Treatment of decompression illness in the field - guidelines published

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Dr Simon Mitchell

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Hello,

The guidelines for field management of decompression illness recently published in Diving and Hyperbaric Medicine are now available on the journal's website. The usual one year embargo on newly published papers has been lifted by the excoms of SPUMS and EUBS (thanks!).

The paper is reasonably self explanatory.

Much of it is devoted to the very controversial issue of acceptable practice around the remote triage of decompression illness patients by diving physicians. On the face of it this might not seem relevant to divers themselves. In fact, for technical divers on expeditions in remote locations this is extremely relevant, because it could have a profound influence on whether or not a diver with possible mild DCI has to be evacuated for further assessment or not.

The other topical discussion is on in-water recompression. This is the first time that an expert group of diving physicians convened for the purpose of defining best practice has endorsed in water recompression. The support is qualified, but it is real. This contrasts with ill informed comments that recently appeared about in-water recompression in another thread on this forum. The topic of in-water recompression will be covered in more detail in a paper that will be released in the June edition of DHM, but the present paper outlines the committee's basic thoughts.

Simon M
 
Simon, well done to you and the rest of the team. Thank you for your work.

Best regards,
DDM
 
Ditto, great reading.
 
Morning Simon, thanks for posting this.

I was really pleased to see the recommendation of taking an NSAID as part of treatment. I tend to do this as a normal part of my diving to help manage the inflammatory response to bubbles.

I did have a question about rehydration using "non-glucose containing isotonic crystalloid." What the heck is that? In the past I have seen you recommend Gatorade or the like to restore electrolytes, but I'm guessing they contain glucose.

Appreciate any info.

Thanks,
Mike
 
.... The topic of in-water recompression will be covered in more detail in a paper that will be released in the June edition of DHM,....

I'm very much interested in reading that, can you re-post a thread when it becomes available ?
 
Hello,

The guidelines for field management of decompression illness recently published in Diving and Hyperbaric Medicine are now available on the journal's website. The usual one year embargo on newly published papers has been lifted by the excoms of SPUMS and EUBS (thanks!).

The paper is reasonably self explanatory.

Much of it is devoted to the very controversial issue of acceptable practice around the remote triage of decompression illness patients by diving physicians. On the face of it this might not seem relevant to divers themselves. In fact, for technical divers on expeditions in remote locations this is extremely relevant, because it could have a profound influence on whether or not a diver with possible mild DCI has to be evacuated for further assessment or not.

The other topical discussion is on in-water recompression. This is the first time that an expert group of diving physicians convened for the purpose of defining best practice has endorsed in water recompression. The support is qualified, but it is real. This contrasts with ill informed comments that recently appeared about in-water recompression in another thread on this forum. The topic of in-water recompression will be covered in more detail in a paper that will be released in the June edition of DHM, but the present paper outlines the committee's basic thoughts.

Simon M
Historical reference for comparison:
Management of Mild or Marginal Decompression Illness in Remote Locations 2004
 
https://www.shearwater.com/products/teric/

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