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Diving Injury (Decompression Sickness or Bends)

Date Last Search Run: Oct 01, 2021
Table last updated: Dec 12, 2017
Data last added: Apr 01, 2015

Recommendation RECOMMENDATION FOR INTERVENTION
STRENGTH OF EVIDENCE FOR INTERVENTION   SUPPORTIVE (Green) NEUTRAL (Yellow) AGAINST (Red) NOT YET GRADED (White)
1 (strong evidence exists)    
2 (fair evidence exists)      
3 (weak evidence exists)    


Interventions

Decompress Tension Pneumothorax
Level Direction Primary Outcome Patient/Process Setting Reference

Direct Transport To Hyperbaric Facility
Level Direction Primary Outcome Patient/Process Setting Reference
I Neutral (Yellow) Effectiveness Patient In-Patient Bennett MH., Lehm JP., Mitchell SJ., Wasiak J. Recompression and adjunctive therapy for decompression illness: A systematic review of randomized controlled trials. Anesth Analg 2010; 111(3):757-62. Medline
III Supportive (Green) Efficacy Patient ED-MD Sato T., Iga T., Nagashima K., Matsubara S. Is centralization in emergency rural medicine always right? Lessons learned from two cases of decompression sickness. Rural Remote Health 2011; 11(2):1711. Medline
III Neutral (Yellow) Resolution of symptoms Process In-Patient Myers RA., Bray P. Delayed treatment of serious decompression sickness. Ann Emerg Med 1985; 14(3):254-7. Medline

IV access
Level Direction Primary Outcome Patient/Process Setting Reference

NSAIDs
Level Direction Primary Outcome Patient/Process Setting Reference
I Neutral (Yellow) Effectiveness Patient In-Patient Bennett MH., Lehm JP., Mitchell SJ., Wasiak J. Recompression and adjunctive therapy for decompression illness: A systematic review of randomized controlled trials. Anesth Analg 2010; 111(3):757-62. Medline

Oxygen
Level Direction Primary Outcome Patient/Process Setting Reference
III Supportive (Green) Symptom resolution Patient In-Patient Krzyzak J. A case of delayed-onset pulmonary barotrauma in a scuba diver. Undersea Biomed Res 1987; 14(6):553-61. Medline
III Neutral (Yellow) Adverse event Patient ED-MD Gallagher TJ. Scuba diving accidents: Decompression sickness, air embolism. J Flordia MA 1997; 84:446-51. Medline
III Neutral (Yellow) Patient condition Patient PH-Paramedic Lim EB., How J. A review of cases of pulmonary barotrauma from diving. Singapore Med J 1993; 34(1):16-19. Medline
III Neutral (Yellow) Patient condition Patient ED-MD Perez J., Teatino R. Pneumomediastinum in a snorkelling diver. BMJ Case Rep 2012. Medline
III Neutral (Yellow) Resolution of symptoms Patient ED-MD Tasios K., Sidiras GG., Kalentzos V., Pyrpasopoulou A. Cutaneous decompression sickness. Diving Hyperb Med 2014; 44(1):45-47. Medline

Trendelenburg on Lt side
Level Direction Primary Outcome Patient/Process Setting Reference


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