Decompression tables for inside chamber attendants working at altitude.

Area of Science:

• Hyperbaric Medicine
• Altitude Physiology
• Occupational Health

Background:

• Inside attendants (IAs) in hyperbaric oxygen (HBO2) chambers face decompression sickness (DCS) risks.
• Standard decompression protocols are designed for sea-level use, not high-altitude environments.

Purpose of the Study:

• To evaluate the incidence of DCS in IAs working in high-altitude HBO2 facilities.
• To assess the effectiveness of altitude-corrected decompression strategies and supplemental oxygen for IAs.

Main Methods:

• Retrospective analysis of IA exposures and DCS cases at two high-altitude medical centers (Denver, CO and Murray, UT).
• Review of decompression protocols, including U.S. Navy Standard Air Tables, Bühlmann Tables, Nobendem© calculator, and supplemental oxygen use.
• Analysis of chamber pressures and treatment depths for routine wound care and poisoning cases.

Main Results:

• Over 26,900 IA exposures at Presbyterian/St. Luke's and 1,847 at Intermountain Medical Center between 1990-2013.
• A low incidence of DCS was observed: four cases at Presbyterian/St. Luke's and one at Intermountain.
• DCS incidents occurred early in the operational history of the chambers at both facilities.

Conclusions:

• The risk of DCS for IAs in high-altitude HBO2 chambers is low when supplemental oxygen is administered.
• Current decompression management strategies, including altitude correction and oxygen breathing, appear effective in mitigating DCS risk for IAs.