apply the SOP?Yes.

Based on specialist physician diagnosis, with a likely history of increased tissue nitrogen solution, such as scuba diving, caisson work.

Are there sub-factors that require specific information? – No.
Additional diagnoses covered by SOP
  • The bends
  • Caisson disease
Conditions excluded from SOP
  • Pulmonary barotrauma, ICD 9 code 993.31
  • Dysbaric osteonecrosis, ICD 9 code 993.32
  • Fat embolism
Unconfirmed diagnosis

If, after applying the above information, you are unable to confirm the diagnosis, you should then seek medical officer advice about further investigation.