Decompression Illness (DCI) is a term used to describe two diseases, Decompression Sickness (DCS) and Arterial Gas Embolism (AGE). DCS is thought to result from inert gas bubbles growing in tissues and causing damage, while AGE results from bubbles travelling through the body's arterial circulation and causing tissue damage by blocking blood flow.
Decompression Illness mainly affects divers although aviators, astronauts and compressed air workers can also suffer from DCI.
Symptoms of DCI can include:
Signs of DCI can include:
The above is not an exhaustive list of signs and symptoms. Severe DCI is easy to spot but in milder cases one of the most common symptoms is denial. A minor joint ache or an abnormal sensation in an extremity is put down to another cause such as overexertion, heavy lifting or a tight fitting wetsuit which often leads to a delay in seeking treatment.
Remember, if you feel unwell or have any symptoms of DCI after a dive that until proven otherwise, you may be suffering from DCI and you should obtain advice from a diving physician.
The only definitive treatment for DCI is recompression therapy in a hyperbaric chamber. Early oxygen first aid is very important in managing a case of DCI and may reduce the symptoms, however this should never change the treatment plan. Even if DCI symptoms resolve after initial oxygen breathing, they may reappear again later. Because of this, always consult a dive physician in cases of suspected DCI even if the symptoms and signs appear to have resolved. In Cyprus contact our 24 hour helpline which provides free advice and information on +357-99-518837.
HBOT for DCI works by re-pressurising the patient so that the inert gas bubbles that are causing the problem are made smaller and they can be re-dissolved back into the body tissues. By breathing Oxygen, a large pressure diffusion gradient is established. As the patient is slowly brought back to surface the inert gases are able to gradually diffuse out of the body.
There are various treatment tables that control the exact combination of depths and time for recompression therapy. The most common table used is the USN TT6 (United States Navy, Treatment Table). This consists of 3 x 20 minute periods of breathing Oxygen at 60 feet with 5 minute air breaks in between, followed by a 30 minute ascent to 30 feet, followed by 2 x 60 minute periods of breathing Oxygen with 2 x 15 minute air breaks in between, finally a 30 minute ascent is carried out to the surface, Oxygen is breathed on all the ascents. This means the therapy will take 4 hours and 45 minutes (excluding the descent time to 60 feet) however the diving physician in charge of the treatment can extend the table at 60 and 30 feet for up to 2 additional Oxygen breathing periods if they feel it will be beneficial for the patient.
If there are still symptoms after the initial treatment then follow up treatments are indicated. These follow up treatments may use the same or different treatment tables depending on circumstances and will continue until there is a full resolution of the symptoms or there is a plateau in treatment where there seems to be no further improvement.
In cases of severe neurological DCI a more aggressive treatment then a USN TT6 may indicated, such as the COMEX 30 treatment table. This table involves initial treatment at 30 metres but due to Oxygen toxicity concerns a mixture of 50% Helium and 50% Oxygen (Heliox) is breathed until 18 metres is reached where 100% Oxygen can then be breathed. HTTC is the only hyperbaric facility in Cyprus able to offer this advanced (and potentially) life saving treatment.
HTTC are the preferred provider in Cyprus for DAN, USAAF, British and NATO forces. We run the only free 24 hour helpline and emergency response system in Cyprus for diving related emergencies. Contact the helpline on +357-99-518837