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. 2017 Jun;47(2):118-122.
doi: 10.28920/dhm47.2.118-122.

Treatment preferences for decompression illness amongst Singapore dive physicians

Valerie Huali Tan  1 , Kenneth Chin  2 , Aravin Kumar  3 , Jeremiah Chng  4 , Chai Rick Soh Rick Soh  5
Affiliations

Treatment preferences for decompression illness amongst Singapore dive physicians

Valerie Huali Tan et al. Diving Hyperb Med. 2017 Jun.

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.

Keywords: Cerebral arterial gas embolism (CAGE); Decompression sickness; Hyperbaric medicine; Hyperbaric oxygen therapy; Recompression; Survey.

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Conflict of interest statement

Funding and conflicts of interest: nil

Figures

Figure 1
Figure 1
Hyperbaric treatment preferences of 17 physicians for decompression sickness presenting with joint pain only; A – presenting within 4 h; B – presenting at 48 h
Figure 2
Figure 2
Hyperbaric treatment preferences of 17 physicians for decompression illness; A - cutis marmorata; B – mild sensory symptoms at 48 h; C – cerebral air embolism or paraplegia
See this image and copyright information in PMC

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