Diving incident first aid covers the essential early steps to take following the recognition of decompression sickness symptoms in a diver. Whilst recompression is the definitive treatment for decompression illness, first aid for divers can make a very real, positive difference to the clinical outcome.
Call for Help & Basic Life Support
Make an early call for specialist advice. At sea, contact the Coastguard on DSC70 or Channel 16. On land call 999 or ring for advice on the 24 hour help line 07770 423637. Seek early advice from a specialist diving physician at a hyperbaric facility as recompression is the best treatment option.
Provide Basic Life Support if trained to do so.
Give the diver oxygen. Breathing 100% oxygen (O2) speeds up removal of nitrogen (N2) from the lungs and can ease symptoms. The breathing apparatus must supply to the lungs as close to 100% O2 as possible. This means an anaesthetic type mask or an O2 diving regulator as used in technical and commercial diving.
All suspected cases of decompression sickness should be given 100% O2 straight away and stay on oxygen during transfer of the patient to the recompression chamber.
Unconscious divers, if not breathing of their own accord, will require assisted ventilation by attending medics.
If symptoms improve on oxygen then the diver is highly likely to have decompression illness – call for specialist advice.
An unconscious diver should be placed in the recovery position and the first aider should protect the airway at all times.
The Trendelenburg (30 degree head down, feet up) position that used to be taught is no longer recommended. Having the head lowered raises the pressure locally in the brain and this can aggravate any brain injury present.
Because of the tendency for gas bubbles to rise, sitting or standing may be dangerous in patients with air embolism or cerebral decompression sickness where the bubbles are still in the blood stream, so keep the diver laying down.
Stay with the diver – do not leave them alone.