Time to Treatment for DCI

[Foggy]

Just came across this:-

From the North Sea Medical Centre and HSE (RR550)

There is conflicting evidence in the medical literature on whether DCI is more responsive to early rather than late treatment with hyperbaric oxygen (HBO).

This study shows that early treatment with HBO is associated with a better outcome.

Divers are less responsive if treatment is delayed for 350 minutes or more after surfacing. (6 hours)

If normobaric oxygen is administered before HBO, it tends to protect divers against the delay in treatment with HBO.

The study recommends a time to treatment action plan, which specifies what to do when a diver develops suspicious DCI symptoms.



-Nothing new, just confirmation of common sense.

Cheers, Paul

[dublinbay]

Originally Posted by Foggy

Just came across this:-

From the North Sea Medical Centre and HSE (RR550)

There is conflicting evidence in the medical literature on whether DCI is more responsive to early rather than late treatment with hyperbaric oxygen (HBO).

This study shows that early treatment with HBO is associated with a better outcome.

Divers are less responsive if treatment is delayed for 350 minutes or more after surfacing. (6 hours)

If normobaric oxygen is administered before HBO, it tends to protect divers against the delay in treatment with HBO.

The study recommends a time to treatment action plan, which specifies what to do when a diver develops suspicious DCI symptoms.



-Nothing new, just confirmation of common sense.

Cheers, Paul

Yes indeed Paul.............................................. .....................BUT:

Will the ambulance crew bring you directly to the chamber? I was brought to a casualty in a general hospital, presenting semi conscious. Result was ,MRI and CAT scans and 7 hours later sent to the chamber. The ambulance crew put me on Entenox despite protestations . Soooooooooooo if you have DAN, call EMS first, DAN immediately after and give them details, location etc and let DAN run the show.

[sas steve]

Originally Posted by dublinbay

Yes indeed Paul.............................................. .....................BUT:

Will the ambulance crew bring you directly to the chamber? I was brought to a casualty in a general hospital, presenting semi conscious. Result was ,MRI and CAT scans and 7 hours later sent to the chamber. The ambulance crew put me on Entenox despite protestations . Soooooooooooo if you have DAN, call EMS first, DAN immediately after and give them details, location etc and let DAN run the show.

We are pretty lucky here on the South coast, As a chamber Supervisor we also run open days for local ambulance crews to let them see the other end of things and from that we now have a pretty good and efficient EMS service from the Coastguard to the chamber.
The call to send the patient to hospital or chamber is done by a hyperbaric doctor who meets the patient at the helo landing site and evaluates them there. The ambulance is only normally used from that point and they are aware of the Entonox issue.
DAN is only called afterwards if the patient has DAN insurance and needs to claim.maybe we are just fortunate to have this all on our doorstep.

Dorset the best place to get bent.

[TerryH]

Originally Posted by sas steve

Dorset the best place to get bent.

Oooo no.

Much better if it's Hampshire.
Chambers at Haslar and QA + at least 2 more at the RN base and of
course we have the helo base at Lee-on Solent.

Guess where that 24 hour number for the RN doc goes to.

Can't get better than that

[dublinbay]

Excellent. We`re not so clued in over here., Knowledge about DCI and treatment is very thin on the ground, .however, I got bent in Menorca. With the amount of divers travelling abroad for diving hols, most take for granted that dive operators and local EMS know what to do in a DCI emergency. Not so. Liveaboards in the Red Sea, say diving the Brothers, HOW FAR FROM
A. Land
B. Nearest hospital
C. Nearest chamber
D. Nearest helo evac
Friends of mine were there in Oct ,when they had a fatality, not diving related afaik, but word was no radio contact could be made directly with EMS and had to be relayed ship to ship. Top Diving,Puerto Rico ,Gran Canaria have their own chamber with qualified operator. Safest dive centre in sunny climes methinks
.

Originally Posted by sas steve

We are pretty lucky here on the South coast, As a chamber Supervisor we also run open days for local ambulance crews to let them see the other end of things and from that we now have a pretty good and efficient EMS service from the Coastguard to the chamber.
The call to send the patient to hospital or chamber is done by a hyperbaric doctor who meets the patient at the helo landing site and evaluates them there. The ambulance is only normally used from that point and they are aware of the Entonox issue.
DAN is only called afterwards if the patient has DAN insurance and needs to claim.maybe we are just fortunate to have this all on our doorstep.

Dorset the best place to get bent.

[Devon Diver]

Very lucky with my recent bend, a hyperbaric doctor turned up before the ambulance. From Tobermory harbour to pressure in Oban in less than 3½ hours.

Roy

[gerry brain]

I have to agree with Terry on this one, I missed a few stop and was transported to the RN chamber in Hampshire.

Very proffesional service from all concerned from paramedics to the chamber staff.

Fortunately I had not signs or symptoms so it was a precautionary hyperbaric treatment for two and a half hours with a seven day lay off

Gerry

[mad major]

A diver from our club had a similar delay whilst diving in the Moray Firth. Delayed in getting to the chamber. Out come was not so clear he is waiting for follow up tests.

[Tassie Devil]

Originally Posted by Foggy

Just came across this:-

There is conflicting evidence in the medical literature on whether DCI is more responsive to early rather than late treatment with hyperbaric oxygen (HBO).

Cheers, Paul

Always good to remind people of this! Conflicting? I thought this was standard knowledge? Longer you wait, harder it is to treat. You end up treating the damage caused rather than relieving the bend.

Geeze, giving an MRI to a diver suffering a suspected DCI is poor!! Hope all is well

[Kevin Heath]

Originally Posted by TerryH

Oooo no.

Much better if it's Hampshire.
Chambers at Haslar and QA + at least 2 more at the RN base and of
course we have the helo base at Lee-on Solent.

Guess where that 24 hour number for the RN doc goes to.

Can't get better than that

Here in Orkney you will be picked up, taken to the medical center, examined and be in the chamber within a very short time! if needed plus all of the boats have O2 so from first aid to treatment should be about an hour !