Ver el código de «Nitrogen narcosis»

==Background==
*Toxic effects of breathing nitrogen-containing gases while at depth
*Called the "rapture of the deep"
*Develops between 3-4ATM (99-132 feet)<ref name="Grover">Grover CA, Grover DH. Albert Behnke: nitrogen narcosis. J Emerg Med. 2014 Feb;46(2):225-7.</ref>
**Rare at depths less than 30 meters (100 ft) unless breathing non-standard air mixtures
**Similar to alcohol, frequent divers can develop subjective "tolerance" to the effects, but impairment remains<ref name="Levett">Levett DZ, Millar IL. Bubble trouble: a review of diving physiology and disease. Postgrad Med J. 2008 Nov;84(997):571-8.</ref><ref name="Grover" />
*Can be prevented by using nitrogen-free gas mixture (e.g. heliox), or mixtures with reduced nitrogen content (e.g. helium-nitrogen-oxygen)<ref name="Grover" />
*Risk factors = exertion during dive, cold conditions, alcohol intoxication before dive<ref name="Grover" />
*Other inert gases cause similar symptoms at depth - severity based on lipid solubility of the gas<ref>Bove AA. Diving medicine. Am J Respir Crit Care Med. 2014 Jun 15;189(12):1479-86.</ref>

{{Diving Physiology}}

==Clinical Features==
*Insidious onset of symptoms similar to [[alcohol intoxication]] (or nitrous oxide inhalation)<ref name="Grover" /><ref name="Levett" />
**Early stage: Euphoria, false sense of security, impaired judgement, diminished reaction times
**Later stage: Impaired concentration and memory, [[paresthesias]], [[hallucinations]]
**Final stage: [Occurs at depths of at least 10-13ATM (333-429 feet)], [[lethargy]] and [[loss of consciousness]]
*Causes high risk of making bad decisions at depth, i.e. impairs diver's judgment therefore leading to drowning accidents (cause of up to 9% of diving deaths)<ref name="Grover" /><ref name="Levett" />

==Differential Diagnosis==
{{Scuba diving DDX}}

==Evaluation==
*Clinical diagnosis

==Management==
*Ascent - symptoms completely reversed within minutes by ascending to a shallower depth, with no long-term effect
**Therefore, consider other causes in patients with continued symptoms after ascent

==Disposition==
*Discharge

==See Also==
*[[Scuba diving emergencies]]

==External Links==


==References==
<references/>

[[Category:Environmental]]