Medicine and Health · Traumatic Gas Embolism (TGE)

Introduction

Neumothorax

Mediastinal Emphysema

Subcutane Emphysema

Introduction
TGE is associated to 3 illnesses, which are caused by the deviation or expansion of the air inhaled during the dive.

Neumothorax:
This occurs when, due to an excess in pressure, the air which has escaped the pulmonary alveoli stays between the pleural cavity and the lung, causing an accumulation of air that compresses the lung.
Some of the symptoms include: sharp pain in the chest which worsens with deep breaths, paleness, hunching over to one side, and lung collapse.
If the case of neumothorax is a simple one, with little complications, it can be treated by administering the patient with oxygen at 100%. In more serious cases an insertion of a tube will be required to release the air and inflate the lung. Urgent medical attention is of utmost importance. In most cases it is recommended that the diver wait 6 months before diving again .

Mediastinal Emphysema :
This is produced by the expansion of air in the tissue surrounding the heart, main blood vessels and pulmonary alveoli. In this case the air does not rupture the alveoli but rather the bronchioles.
The most common symptoms include moderate to strong pain under the sternum (it feels like something pressing down), and becomes more intense when the patient breathes deeply or swallows. There are cases where alterations in the voice and pain in the shoulder, back and neck can be felt.
It is advisable to administer oxygen at 100% to the patient and take him to a chamber for recompression immediately .

Subcutane Emphysema:
This is brought about by a deviation of the air from the mediastine to the subcutaneous region, specially around the neck and shoulders, forming bubbles of air beneath the skin. In mild cases this emphysema is hardly noticeable to the diver. There may be a light swelling in the neck, skin that is “creaks” when touched and a change in voice pitch. A supply of oxygen at 100% is recommended in all cases and so is recompression for more serious cases.
Besides the above mentioned causes, another cause of a traumatic gas embolism involves the diver holding his breath during ascent.
As a general rule, it is advisable that a diver who has suffered from a TGE and who has inhaled air under pressure, of any type, and who loses consciousness within the first 10 minutes of having reached the surface, be taken to a recompression treatment center as soon as possible.