Report of the Decompression Illness Adjunctive Therapy Committee of the Undersea and Hyperbaric Medical Society

ADJ THER Cover copy
Report of the Decompression Illness Adjunctive Therapy Committee of the Undersea and Hyperbaric Medical Society 
Summary: 

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American Heart Association Guidelines for Clinical Efficacy:

  • Class 1: Conditions for which there is evidence and/or general agreement that a given procedure or treatment is useful and effective

  • Class 2: Conditions for which there is conflicting evidence and/or a divergence of opinion about the usefulness/efficacy of a procedure or treatment

  • Class 2A: Weight of evidence/opinion is in favor of usefulness/efficacy 

  • Class 2B: Usefulness/efficacy is less well established by evidence/opinion

  • Class 3: Conditions for which there is evidence and/or general agreement that the procedure/treatment is not useful/effective and in some cases may be harmful

  • Level of Evidence A: Data derived from multiple randomized clinical trials

  • Level of Evidence B: Data derived from a single randomized trial or nonrandomized studies

  • Level of Evidence C: Consensus opinion of experts


UHMS Guidelines for Adjunctive Therapy of DCI

Aspirin   
   Class Level
AGE (no significant inert gas load)  2B C
 DCS: pain only/mild  2B C
 DCS: neurological  2B C
 DCS: chokes  2B C

NSAIDs*
 Class  Level
AGE (no significant inert gas load)  2B C
DCS: pain only/mild  2B B
DCS: neurological  2B B
DCS: chokes  2B C

* The only evidence thus far available applies to the use of tenoxicam, a nonselective inhibitor of cyclooxygenase (COX). NSAIDs are not currently recommended for use in the field. Use of nonselective COX inhibitors, because of their effect on platelet function, could engender some risk for combat divers who may be required to return to action after treatment of an episode of decompression illness.

 

 Disclosure: The views, opinions, and findings contained herein are those of the author(s) and should not be construed as an official Agency position, policy, or decision unless so designated by other official documentation.