CHAPTER 21 Recompression Therapy
Change A 21-19
Emergency Management. Emergency situations that require specialized medical
care should always have the best qualified person provide it. The best qualified
person may be a surgeon, repiratory therapist, IDC, etc. Since these are emergency
exposures, no special medical or physical prerequisites exist. A qualified Inside
Tender is required inside the chamber to handle any system related requirements.
Patient Positioning. Inside the chamber, the tender ensures that the patient is
lying down and positioned to permit free blood circulation to all extremities. The
tender closes and secures the inner lock door and pressurization begins at 20 fpm.
Equalizing During Descent. Descent rates may have to be decreased as necessary
to allow the patient to equalize; however, it is vital to attain treatment depth in a
timely manner for a suspected arterial gas embolism patient.
Inside Tender Responsibilities. During the early phases of treatment, the inside
tender must monitor the patient constantly for signs of relief. Drugs that mask
signs of the illness should not be given. Observation of these signs is the principal
method of diagnosing the patients illness. Furthermore, the depth and time of
their relief designates the treatment table to be used. The inside tender is also
Releasing the door latches (dogs) after a seal is made
Communications with outside personnel
Providing first aid as required by the patient
Administering treatment gas to the patient at treatment depth
Providing normal assistance to the patient as required
Ensuring that sound attenuators for ear protection are worn during compres-
sion and ventilation portions of recompression treatments
Oxygen Breathing and Toxicity During Treatments. During
ments on Treatment Tables 4, 7, or 8, pulmonary oxygen toxicity may develop.
Acute CNS oxygen toxicity may develop on any oxygen treatment table. Refer to
paragraph 19-2.4 for further discussion of oxygen toxicity during in-water dives.
Central Nervous System Oxygen Toxicity. When employing the oxygen treat-
ment tables, tenders must be particularly alert for the early warning signs of CNS
oxygen toxicity. The warning signs can be remembered readily by using the
mnemonic VENTIDC (Vision, Ears, Nausea, Twitching\Tingling, Irritability,
Dizziness, Convulsions). For additional information, refer to paragraph 19-2.4.2.
21-18.104.22.168.1 Procedures in the Event of Oxygen Toxicity. At the first sign of CNS oxygen
toxicity, the patient should be removed from oxygen and allowed to breathe
chamber air. Fifteen minutes after all symptoms have subsided, resume oxygen
breathing at the point of interruption. If symptoms of CNS oxygen toxicity
develop again or if the first symptom is a convulsion, take the follow action: