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Basic life support in a diving bell and deck decompression chamber
1A specialist in the Hyperbaric Medicine Unit, Department of Anaesthesia and Intensive Care, Royal Adelaide Hospital, Adelaide, South Australia 5001, Australia, Phone: +61-(0)8-8222-5116, Fax: +61-(0)8-8232-4207,
Diving and Hyperbaric Medicine
|June 14, 2012
Summary
Performing basic life support for divers in confined hyperbaric environments like diving bells is challenging. Modified cardiopulmonary resuscitation techniques may be necessary due to space and equipment limitations.
Area of Science:
- Diving Medicine
- Emergency Medical Services
- Hyperbaric Physiology
Background:
- Basic life support (BLS) is significantly complicated within the confined spaces of diving bells (DB) and deck decompression chambers (DDC).
- Limited equipment and extreme spatial constraints hinder standard resuscitation procedures for unconscious divers.
- Victim positioning during resuscitation (pulley suspension vs. semi-supine) critically impacts effectiveness.
Purpose of the Study:
- To evaluate the feasibility and effectiveness of basic life support techniques in diving bells and deck decompression chambers.
- To identify optimal resuscitation strategies for unconscious divers in hyperbaric environments.
- To assess the suitability of advanced airway devices in confined hyperbaric settings.
Main Methods:
- Review of physiological limitations of BLS in supine and suspended positions within confined hyperbaric spaces.
- Analysis of the impact of space constraints on cardiopulmonary resuscitation (CPR) techniques, including compression-only CPR and compression-ventilation CPR.
- Consideration of advanced airway management options and the unstudied use of automated external defibrillators in hyperbaric chambers.
Main Results:
- Standard BLS is likely ineffective for suspended divers due to inadequate cerebral perfusion.
- Compression-only CPR may be the sole option for divers positioned against the chamber wall.
- Compression-ventilation CPR is possible in DDCs if rescuers have access.
- Automated external defibrillators are not recommended due to lack of study in hyperbaric environments.
- The i-gel™ airway device shows potential as a more suitable option than the laryngeal mask airway.
Conclusions:
- Resuscitation of unconscious divers in DBs and DDCs requires modified approaches due to severe space and equipment limitations.
- Modified CPR techniques, such as compression-only CPR, may be necessary depending on patient positioning.
- The i-gel™ presents a promising alternative for airway management in hyperbaric environments, warranting further investigation.
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