Treatment of Decompression Illness.

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Treatment of Decompression Illness.

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Title: Treatment of Decompression Illness.
Author: Moon, RE; Sheffield, PJ
Abstract: PREFACE: This workshop on treatment of decompression illness (DCI) is sponsored by the Aerospace Medical Association, the Undersea and Hyperbaric Medical Society, and the Divers Alert Network, with additional sponsorship provided by the Gulf Coast Chapter of UHMS and the United States Navy. It is one of a series of workshops (1,2) that have been held on the treatment of DCI, but represents the first collaborative effort of these organizations. This 2-day workshop consisted of 27 presentations on pathophysiology, treatment principles, and treatment alternatives. It was attended by 104 participants from 13 countries, with a wide range of experience in the management of DCI. The goals of the workshop were to: review the international medical practice for managing DCI that results from exposure to altitude and hyperbaric conditions provide participants with the clinical rationale for the various treatment methods used for DCI and arrive at a consensus on the management of DCI. The term decompression illness encompasses both decompression sickness (DCS), which is caused by tissue bubble formation due to inert gas supersaturation, and arterial gas embolism (AGE) caused by entry of gas into blood vessels during a rapid decompression due to pulmonary gas trapping and alveolar rupture. Since DCI can occur as a result of decompression across the entire pressure continuum, this workshop includes treatment of DCI occurring from both diving and altitude exposures. This report documents the currently known methods for treating DCI. The treatment methods presented are similar in that each applies pressure, oxygen and adjunctive treatments such as fluids and, frequently, pharmacotherapy. Treatment for DCI experienced in different environments may differ in the treatment pressure, the partial pressure of oxygen, the diluent inert gas, and the time under pressure. A consensus statement, including guidelines for diagnosis and treatment, is presented at the end of this document. The Undersea and Hyperbaric Medical Society is accredited by the American College of Continuing Medical Education to sponsor physician continuing medical education. The UHMS designated this workshop for up to 19 credit hours of Category 1 Continuing Medical Education in the Physician Recognition Award of the American Medical Association. CONTENTS: Preface; Acknowledgments; Participants; SESSION I Clinical findings in decompression illness: a proposed terminology - A. J. Dutka; Histology of decoompression illness - I. M. Hardman; Discussion; SESSION 2 Altitude decompression sickness - A. A. Pilmanis; Treatment of altitude decompression sickness - P. N Kimbrell; Decompression sickness in space: manifestations and treatment - M. R. Powell; Discussion; SESSION 3 Principles of U.S. Navy recompression treatments for decompression sickness - E. D. Thalmann; The treatment of arterial gas embolism - D. F Gorman; Discussion; SESSION 4 Deep treatments and Hawaiian experience - R. K. Overlock, K. A. Tolsma, C. W Turner, and N Bugelli; Use of short versus long tables in the treatment of decompression sickness and air embolism - E. P. Kindwall; Serious decompression injury: pharmacologic aids to treatment - A. J. Dutka; Discussion; SESSION 5 Neurological imaging in patients with decompression illness - M. W Hanson and L. K. Jordan III; The use of psychometric testing in decompression illness - M. D. Curley and T. L. Amerson; Inner ear decompression sickness versus inner ear barotrauma: differential diagnosis and treatment of diving related inner ear dysfunction - J. C. Farmer; Discussion; SESSION 6 The treatment of divers in the North Sea - D. H. Elliott; Treatment of decompression illness (DCI) and arterial gas embolism (AGE): U.S. experience New Orleans practice protocols for DCI and AGE - K. VanMeter; Discussion; SESSION 7 Flow-chart for the treatment of decompression illness Hans Ornhagen; Underwater oxygen treatment of DCS - C. Edmonds; Late treatment of decompression illness and use of SPECT brain imaging - P. G. Harch; Saturation treatment of decompression illness in a hospital based hyperbaric facility - P. Davis, C. A. Piantadosi, and R. E. Moon; Discussion; SESSION 8 Effect of different breathing gasses on bubble resolution in lipid and aqueous tissues. Animal experiments - O. Hyldegaard and J. Madsen; He-02 treatment for severe air diving-induced neurological decompression illness - A. Shupak; Discussion; SESSION 9 Prognostic factors in DCI in recreational divers - R. D. Vann, B. P. Bute, D. M. Uguccioni and L. R. Smith; Association of CNS hemorrhage with failure to respond to recompression treatment - implications for management of refractory cases of decompression illness - J. R. Broome; Principles of resuscitation in CNS injury and future directions - D. S. Warner; Evolution and performances of Comex treatment tables - J. P. Imbert; Discussion; SUMMARY DISCUSSION; CONSENSUS
Description: Copyright Undersea and Hyperbaric Medical Society.
URI: http://archive.rubicon-foundation.org/7999
Date: 1996

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  • UHMS Workshops
    This is a collection of the published workshops held by the Undersea and Hyperbaric Medical Society (UHMS).

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