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USN Treatment Table 9.

Dick Clarke1

  • 1Columbia, South Carolina, dick.clarke@palmettohealth.org.

Diving and Hyperbaric Medicine
|March 31, 2017
PubMed
Summary
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United States Navy Treatment Table 9 (USN TT9) offers safety and operational advantages over USN TT5 for incomplete decompression sickness. USN TT9 reduces risks of CNS oxygen toxicity and iatrogenic DCS for divers and attendants.

Area of Science:

  • Hyperbaric medicine and diving physiology.
  • Decompression sickness (DCS) and arterial gas embolism (AGE) treatment protocols.

Background:

  • The United States Navy (USN) Treatment Table 9 (TT9) was introduced in 1999 for managing incomplete resolution of DCS and AGE after initial USN TT6 treatment.
  • USN TT5 is commonly used for follow-up therapy, particularly for Type 1 DCS, but USN TT9 presents significant safety and operational benefits.

Discussion:

  • USN TT9 operates at a maximum pressure of 243 kPa, reducing the risk of central nervous system (CNS) oxygen toxicity compared to USN TT5's 284 kPa.
  • USN TT9 lowers the risk of iatrogenic DCS for chamber attendants, as extended air-breathing periods on USN TT5 can lead to significant DCS exposure.
  • The operational profile of USN TT9 aligns with standard multiplace chamber hyperbaric oxygen treatments, facilitating integration into clinical practice.

Key Insights:

Keywords:
Decompression illnessDecompression sicknessLetters (to the Editor)Recompression

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  • USN TT9 provides a safer alternative to USN TT5 for follow-up DCS treatment, mitigating risks of oxygen toxicity and iatrogenic DCS.
  • Despite its advantages, USN TT9 is underutilized in clinical practice for managing incomplete DCS relief.
  • USN TT9 is considered a standard of care for specific DCS management scenarios based on USN treatment procedures.

Outlook:

  • Increased awareness and adoption of USN TT9 are recommended to improve patient and attendant safety in hyperbaric treatment protocols.
  • Further research may explore expanded applications of USN TT9 for non-diving related toxicities.