Which of the following is a major symptom of decompression illness to consider?

• A. Vertigo
• B. Pneumothorax
• C. Localized swelling with pain
• D. Girdle burning discomfort

Answer: (B)

Pulmonary barotrauma can occur during ascent and lead to pneumothorax, which is a life-threatening complication to recognize in divers with decompression illness. A pneumothorax presents as sudden chest pain and shortness of breath, and may show diminished breath sounds on the affected side. Because it can rapidly worsen and require urgent intervention, identifying pneumothorax is prioritized when evaluating someone with suspected decompression illness.

While vertigo and other symptoms can occur with DCI, they do not carry the same immediate risk as a developing pneumothorax. Localized swelling with pain or girdle burning discomfort may reflect musculoskeletal or regional symptoms but are not as critical from a respiratory emergency standpoint. In practice, give high-flow oxygen, monitor and support breathing, and transport promptly to a hyperbaric facility; be prepared to treat a tension pneumothorax if present per protocol.