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1.
Confirm the diagnosis, and re-evaluate the severity of
the injured diver’s clinical condition.
2.
Transfer the seriously injured diver to the nearest
available hospital that can provide qualified
evaluation and proper emergency care despite the
fact that a hyperbaric chamber with an experienced
hyperbaric physician may be closer.
3.
In the hospital, a physician will apply necessary
emergency procedures to ensure the patient’s
survival. DAN emergency medical services should be
contacted (+1-919-684-9111), and the best procedure
regarding hyperbaric treatment should be decided. In
some cases it may include a medical air evacuation
to the most appropriate hospital when the patient’s
status permits it.
Van Hoesen:
Divers with DCS symptoms should breathe
surface oxygen if available. If the diver is conscious, awake
and alert, he should drink fluids and stay well hydrated.
If pain is the only symptom, taking a nonsteroidal anti-
inflammatory medication such as ibuprofen or naproxen can
be considered. The diver should avoid alcohol intake. Do not
initiate in-water recompression.
AD
NOTE: Regardless of the opinions expressed herein, each
case of DCS should be discussed on an individual basis with
DAN medical staff to ensure proper diagnosis, treatment and
evacuation, if indicated. Additionally, these opinions are for
recreational divers and do not apply to technical, mixed-gas,
commercial or saturation divers.
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Jordi Desola, M.D., Ph.D.,
is the head of the Hyperbaric
Therapy Unit of the Red Cross Hospital of Barcelona (Catalonia, Spain).
His specialties are internal medicine, occupational medicine and
sports medicine. He is professor of diving and hyperbaric medicine at
the University of Barcelona, cofounder of DAN Europe and a perma-
nent member of the executive committee of the European Committee
for Hyperbaric Medicine (ECHM). He was chairman and president of
the 15th International Congress on Hyperbaric Medicine (ICHM) in
2005. He is also a diving instructor and a pilot.
Karen Van Hoesen, M.D.,
is the director of the University
of California San Diego (UCSD) Diving Medicine Center and Undersea
and Hyperbaric Medicine Fellowship. She is a clinical professor of emer-
gency medicine in the UCSD Health System and has authored numerous
papers and book chapters on diving and hyperbaric medicine. She is an
active diver and one of DAN’s on-call consulting physicians.
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