Explain the pathophysiology and a key treatment principle for decompression sickness risk during rapid changes in cabin pressure.

Explain the pathophysiology and a key treatment principle for decompression sickness risk during rapid changes in cabin pressure.

• A. Gas bubbles form in tissues due to reduced ambient pressure; treat with 100% oxygen and rapid transfer to hyperbaric therapy
• B. Gas bubbles form in tissues due to reduced ambient pressure; treat with diuretics
• C. Gas bubbles form in the blood due to increased ambient pressure; treat with rest
• D. Decompression sickness is not a concern in aviation

Answer: (A)

Decompression sickness happens when a rapid drop in ambient pressure causes dissolved nitrogen in tissues and blood to come out of solution and form gas bubbles. In aviation, sudden decompression or rapid ascent lowers the surrounding pressure, so these nitrogen bubbles can obstruct small vessels and trigger inflammation, leading to joint and muscle pain, neuro symptoms, or cardiopulmonary issues. The key treatment principle is to administer 100% oxygen because it speeds nitrogen washout from tissues and reduces bubble formation, while also ensuring tissues get adequate oxygen. If symptoms are present or complications are suspected, rapid transfer to a hyperbaric facility for recompression and continued high‑flow oxygen is essential, as this helps shrink the bubbles and re‑dissolve the gas. Diuretics do not address the underlying gas bubbles, resting alone is not sufficient, and decompression sickness is indeed a concern in aviation, not something to overlook.