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What would you include in you provisional differential diagnosis at this stage?
Shortly, his wife arrives in the department. You take a collateral history. He has not shown any of these symptoms in the last week and she is surprised at his sudden illness as he had a medical 2 weeks prior to participating in wreck diving over 3 days in a lake in Scotland, returning home 2 days ago. You enquire about his hobbies and previous occupation.
He is a retired SCUBA instructor and now continues to dive recreationally.
GCS 14 E3M6V5
HR 82 bpm regular
Sats 98% 5L O2
Chest clear. HS normal.
Abdomen general discomfort with palpable bladder.
Power 3/5 on left leg with reduced sensation distally. Normal reflexes.
He seems orientated but drowsy with poor concentration. He says he feels tired and thirsty.
You suspect that his symptoms could be related to his recent SCUBA diving session.
What immediate tests will you arrange in the ED?
What further tests will help with a diagnosis?
You consider spinal DCS. What action is necessary now?
Please tick true statement
Urgent MRI prior to neurology referral
Urgent MRI prior to contacting nearest Dive chamber
Contact nearest Dive chamber immediately
In addition to the difficulty in arranging an urgent MRI, the Dive chamber will consider recompression if warranted without the need for an MRI spinal cord. However, it is better to consult the dive chamber first and begin arranging transfer
Is this statement true or false?