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In-water recompression
David J Doolette1, Simon J Mitchell2
1Department of Anaesthesiology, University of Auckland, Auckland, New Zealand.
Diving and Hyperbaric Medicine
|June 12, 2018
Summary
In-water recompression (IWR) may be a viable emergency treatment for severe decompression illness (DCI) when recompression chambers are unavailable. However, risks like drowning from oxygen convulsions must be carefully managed.
Area of Science:
- Diving Medicine
- Hyperbaric Physiology
- Emergency Medical Services
Background:
- Decompression illness (DCI) treatment is often delayed in remote diving locations.
- In-water recompression (IWR) offers theoretical benefits due to rapid initiation of treatment.
- Current data on IWR efficacy compared to standard care are limited.
Purpose of the Study:
- To evaluate the potential benefits and risks of in-water recompression (IWR) for divers with decompression illness (DCI).
- To compare IWR protocols with conventional first aid and surface oxygen treatment.
- To assess the safety and effectiveness of IWR in remote diving scenarios.
Main Methods:
- Review of theoretical benefits of rapid recompression initiation.
- Analysis of retrospective data on delayed recompression outcomes.
- Examination of existing IWR oxygen-breathing protocols and historical treatment table data.
Main Results:
- IWR allows for very short delays to recompression, potentially improving outcomes.
- Military and experimental diving data show high resolution rates with timely recompression.
- IWR protocols use shallower depths and shorter durations than standard tables due to convulsion risks.
Conclusions:
- Recompression at pressures and durations similar to IWR protocols can be effective.
- IWR is not recommended for mild symptoms or severely compromised divers.
- IWR may be justified for life or limb-threatening DCI when timely chamber recompression is unavailable, if conducted by trained personnel.
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