Acute decompression sickness: 50 cases

In a review of the most recent 50 consecutive cases of acute decompression sickness in US Navy divers undergoing training at the Naval School, Diving and Salvage, in no instance was recompression following the initial treatment necessary, nor was there any permanent morbidity post-treatment. Factors common to this series are 1) strict physical screening and conditioning; 2) physician and diver awareness of the signs and symptoms of decompression sickness; 3) short surface interval between symptom onset and recompression; 4) aggressive diagnostic and therapeutic use of hyperbaric oxygenation, and 5) judicious use of adjunctive measures such as intravenous fluid and dexamethasone (Decadron). In the ideal management, the physician sees the patient shortly after symptom appears. As soon as central nervous system involvement appears, 100% oxygen by mask is administered and the patient is recompressed supine to 60 feet of sea water.