21-20 Change A
U.S. Navy Diving Manual—Volume 5
For Treatment Tables 5, 6, and 6A:
1.
Remove the mask
2.
After all symptoms have completely subsided, decompress 10 feet at a rate of
1 fsw/min. For a convulsion, begin travel when the patient is fully relaxed and
breathing normally.
3.
Resume oxygen breathing at the shallower depth at the point of interruption.
4.
If another oxygen symptom occurs, contact a Diving Medical Officer to mod-
ify oxygen breathing schedule to meet requirements.
For Treatment Tables 4, 7, and 8:
1.
Remove the mask.
2.
Consult with a Diving Medical Officer for administering further oxygen
breathing. No compensatory lengthening of the table is required for interrup-
tion in oxygen breathing
21-5.5.6.1.2 Interruptions Due to Oxygen Toxicity. CNS oxygen toxicity is unlikely in resting
individuals at depths of 50 feet or shallower and very unlikely at 30 feet or shal-
lower, regardless of the level of activity. However, patients with severe Type II
decompression sickness or arterial gas embolism symptoms may be abnormally
sensitive to CNS oxygen toxicity. Convulsions unrelated to oxygen toxicity may
also occur and may be impossible to distinguish from oxygen seizures. Inserting
an airway device or bite block is unnecessary while the patient is convulsing; it is
not only difficult but may cause harm if attempted. Figure 21-7, Figure 21-8, and
Figure 21-9 explain how to handle interruptions in oxygen breathing on Treatment
Tables 5, 6, and 6A. Treatment Tables 4, 7, and 8 do not require compensatory
lengthening or alteration if oxygen breathing must be interrupted.
21-5.5.6.2
Pulmonary Oxygen Toxicity. Pulmonary oxygen toxicity is unlikely to develop
on Treatment Tables 5, 6, or 6A. On Treatment Tables 4, 7, or 8, the large amounts
of oxygen that may have to be administered may result in end-inspiratory discom-
fort, progressing to substernal burning and severe pain on inspiration. Substernal
burning is normally cause for discontinuing oxygen breathing in patients who are
responding well to treatment. However, if a significant neurological deficit
remains and improvement is continuing (or if deterioration occurs when oxygen
breathing is interrupted), oxygen breathing should be continued as long as consid-
ered beneficial or until pain limits inspiration. If oxygen breathing must be
continued beyond the period of substernal burning, or if the 2-hour air breaks on
Treatment Tables 4, 7, or 8 cannot be used because of deterioration upon the
discontinuance of oxygen, the oxygen breathing periods should be changed to 20
minutes on oxygen, followed by 10 minutes breathing chamber air. The Diving
Medical Officer may tailor the above guidelines to suit individual patient response
to treatment.
