Aspirin for DCI?

[mbacarella]

I read in "Shadow Divers" that John Chatterton, who served as a medic in the armed services, administered a handful of aspirin to a diver that had missed their deco-stop on a deep wreck dive.

Are NSAIDs a common first-aid for suspected DCI?

 

[ptyx]

As far as I know, Aspirin was (is?) recommended because it improved circulation, not as as an anti-inflammatory. (Wikipedia tells me that's properly called 'antiplatelet' effect).

 

[AggieDiver]

Aspirin thins the blood and helps prevent clotting. When I was doing my OW, AOW, and rescue classes a decade ago, it was considered part of the standard response for suspected DCI along with oxygen if available.

 

[joker31]

There is the misconception that Aspirin thins the blood. This is not true. What it does is make it more difficult for platelets to stick together (clot). This is why Aspirin is given during a heart attack. It will not dissolve a clot, but will keep it from getting bigger.
Now giving it during DCI? The circulation issue there is due to gases not blood clots, so giving Aspirin will not help. I guess you will not have to worry about there being blood clots too, but giving large doses of Aspirin has it's own problems. As a Paramedic I would strongly advise against it.

 

[AggieDiver]

I thought the problem with gas bubbles was that blood clotted around the edges of them and caused blockages in addition to the obstruction of the bubble itself, such that even when the bubble is gone, the clot can remain. In that situation, wouldn't reduction in clotting be a good thing?

In any case, I never heard anybody recommend anything other than the recommended dose of regular aspirin. They may have used more in Shadow Divers, but that wasn't ever anything I remember seeing from PADI, DAN or elsewhere.

 

[knotical]

From a 2001 article on DAN.org at:
DAN Divers Alert Network : Fitness Issues for Divers With Musculoskeletal Problems - Part I

…some divers take aspirin to decrease the ability of platelets to clot, preventing the cascade leading to DCS. This effect has prompted some physicians in the past to use aspirin and NSAIDs in the treatment of acute DCS. Today, neither aspirin nor NSAIDs are recommended by most dive physicians in treatment of DCI. A scientific study to determine whether they have any value in treating DCI is under way in Australia.

You'd think by now, 9 years later, the study would have been completed.

Also discussed, without conclusion, in this thread:
http://www.scubaboard.com/forums/diving-medicine/256344-aspirin-diving.html

 

[ptyx]

I guess you will not have to worry about there being blood clots too, but giving large doses of Aspirin has it's own problems. As a Paramedic I would strongly advise against it.

In any case, I never heard anybody recommend anything other than the recommended dose of regular aspirin.

When I started diving, "old" divers tribal knowledge amounted to "pump the victim full of aspirin, max dose, and then some - with a lot of water". Definitely something from the "what doesn't kill you makes you stronger" school of diving...

The official (and more reasonable) recommendation from the agency was that if the victim was conscious, not allergic, and willing, proposing a regular dose (50 or 100mg?) - again with lots of water - couldn't hurt.

The only thing I could find on the DAN site was a note in a 2001 article:

Conversely, before a dive, some divers take aspirin to decrease the ability of platelets to clot, preventing the cascade leading to DCS. This effect has prompted some physicians in the past to use aspirin and NSAIDs in the treatment of acute DCS. Today, neither aspirin nor NSAIDs are recommended by most dive physicians in treatment of DCI. A scientific study to determine whether they have any value in treating DCI is under way in Australia.

Anyone with fresher information?

 

[knotical]

Great minds, eh ptyx?