Boussages et al developed a “gravity” score for determining the severity of neurologic decompression illness in divers. This can help to identify a diver who is more likely to have complications and to benefit from more aggressive management. The authors are from Hospital Salvator in Marseille, France.
Sequelae were persistent neurologic signs or symptoms. Incapacitating sequelae were objective sensory, motor or urinary signs that were persistent.
Parameters:
(1) repetititve dive
(2) clinical course prior to hyperbaric therapy
(3) objective sensory disorder
(4) type of motor impairment
(5) urinary disturbance
Parameter |
Finding |
Points |
repetitive dive |
no |
0 |
|
yes |
2 |
clinical course before |
improvement |
0 |
|
stable |
3 |
|
worsening |
5 |
objective sensoyr disorder |
no |
0 |
|
yes |
4 |
motor impairment |
no |
0 |
|
hemiplegia |
3 |
|
paresis (mono, para, tetra) |
4 |
|
paraplegia |
6 |
urinary disturbance |
no |
0 |
|
yes |
5 |
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score 22
• A score > 7 was associated with incapacitating sequelae.
Specialty: Emergency Medicine, Critical Care
ICD-10: ,