The transportable recompression rescue chamber as an alternative to delayed treatment in serious diving accidents

This report summarizes experience in the use of a Transportable Recompression Rescue Chamber (TRRC) for one man in the rapid initiation of treatment and evacuation in severe scuba diving accidents. An evacuation system is described which incorporates the centralized management of all diving accidents and standardized TRRCs capable of interlocking under pressure with the stationary medical chamber. Oxygen breathing capability in the TRRC allows the use of up-to-date U.S. Navy oxygen treatment tables. Included are 19 cases of Type II decompression sickness and pulmonary barotrauma with neurological manifestations, most of which occurred at remote diving sites with no nearby walk-in chambers. Case analysis includes distance and means of evacuation, delay in initiating therapy, time spent in TRRC, and initial and final outcome. Together, TRRCs and airborne evacuation to a stationary medical chamber insures a minimal delay between the onset of symptoms and the start of recompression therapy. The use of the TRRC is a prime factor in minimizing delay. No complications associated with the use of TRRCs have been encountered. Ideally, evacuation should be made in a pressurized two-compartment (for a victim and an attendant) chamber. However, if this is not available we strongly advocate the use of one-man pressurized TRRCs over unpressurized evacuation.