CHAPTER 21 — Recompression Therapy
Change A 21-5
Do not ignore seemingly minor symptoms. They can quickly become major
symptoms.
Follow the selected treatment table unless changes are recommended by a
Diving Medical Officer.
If multiple symptoms occur, treat for the most serious condition.
21-1.9
In-Water or Air Recompression. Recompression in a facility equipped for oxygen
breathing is preferred. However, the procedures covered here also address situa-
tions where either no chamber is available or where only air is available at the
recompression facility. In-water or air recompression treatments are used only
when the delay in transporting the patient to a recompression facility having
oxygen would cause greater harm.
21-2
PRESCRIBING AND MODIFYING TREATMENTS
Not all Medical Officers are DMOs. The DMO shall be a graduate of the Diving
Medical Officer course taught at the Naval Diving and Salvage Training Center
(NDSTC). DMOs shall have subspecialty codes of 16U0 or 16U1 (Undersea
Medical Officer). Saturation Diving Medical Officers have an Additional Qualifi-
cation Designator (AQD) of 6UD and Submarine Medical Officers an AQD of
6UM. Medical Officers who only complete the short diving medicine course at
NDSTC do not receive DMO subspecialty codes, but are considered to have the
same privileges as DMOs when treating diving accidents, with the exception that
they are not granted the privilege of modifying treatment protocols. Only DMOs
with appropriate subspeciality codes cited above may modify the treatment proto-
cols as warranted by the patient’s condition with the concurrence of the
Commanding Officer or Officer in Charge. Other physicians may assist and advise
treatment and care of diving casualties but may not modify recompression
procedures.
21-3
OMITTED DECOMPRESSION
Certain emergencies, such as uncontrolled ascents, an exhausted air supply, or
bodily injury, may interrupt or prevent required decompression. If the diver shows
symptoms of decompression sickness or arterial gas embolism, immediate treat-
ment using the appropriate oxygen or air recompression treatment table is
essential. Even if the diver shows no symptoms, omitted decompression must be
addressed in some manner to avert later difficulty. Table 21-3 summarizes
management of asymptomatic Omitted Decompression.
21-3.1
Planned and Unplanned Omitted Decompression. Omitted decompression may
or may not be planned. Planned omitted decompression results when a condition
develops at depth that will require the diver to surface before completing all of the
decompression stops and when there is time to consider all available options,
ready the recompression chamber, and alert all personnel as to the planned evolu-
tion. Equipment malfunctions, diver injury, or sudden severe storms are examples
of these situations. In unplanned omitted decompression, the diver suddenly
appears at the surface without warning or misses decompression for some unfore-
