From the Guidelines
The primary treatment for decompression sickness (the bends) is immediate recompression therapy in a hyperbaric chamber, along with administration of 100% oxygen. This approach is crucial for reducing the severity of symptoms and preventing long-term damage. The use of oxygen in the treatment of decompression sickness is supported by a study published in Circulation in 2010 1, which suggests that normobaric oxygen can aid in the recovery of underwater divers experiencing decompression injury.
Key Components of Treatment
- Immediate recompression therapy in a hyperbaric chamber
- Administration of 100% oxygen
- Transportation to the nearest hyperbaric facility as quickly as possible while receiving high-flow oxygen
- Following the standard treatment protocol, typically U.S. Navy Treatment Table 6
- Adjunctive medications for pain management and inflammation reduction
Adjunctive Care
While awaiting transport, patients should:
- Lie flat to reduce the risk of further injury
- Stay warm to maintain comfort and prevent hypothermia
- Receive intravenous fluids to maintain hydration
- Be monitored closely for any signs of worsening symptoms or complications
Importance of Prompt Treatment
Prompt treatment is essential for decompression sickness, as delays can lead to increased morbidity and mortality. The goal of treatment is not only to alleviate immediate symptoms but also to prevent long-term consequences, such as persistent neurological deficits or joint pain. By prioritizing immediate recompression therapy and oxygen administration, healthcare providers can significantly improve outcomes for patients with decompression sickness.
From the Research
Treatment for Decompression Sickness
The treatment for decompression sickness, also known as the bends, involves several key components:
- Recompression therapy combined with hyperbaric oxygen breathing is the primary treatment 2, 3, 4, 5
- Supportive therapy, including 100% normobaric oxygen breathing, oral or intravenous fluids, and a flat position on the back, is essential before hyperbaric oxygen therapy 2
- Hyperbaric oxygen therapy is typically administered at 2.8 ATA, equivalent to 60 ft of sea water pressure, with intermittent oxygen and air breathing periods during slow decompression to surface 3, 4
- Isotonic, glucose-free fluids are recommended for prevention and treatment of hypovolemia 4
Adjunctive Therapies
Additional treatments may be used for residual manifestations, including:
- Corticosteroids and anticoagulants, although their use is still under discussion 2
- Acetylsalicylic acid, which may be beneficial for patients with cerebral and spinal cord trauma due to decompression accidents 2
- Early intervention with hyperbaric oxygen therapy can greatly influence the patient's outcome, especially in cases of spinal cord decompression sickness 6
Importance of Prompt Treatment
Prompt treatment is crucial, as latency of onset of decompression illnesses is a prognostic indicator 2 Delayed treatment can result in a poor prognosis for recovery, especially in cases of spinal cord decompression sickness 6