orally or via IV. If you are experiencing
nausea or vomiting, you may also be
given medication for that.
If you have a pneumothorax the
doctor may need to place a tube
through your chest wall to release
air and allow your lung to reexpand.
A pneumothorax can become life-
threatening if it is not appropriately
managed prior to treatment in a
hyperbaric chamber.
Will I Need a Chamber?
Hyperbaric oxygen therapy involves the
administration of 100 percent oxygen
during compression in a hyperbaric
chamber. Both forms of DCI warrant
chamber therapy, but other diving-
related medical conditions do not.
Physicians in the ER who manage
patients with diving-related illnesses
are encouraged to call DAN for
consultation and information about
nearby dive-medicine specialists and
hyperbaric chambers. As a patient, it
is important to be your own advocate;
ask your doctor to call DAN for
consultation about your diagnosis and
treatment.
If hyperbaric treatment is indicated,
you may need to be transported to
a chamber at a different location.
This may involve transport in an air
ambulance (helicopter or fixed-wing).
Helicopter crews are typically instructed
to minimize altitude exposure by
flying as low as safely possible when
transporting dive-accident patients.
Most fixed-wing air ambulances are
pressurized to very low altitudes or even
sea level.
The Chamber
Once you arrive at a facility with a
hyperbaric chamber you may experience
déjà vu as it is likely you will pass
through another emergency department
where you will be registered, have your
vital signs rechecked and be reexamined
by a doctor.
You will meet the hyperbaric
physician and staff who will take you to
the chamber to begin your treatment.
The most common hyperbaric
treatment protocol used for DCS and
AGE is the U.S. Navy Treatment Table
6.
The initial descent will take you and
the inside attendant (if the chamber
can accommodate one) to 60 feet, the
maximum depth of a Table 6. The total
time of the treatment is at least four
hours and 45 minutes. Dive physicians
sometimes use other treatments, but
they’re all long enough that a trip to
the bathroom is highly recommended
before you enter the chamber.
What Happens Next?
Depending on the severity of your
symptoms and your response to
treatment, you will either be admitted
to the hospital or allowed to go
home after you exit the chamber. If
your symptoms were severe or your
response incomplete, it is likely you will
need additional “tailing,” or subsequent,
hyperbaric treatments during the
following days.
Once you are discharged, you should
talk to your primary-care physician
about what happened. Your recovery
may take days, weeks, months or, in
some rare cases, years. DAN is available
as a resource for you during your
recovery and can provide advice about
safely returning to diving.
Once your recovery is complete, a
doctor trained in dive medicine should
evaluate you to make sure it is safe for
you to return to diving. The doctor
may recommend modifications in your
diving procedures and habits.
Diving is a rewarding sport with
beautiful and thrilling sites to see. The
ability to explore the underwater world
is a privilege that comes with significant
responsibility. Divers must practice and
sharpen their skills, demand excellence
in education and training programs and
adhere to the highest standards of diver
etiquette. Education and preparation
reduce the risk of dive accidents, but
accidents can and do happen. Knowing
how to handle a dive emergency and
what to anticipate should one occur
helps alleviate anxiety and empowers
you to be an active participant in the
process.
AD
www.alertdiver.com
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From left: A heel-to-shin test assesses
coordination, which may be impaired in people
with DCI. Hyperbaric technicians or nurses
operate chambers from consoles just outside.
Once a doctor has diagnosed DCI, the next stop
is usually the chamber.