Decompression Illness Treated with the Hart-Kindwall Protocol in a Monoplace Chamber

Area of Science:

• Aerospace Medicine
• Hyperbaric Medicine
• Emergency Medicine

Background:

• Standard treatment for severe altitude decompression illness (DCI) involves hyperbaric oxygen (HBO₂) therapy in multiplace chambers.
• Monoplace chambers may be the only available option in some healthcare settings, posing a challenge for DCI management.
• Rapid decompression during flight operations can lead to severe DCI, necessitating timely and effective treatment.

Observation:

• A 34-year-old male aviator experienced severe DCI symptoms, including chest pain and cognitive impairment, after rapid decompression at 33,000 feet.
• Access to a multiplace hyperbaric chamber was delayed due to geographical distance (3-hour drive).
• Emergency treatment was initiated using the Hart-Kindwall protocol in a monoplace chamber 4 hours post-decompression.

Findings:

• The patient received emergency hyperbaric oxygen (HBO₂) therapy with the Hart-Kindwall protocol in a monoplace chamber.
• Full recovery was achieved, and the aviator returned to flight duty within two weeks.
• The monoplace chamber treatment successfully managed severe altitude DCI in this case.

Implications:

• Emergency hyperbaric oxygen (HBO₂) therapy using the Hart-Kindwall protocol in monoplace chambers can be an effective treatment for severe DCI.
• This strategy is particularly valuable for remote locations lacking immediate access to multiplace chambers.
• Establishing logistical plans for transferring patients to multiplace facilities for persistent symptoms is crucial.