ABSTRACT
The currently accepted classification of decompression illness distinguishes between Cerebral Arterial Gas Embolism (CAGE) and Decompression Sickness (DCS) and further subdivides DCS into two categories, Type I or minor, and Type II or serious manifestations. The differentiation assumes certain mechanisms are responsible and requires an interpretation by a physician or supervisor to categorise the condition for appropriate treatment. The accuracy of any diagnosis is therefore highly dependent on the philosophical, intellectual and cultural background of the individual performing the classification. This is a far from ideal basis for data collection for national or international computer based databases or for the epidemiological studies which are derived from them.
The solution requires a reclassification of dysbaric illness which is not dependent on presumed mechanisms or interpretation of symptoms and signs. Reversion to the classic scientific method of description allows the almost infinite presentations of the decompression illnesses to be conveyed accurately. The proposed classification describes the decompression illness in terms of its evolution and presentation or manifestation.
Use of this classification removes the inherent inaccuracies and difficulties associated with the present convention permitting the acquisition of sound database information on an international basis which is independent of presumed pathological mechanisms. The Institute of Naval Medicine is fully committed to its adoption.
