[abstract]CASE STUDY: HBO2 TREATMENT AND RISK ASSESSMENT FOR ALTITUDE-INDUCED DECOMPRESSION SICKNESS

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[abstract]CASE STUDY: HBO2 TREATMENT AND RISK ASSESSMENT FOR ALTITUDE-INDUCED DECOMPRESSION SICKNESS

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Title: [abstract]CASE STUDY: HBO2 TREATMENT AND RISK ASSESSMENT FOR ALTITUDE-INDUCED DECOMPRESSION SICKNESS
Author: Chin W; Le D; Debbold E; Sprau S
Abstract: INTRODUCTION/BACKGROUND: Although modern aircraft are more reliable, technological advancements can result in pressure-related complications. Altitude-induced DCS produces joint pain, complex neurological findings, circulatory collapse and death. It remains under-reported, with 75.5 percent of pilots anonymously reporting experiencing altitude-DCS symptoms. The US Air Force spends $7 million per squadron in training annually, requiring effective risk mitigation and treatment. We present a case where HBO2 therapy successfully treated altitude-induced DCS. We suggest that the pilot had a 5 percent risk for DCS based solely on altitude and exposure; however, additional factors increased his DCS-risk: lack of preoxygenation protocol, 6G flight maneuvering, and night-before alcohol consumption. MATERIALS AND METHODS: After flying for 2+ hours above 42K feet with cockpit pressurized to 18K feet, a 31-year-old male Air Force Safety Director and F-16 pilot presented to the UCLA Hyperbaric Department on January 29, 2013, with symptoms of Type II altitude-DCS: fatigue, left elbow pain and left back arm paresthesia. The pilot reported breathing 100 percent oxygen as a mid-flight precaution, but aforementioned risk factors and self-transportation significantly aggravated DCS symptoms. HBO2 therapy was initiated according to U.S. Navy TT6 (one treatment) and TT5 (two treatments). RESULTS: The patient tolerated the procedure well. Within one to two hours of TX1, the patient reported decreased elbow pain and return of sensation in his left arm. Following TX2, he had pain only with extension of the elbow. After TX3 on February 1, the patient reported significant overall improvement with only residual “tightness.” The patient will return for follow-up in four weeks. SUMMARY/CONCLUSIONS: DCS in fighter pilots is a serious complication of modern aviation. Policies and procedures for risk reduction (preoxygenation, exercise minimization, exposure time minimization, and cockpit pressurization systems) should be reconsidered and expanded for pilot safety. This case study demonstrates HBO2’s efficacy in treating altitude-induced DCS, and emphasizes the necessity for DCS-based medical transport.
Description: Undersea and Hyperbaric Medicine : Journal of the Undersea and Hyperbaric Medical Society, Inc.
URI: http://archive.rubicon-foundation.org/10858
Date: 2013

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  • UHMS Meeting Abstracts
    This is a collection of the published abstracts from the Undersea and Hyperbaric Medical Society (UHMS) annual meetings.

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