No-Stop 60 FSW Wet and Dry Dives Using Air, Heliox, and Oxygen-Nitrogen Mixtures. Data Report on Projects 88-06 and 88-06A: Improved Decompression Procedures for Free-Swimming Divers

Hamilton, RW; Thalmann, ED; Et, Flynn; Temple, DJ

doi:10.21236/ada452905

Cited by 3 publications

(3 citation statements)

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“…The data were broadly indicative of rapid and complete recovery in the vast majority of cases. 35,36,[38][39][40][41][42][43][44][45][46]61 This contrasted with a large series of recreational divers with much longer median recompression latency who required greater numbers of recompression treatments and exhibited a substantially higher incidence of residual symptoms on completion of hyperbaric treatment. 62 This analysis will be reported in more detail in the 2017 workshop proceedings.…”

Section: In-water Recompressionmentioning

confidence: 99%

Pre hospital management of decompression illness: expert review of key principles and controversies

Mitchell

Bennett

Bryson³

et al. 2018

Diving Hyperb Med

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Guidelines for the pre-hospital management of decompression illness (DCI) had not been formally revised since the 2004 Divers Alert Network/Undersea and Hyperbaric Medical Society workshop held in Sydney, entitled "Management of mild or marginal decompression illness in remote locations". A contemporary review was initiated by the Diver's Alert Network and undertaken by a multinational committee with members from Australasia, the USA and Europe. The process began with literature reviews by designated committee members on: the diagnosis of DCI; first aid strategies for DCI; remote triage of possible DCI victims by diving medicine experts; evacuation of DCI victims; effect of delay to recompression in DCI; pitfalls in management when DCI victims present at hospitals without diving medicine expertise and in-water recompression. This was followed by presentation of those reviews at a dedicated workshop at the 2017 UHMS Annual Meeting, discussion by registrants at that workshop and finally several committee meetings to formulate statements addressing points considered of prime importance to the management of DCI in the field. The committee placed particular emphasis on resolving controversies around the definition of "mild DCI" arising over 12 years of practical application of the 2004 workshop's findings, and on the controversial issue of in-water recompression. The guideline statements are promulgated in this paper. The full workshop proceedings are in preparation for publication.

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Section: In-water Recompressionmentioning

confidence: 99%

Pre hospital management of decompression illness: expert review of key principles and controversies

Mitchell

Bennett

Bryson³

et al. 2018

Diving Hyperb Med

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“…In addition to the above, we have collated reports of 140 cases of DCS arising from experimental dives at NEDU, NMRI, and the Naval Submarine Medical Research Laboratory from 1988 to 2006 in which delay to recompression and details of the clinical course are available. [26][27][28][29][30][31][32][33] Up to 16 of ; "Paralysis/Weakness" includes motor weakness, whereas "Weakness (with pain)" is weakness associated with a painful joint; "Girdle/Abdominal Pain" includes bilateral hip pain; "L.O.C." − loss of consciousness; "S.O.B."…”

Section: Efficacy Of Treatment Following Short Delay To Recompressionmentioning

confidence: 99%

“…Excluding one 26-h treatment, the total treatment times ranged from 35 to 180 min (mean 70 min). DCI signs and symptoms treated at 33 fsw or shallower (number of cases) included pain (26), special senses (6), rash (5), sensory (3), chokes (3), syncope (3), motor weakness/ paralysis (3), loss of consciousness (1) and nausea and vomiting (1). Being largely treatments for experimental dives, the delay to recompression was relatively short, with a median of 37 min (range 0-270 min).…”

Section: Shallow and Short Treatmentsmentioning

confidence: 99%

In-water recompression

Doolette

Mitchell

2018

Diving Hyperb Med

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Divers suspected of suffering decompression illness (DCI) in locations remote from a recompression chamber are sometimes treated with in-water recompression (IWR). There are no data that establish the benefits of IWR compared to conventional first aid with surface oxygen and transport to the nearest chamber. However, the theoretical benefit of IWR is that it can be initiated with a very short delay to recompression after onset of manifestations of DCI. Retrospective analyses of the effect on outcome of increasing delay generally do not capture this very short delay achievable with IWR. However, in military training and experimental diving, delay to recompression is typically less than two hours and more than 90% of cases have complete resolution of manifestations during the first treatment, often within minutes of recompression. A major risk of IWR is that of an oxygen convulsion resulting in drowning. As a result, typical IWR oxygen-breathing protocols use shallower maximum depths (9 metres' sea water (msw), 191 kPa) and are shorter (1-3 hours) than standard recompression protocols for the initial treatment of DCI (e.g., US Navy Treatment Tables 5 and 6). There has been no experimentation with initial treatment of DCI at pressures less than 285 kPa since the original development of these treatment tables, when no differences in outcomes were seen between maximum pressures of 203 kPa (10 msw) and 285 kPa (18 msw) or deeper. These data and case series suggest that recompression treatment comprising pressures and durations similar to IWR protocols can be effective. The risk of IWR is not justified for treatment of mild symptoms likely to resolve spontaneously or for divers so functionally compromised that they would not be safe in the water. However, IWR conducted by properly trained and equipped divers may be justified for manifestations that are life or limb threatening where timely recompression is unavailable.

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Extreme Scuba Diving Medicine

Mitchell

Doolette

2016

Extreme Sports Medicine

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No-Stop 60 FSW Wet and Dry Dives Using Air, Heliox, and Oxygen-Nitrogen Mixtures. Data Report on Projects 88-06 and 88-06A: Improved Decompression Procedures for Free-Swimming Divers

Cited by 3 publications

References 0 publications

Pre hospital management of decompression illness: expert review of key principles and controversies

Pre hospital management of decompression illness: expert review of key principles and controversies

In-water recompression

Extreme Scuba Diving Medicine

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