Mild DI

Mild DI includes those categories traditionally assigned to Type I in the Golding Classification 26. Mild DI forms do not display any features of moderate to severe DI and this should be confirmed by a competent health care professional.

Pain

The upper extremities are involved 3 times more often than the lower limbs in recreational and compressed air commercial diving. The situation is reversed in caisson workers and in commercial saturation (Heliox) diving.

The pain can range from slight transient discomfort ('niggle') to a dull, deep, boring and unbearable pain. It is usually not affected by movement and

* As iterated in the preceding sections, DI does not present in watertight clinical compartments, nor can the etiology always be confirmed. It should therefore be understood that the clinical entities presented here may coincide or overlap with others across the arbitrarily assigned boundaries of mild, moderate and severe DI.

there can occasionally be some degree of overlying local pitting edema and subjective numbness (refer section 4.4.1).

Lymphatic Manifestations

The lymphatic manifestations of DI presumably result from obstruction of lymphatic vessels by bubbles. The manifestations can include pain and swelling of regional lymph nodes, with lymph edema of those tissues drained by the obstructed lymph nodes.

Cutaneous Manifestations

Itching is commonly reported during decompression from dry chamber dives where the skin is surrounded by chamber atmosphere rather than water. It is thought to be the result of diffusion of gas from the chamber atmosphere directly into the skin, followed by expansion during decompression and a consequent itching sensation. This is not considered a systemic form of DI and therefore need not be treated with recompression. Itching with or without discoloration, signs of urticaria and/or blotchiness occurring after in-water diving is considered to be systemic cutaneous DI *.

Cutis Marmorata or marbling is thought to result from bubble-related cutaneous venous obstruction. It usually presents as an area of erythema, frequently affecting the upper back and chest. Lesions may migrate spontaneously or with palpation and prominent linear purple markings are frequently observed. These manifestations are considered to be an overt manifestation of DI and should be promptly treated ¥. Recompression often, although not always, leads to prompt resolution.

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