Valerie Huali Tan1, Kenneth Chin2, Aravin Kumar3, Jeremiah Chng4, Chai Rick Soh Rick Soh5. 1. Hyperbaric and Diving Medicine Centre, 16 College Road, Block 4, Level 1, Singapore General Hospital, Singapore 169854, rick.soh.chai@sgh.com.sg. 2. Diagnostic Radiology, Singapore General Hospital, Singapore. 3. Yong Loo Lin School of Medicine, National University of Singapore, Singapore. 4. Hyperbaric Medicine Section, Navy Medical Service, Republic of Singapore Navy, Singapore. 5. Surgical Intensive Care Unit, Hyperbaric and Diving Medicine Centre, Singapore General Hospital.
Abstract
INTRODUCTION: Owing to the scarcity of randomized controlled trials to guide treatment for decompression illness (DCI), there are many unanswered questions about its management. Apart from reviews and expert opinion, surveys that report practice patterns provide information about useful management strategies. Hence, this study aimed to identify current treatment preferences for DCI amongst diving physicians in Singapore. METHODS: An anonymous web-based questionnaire was sent to known diving physicians in Singapore. The demographics of the respondents were captured. Respondents were asked about their preferred management for five different DCI scenarios. RESULTS: The response rate was 74% (17 of 23 responses). All respondents chose to recompress patients described in the five scenarios. Regarding the number of recompression sessions, "one additional session after no further improvement in signs and symptoms" was the most common end point of treatment across all the scenarios (47 of 85 responses). Analgesics would be used by five physicians, three would use lidocaine and two steroids as adjuvant therapies. CONCLUSIONS: Apart from the general agreement that recompression is indicated for DCI, there was no strong consensus regarding other aspects of management. This survey reinforces the need for robust RCTs to validate the existing recommendations for DCI treatment.
INTRODUCTION: Owing to the scarcity of randomized controlled trials to guide treatment for decompression illness (DCI), there are many unanswered questions about its management. Apart from reviews and expert opinion, surveys that report practice patterns provide information about useful management strategies. Hence, this study aimed to identify current treatment preferences for DCI amongst diving physicians in Singapore. METHODS: An anonymous web-based questionnaire was sent to known diving physicians in Singapore. The demographics of the respondents were captured. Respondents were asked about their preferred management for five different DCI scenarios. RESULTS: The response rate was 74% (17 of 23 responses). All respondents chose to recompress patients described in the five scenarios. Regarding the number of recompression sessions, "one additional session after no further improvement in signs and symptoms" was the most common end point of treatment across all the scenarios (47 of 85 responses). Analgesics would be used by five physicians, three would use lidocaine and two steroids as adjuvant therapies. CONCLUSIONS: Apart from the general agreement that recompression is indicated for DCI, there was no strong consensus regarding other aspects of management. This survey reinforces the need for robust RCTs to validate the existing recommendations for DCI treatment.
Authors: Mohammad Hassan Murad; Osama Altayar; Michael Bennett; Justin C Wei; Paul L Claus; Noor Asi; Larry J Prokop; Victor M Montori; Gordon H Guyatt Journal: J Clin Epidemiol Date: 2013-11-01 Impact factor: 6.437