First Aid for Decompression Illness
Initial treatment for decompression illness (DCI) or arterial gas embolism (AGE) is the same for either condition. Remember:
Airways – Breathing – Circulation (Defibrillation)
- Give 100% oxygen (by means of a tight fitting mask).
An example of a DAN O2 kit for divers
- Lay the casualty down and keep them horizontal. This prevents conditions worsening with bubbles travelling to the brain. If the diver loses consciousness put the diver into the recovery position.
- Give fluids orally (aim for 1 litre an hour and no alcohol or caffeine). Only give if the casualty is able to take them unaided and ideally the fluid should be isotonic.
- Keep the patient comfortable.
- Protect against Hypothermia. Cover with blankets or thermal shields.
- Consider the buddy, are there two or more casualties?
- No in-water recompression.
- The only effective treatment is recompression, seek medical help immediately.
- Never give Entonox to suspected DCI / AE cases.
Call 07 999 292 999 immediately if you suspect DCI
Contact London Hyperbaric Medicine for Divers Alert Network Training courses in O2 administration and AED use. Click here for more information.
How is Decompression Illness treated in a chamber?
Divers suffering decompression illness (DCI) are treated using recompression. This simply means that they are placed into a chamber and it is pressurised with air to a preset pressure equivalent to a sea depth of either 30m or 18m. The diver then breathes pure oxygen by a mask or sealed hood tent (much like a clear plastic helmet) for set periods of time separated by ‘airbreaks’ of between 5 and 15 minutes. These treatments are known as treatment tables (as they follow set medical diving tables). These tables are usually between about 5 and 2 hours, however they may be longer dependent on the severity of the DCI. In severe cases of DCI the diver may breathe a mixture of oxygen and helium (known as heliox) or Oxygen and Nitrogen (known as Nitrox).
All treatment tables are prescribed by a doctor after a thorough assessment of the diver’s condition. This assessment will usually include taking a detailed history of the diver and the dives made which may include looking at data from dive computers and log books. There will also be a neurological assessment where the doctor will ask the diver to perform a series of simple tests such as balance and coordination tests and tests to check strength and sensation. The tests will include very routine checks of heart rate breathing rate and possibly an in-depth Electro cardio gram (ECG) or xray. There is still no specific test that can diagnose DCI such as a blood test or a Doppler test (a blood test may be carried out to check for other potential problems).
What are the treatment tables?
The treatment tables have been designed by diving doctors and organisations after extensive testing and research over many years. The most common tables are designed by the US Navy and the US Air force, the Royal Navy and private organisations such as COMEX. See the examples below:
