Treatment of Decompression Illness in Recreational Diving: Is reconciliation of different treatment practices necessary?
Standard treatment for decompression illness (DCS) and arterial gas embolism (AGE) both dive-related and iatrogenic, is recompression and hyperbaric oxygen administration. Treatment practices around the world have been mostly derived from the experience of various navies and commercial companies. In the United States, the UHMS provides guidelines based on the U.S. Navy practices with minor adjustments for the recreational diving environment. The mainstay of UHMS recommendations for initial treatment is U.S. Navy Treatment Table 6 for serious cases and Treatment Table 5 for mild cases. Both treatment tables apply maximum pressure of 2.8 bars (equivalent to 18 msw or 60 fsw depth). Some medical centers in the United States like Hawaii, NASA and Catalina use greater treatment pressures while others that operate monoplace chambers use less pressure and shorter treatment times. In another part of the world, current practice may differ. In France, treatment tables are derived from the French Navy and COMEX tables, and use nitrox and various pressure levels. COMEX 12 and U.S. Navy Table 9 are examples of short and shallow tables. In Russia, treatment pressure sometimes goes higher than 6 bars. Practitioners in China may follow U.S. practice but they have extensive experience with severe and delayed cases in fish farming. Cairns in Australia has extensive experience in treating cases from the Great Barrier Reef and flying after treatment.
A decision to recompress in a case when symptoms resolve before admission may vary. Beyond initial treatment, there are major differences in approach to follow-up treatments, auxiliary treatments and physical rehabilitation of injured divers. Additional differences appear in the recommendation for flying after treatment.
The aim of this workshop is to review variants of current clinical practices, to discuss the rationale for such practices and to consider a need for harmonization of practices.
|Event Date||06-26-2019 8:00 am|
|Event End Date||06-26-2019 5:00 pm|
|Location||Wyndham Grand Rio Mar Puerto Rico Golf & Beach Resort|
|Categories||UHMS Directly Provided Meeting|