Current RMA Instruments

Changes from previous Instruments

SOP Bulletin 179

ICD Coding

• ICD-9-CM Codes: 993.31
• ICD-10-AM Codes: T70.31

Brief description

This is an acute lung injury due to barometric pressure change.  It is generally a serious condition and is potentially fatal.  It is associated most commonly with scuba diving and explosive blasts, and also as a complication of mechanical lung ventilation.  It may result in pneumothorax, pneumomediastinum, subcutaneous emphysema or arterial gas embolism.

Confirming the diagnosis

Diagnosis is made from the history and physical findings, together with imaging (CT or MRI scan).

The relevant medical specialist is a respiratory physician or emergency physician.

Additional diagnoses covered by SOP

• Burst lung

Conditions not covered by SOP

• Decompression sickness*
• Dysbaric osteonecrosis* - osteonecrosis SOP
• Fat embolism^#
• Emphysema*
• otitic barotrauma*
• sinus barotrauma*

* another SOP applies

^# non-SOP condition

Clinical onset

Onset will be acute and immediately follow an event such as a scuba dive, an explosion, or being mechanically ventilated.  Symptoms may include shortness of breath, cough, coughing blood and chest pain.

Clinical worsening

This is an acute injury.  The only SOP worsening factor is for inability to obtain appropriate clinical management.  The condition requires urgent medical attention and may be fatal.