Laura J Tuominen1,2,3, Sofia Sokolowski4, Richard V Lundell1,5, Anne K Räisänen-Sokolowski1,5,6,7. 1. Helsinki University, Helsinki, Finland. 2. Department of Anaesthesia, Tampere University Hospital, Tampere, Finland. 3. Corresponding author: Dr Laura Tuominen, Helsinki University, Yliopistonkatu 4, 00100 Helsinki, Finland, tuominenl@gmail.com. 4. University of Eastern Finland, Kuopio, Finland. 5. Diving Medical Centre, Centre for Military Medicine, Finnish Defence Forces, Helsinki, Finland. 6. Department of Pathology, HUSLAB, Helsinki University Hospital, and Helsinki University, Helsinki, Finland. 7. DAN Europe Foundation, Finnish Division, Roseto, Italy.
Abstract
INTRODUCTION: Technical diving is increasing in popularity in Finland, and therefore the number of decompression illness (DCI) cases is also increasing among technical divers. Although hyperbaric oxygen treatment (HBOT) remains the standard of care, there are anecdotal reports of technical divers treating mild DCI symptoms themselves and not seeking a medical evaluation and possible recompression therapy. This study aimed to make an epidemiologic inventory of technical diving-related DCI symptoms, to establish the incidence of self-treatment and to determine the apparent effectiveness of different treatment methods. METHODS: A one-year prospective survey with online questionnaires was conducted. Fifty-five experienced and highly trained Finnish technical divers answered the survey and reported their diving activity, DCI symptoms, symptom treatment, and treatment outcome. RESULTS: Of the reported 2,983 dives, 27 resulted in symptoms of DCI, which yielded an incidence of 91 per 10,000 dives in this study. All of the reported DCI symptoms were mild, and only one diver received HBOT. The most common self-treatments were oral hydration and rest. First aid oxygen (FAO2) was used in 21% of cases. Eventually, none of the divers had residual symptoms. CONCLUSIONS: The incidence of self-treated DCI cases was 27 times higher than that of HBO-treated DCI cases. There is a need to improve divers' awareness of the importance of FAO2 and other recommended first aid procedures and to encourage divers to seek medical attention in case of suspected DCI. Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms.
INTRODUCTION: Technical diving is increasing in popularity in Finland, and therefore the number of decompression illness (DCI) cases is also increasing among technical divers. Although hyperbaric oxygen treatment (HBOT) remains the standard of care, there are anecdotal reports of technical divers treating mild DCI symptoms themselves and not seeking a medical evaluation and possible recompression therapy. This study aimed to make an epidemiologic inventory of technical diving-related DCI symptoms, to establish the incidence of self-treatment and to determine the apparent effectiveness of different treatment methods. METHODS: A one-year prospective survey with online questionnaires was conducted. Fifty-five experienced and highly trained Finnish technical divers answered the survey and reported their diving activity, DCI symptoms, symptom treatment, and treatment outcome. RESULTS: Of the reported 2,983 dives, 27 resulted in symptoms of DCI, which yielded an incidence of 91 per 10,000 dives in this study. All of the reported DCI symptoms were mild, and only one diver received HBOT. The most common self-treatments were oral hydration and rest. First aid oxygen (FAO2) was used in 21% of cases. Eventually, none of the divers had residual symptoms. CONCLUSIONS: The incidence of self-treated DCI cases was 27 times higher than that of HBO-treated DCI cases. There is a need to improve divers' awareness of the importance of FAO2 and other recommended first aid procedures and to encourage divers to seek medical attention in case of suspected DCI. Copyright: This article is the copyright of the authors who grant Diving and Hyperbaric Medicine a non-exclusive licence to publish the article in electronic and other forms.
Entities:
Keywords:
Cold; Decompression sickness; Epidemiology; First aid oxygen; Hyperbaric oxygen treatment; Technical diving; Trimix
Authors: Richard V Lundell; Olli Arola; Jari Suvilehto; Juha Kuokkanen; Mika Valtonen; Anne K Räisänen-Sokolowski Journal: Diving Hyperb Med Date: 2019-12-20 Impact factor: 0.887