diving emergency
The 4 R’s of Managing a DCI Injury

Recognise

Recognise symptoms

Respond

Respond with oxygen

Relay

Get expert advice

Complete resolution of decompression illness is most likely from early recompression.

Moon RE, Sheffield PJ. Guidelines for treatment of decompression illness. Aviat Space Environ Med. 1997;68:234-243

Treatment of Decompression Sickness

Recompression in a hyperbaric facility experienced in treating diving injuries is the definitive decompression illness treatment.  Self-treating with oxygen on surface, or at depth with oxygen rich mixtures is not recommended and is potentially fatal.

Although a diver with severe decompression sickness or an air embolism requires urgent recompression, it is essential that the diver is stabilised at the nearest medical facility before transportation to the receiving chamber for decompression sickness treatment – if in doubt call 999 initially.

Patient Referral

To discuss or refer a patient for hyperbaric treatment then call our 24 hour advice line on:

07770 423637

Patient Treatment

Decompression illness treatment protocols are selected according to the clinical condition of the diver and with consideration to the degree of gas loading, the dive profile and other factors.

During treatment inside the chamber, divers are cared for directly by trained technician’s who stay with you for the duration.  In some cases a hyperbaric Doctor or Nurse may also be in attendance, in addition to the care team looking after the decompression sickness treatment on the outside of the chamber.

Whilst in the chamber the diver is closely monitored.  In cases where divers are recompressed quickly following the problem dive, divers typically experience immediate relief of symptoms to some degree upon recompression. In cases where any pain, neurologic deficit or other symptoms do not disappear or respond significantly early on in the treatment then the attending hyperbaric Doctor may switch to a deeper and/or longer treatment.

  • Recurrence of symptoms does sometimes occur and in these cases or where initial symptoms are not completely resolved after the initial treatment then shorter follow up treatments may be required.
  • On completion of all hyperbaric treatment patients are discharged, usually home, but in some cases to hospital to receive further on-going care in accordance with their care plan.

Capabilities & Staffing

As a Category One facility in Poole we are able to accept critically ill divers for treatment where required, with specialised ventilatory support available in addition to the deeper mixed gas treatment tables sometimes required to treat high gas load deep dives.

As part of our NHS contract we provide a qualified team of professionals who are on-call 24 hours a day throughout the year to provide immediate emergency care to patients requiring hyperbaric treatment.  Diving Doctors, Supervisors, Technicians, Nurses and Anaesthetists and other healthcare professionals combine to provide the highest standards of care during a patient’s stay with us.

hyperbaric treatment

How Recompression Works

The primary mechanism of recompression is to compress the inert gas bubbles causing symptoms, allowing the bubbles to be re-absorbed.  Breathing higher levels of oxygen speeds up removal of inert gas from the body.  Additionally, the increased oxygen delivered to injured tissues assists repair.

As the gas bubbles shrink and are absorbed back into tissues and on to circulation, they are filtered out by the lung. Recompression treatment is often over 4 or more hours because inert gas bubble elimination can be slow in areas of poor flow, particularly where any injury may have occurred.

Hyperbaric Treatment Tables

These are shown for information purposes only and not intended for use by hyperbaric units as they may not include most recent revisions

Royal Navy Table 62

Usage:

Typically initial treatment of decompression illness

Source: Institute of Naval Medicine, UK

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