Definitive Treatment of Neurological Decompression Sickness in a Resource Limited Location

BACKGROUND: While Fairbanks, AK, USA, is a remote location with significant constraints on medical resources and specialty care, a small U.S. Air Force clinic was able to provide a pilot with definitive care for neurological decompression sickness.CASE REPORT: A 31-yr-old female patient presented to her flight surgeon in Anchorage, AK, USA, with migrating polyarthropathy and headaches 48 h after a flight which included planned aircraft decompression for high altitude low opening (HALO) jump operations. In order to get definitive treatment in a hyperbaric chamber, the patient typically would have to be flown to Seattle, WA, USA. This transfer of care would cost the Air Force approximately 150,000 and may have led to more complicated disease. Fortunately, Eielson Air Force Base (AFB) in Fairbanks had previously procured a Hyperlite hyperbaric chamber specifically for this situation. After consultation with a hyperbaric specialist, the team decided that the most appropriate course of action was to transfer her by car 6 h north from Anchorage to Fairbanks. On initiation of the Hart treatment table, she experienced immediate reduction in joint pain with a reversal of neurological symptoms.DISCUSSION: This patients care could not have been done without the procurement of a hyperbaric chamber. This case demonstrates the utility and necessity for these capabilities at more facilities that manage significant flying operations. Military bases should ensure that hyperbaric treatment capabilities are available within a close proximity.Petruso MJ, Philbrick SM.