Recommended Evacuation Routes for DCS or AGE at Altitude?

[ArcticDiver]

Back again from the real world chore of snow shoveling. Amazing how reality crashes into the neat cyber world

My comments were really based on the idea that although the scenario was set up as having DCS diagnosis confirmed; in reality that would not be the case. So even though there is no argument that recompression is the treatment of choice for DCS, there are a couple steps in the process before getting to that treatment.

So following the standard EMS protocols for your area give you the best chance of providing the excellent care the patient deserves. At the same time it sets in motion the process of getting a good diagnosis and getting the chamber ready if DCS is the diagnosis. If the complaint turns out to be something else, I submit the most likely event, then the patient is already in a place for treatment.

Let me rephrase your senario: My Standing Orders don't cover what to do with a patient who has possible DCS. What should I do to convince my Medical Director and Supervisory Staff to get some criteria and protocols in them?

 

[TheAvatar]

It seems worth noting again that the local clinic "emergency room" is staffed by mostly family practice docs, many who are "loaner docs" who never see DCS cases (I've never heard of a case in either location).

The nearest chamber 1.5hr by ground is a 24/7 chamber that is IN a large hospital with a full ED.

To clarify, since there seems to be confusion (since I wasn't very clear) The purpose of this discussion was, because of the lack of protocols, speculate likely tx decisions of the local clinic doctor of the day that would be after the possible DCS Pt was delivered to the "ED".

From most people are suggesting here, under circumstances where EMS or Water Rescue EMTs have a pt that is exhibiting DCS signs and symptoms with a hx that support DCS, it seems prudent to request the Physician Advisor authorize direct transport to the large hospital /w chamber's ED depending on the situation (and if approved the PA would call ahead to give the hospital 1.5 hours warning) rather than transporting to the local clinic only to retransport to the real hospital as was suggested in my original post (since the local clinic will request a transport if DCS is confirmed or not able to rule out or for just about anything else!)