Goodbye Decompression Sickness

by T.J.R. Francis, D.J. Smith and J.J. W. Sykes, Institute of Naval Medicine, Hampshire, England. The current means by which we classify decompression sickness dates back only 30 years to the experience gained during the construction of the Dartford Tunnel in London. Golding et al [1] proposed a system for decompression sickness based upon perceived severity of the cases which arose in the caisson workers employed in the construction of the tunnel. Only symptoms considered sufficiently severe to bring the man [sic] back for treatment were considered to be decompression sickness. They divided the cases into two types: Type 1, or simple 'bends' and Type II, which were more serious or complicated cases which displayed vertigo, shock, paralysis, epigastric pain and shortness of breath. Their system is still in use today essentially unchanged. Traditionally, decompression sickness has been distinguished from the barotraumata and a summary of the current classification of the decompression disorders is presented in Table 1.