management

Last reviewed 04/2021

Treatment of DCI

• treatment of DCI is by recompression in a recompression chambe
  • for less severe cases of DCI
    • the earlier that recompression is started after the onset of symptoms and signs of DCI, the better the result, but successful therapy has commenced as long as several days after the initial symptoms of DCI had presented
  • in the most severe cases, it has been argued that there is no "time to treatment" effect (1)
    • algorithms are published showing the depths, times and treatment gases that are used depending on the presentation and evolution of signs and symptoms of DCI in the diver
    • in addition, fluid should be administered either orally or intravenously depending upon the conscious state of the diver, as in some cases of DCI the diver is found to be very dehydrated
    • use of non-steroidal anti-inflammatory agents is more controversial
    • steroids and lidocaine are not in use for the routine treatment of DCI

Notes:

• surveys of divers have shown that about 50% of cases of DCI will exhibit signs and symptoms within 1 h of surfacing, while 90% will present within 6 h of surfacing
  • in a few cases, the time interval has been of the order of days
  • a diver could be thought to be drunk or under the influence of drugs when he presents to the GP's surgery or police station. If in doubt as to whether the diver is suffering from DCI then advice should be sought from diving medical experts

Reference:

• 1) Edge CJ. Recreational diving medicine.Current Anaesthesia Critical Care 2008; 19 (4): 235-246.