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Diving Injury (Decompression Sickness or Bends)

Date Last Search Run: Jan 14, 2025
Table last updated: Aug 01, 2022
Data last added: Jul 16, 2022

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
II Neutral (Yellow) Neurological sequelae Patient Other Andre S, Lehot H, Morin J, Louge P, de Maistre S, Roffi R, Druelle A, Gempp E, Vallée N, Vergne M, Blatteau JE. Influence of prehospital management on the outcome of spinal cord decompression sickness in scuba divers. Emerg Med J 2022. 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

POCUS
Level Direction Primary Outcome Patient/Process Setting Reference
X Not Yet Graded (White) - Martinet C, Cungi PJ, Morin J. Usefulness of an Ultrasound-guided Prehospital Care for SCUBA Diving Accidents. Mil Med Aug 2024; 189(9-10):e2264-67. Medline

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


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