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. 2023 Mar 3:21:Doc01.
doi: 10.3205/000315. eCollection 2023.

S2k guideline for diving accidents

Björn Jüttner  1 , Christian Wölfel  2 , Claudio Camponovo  2 , Holger Schöppenthau  3 , Johannes Meyne  4 , Carmen Wohlrab  5 , Henning Werr  5 , Till Klein  6 , Giso Schmeißer  7 , Karsten Theiß  8 , Philipp Wolf  9 , Oliver Müller  10 , Thorsten Janisch  10 , Johannes Naser  11 , Susanne Blödt  12 , Cathleen Muche-Borowski  12
Affiliations

S2k guideline for diving accidents

Björn Jüttner et al. Ger Med Sci. .

Abstract
in English, German

For the purposes of this guideline, a diving accident is defined as an event that is either potentially life-threatening or hazardous to health as a result of a reduction in ambient pressure while diving or in other hyperbaric atmospheres with and without diving equipment. This national consensus-based guideline (development grade S2k) presents the current state of knowledge and recommendations on the diagnosis and treatment of diving accident victims. The treatment of a breath-hold diver as well as children and adolescents does not differ in principle. In this regard only unusual tiredness and itching without visible skin changes are mild symptoms. The key action statements: on-site 100% oxygen first aid treatment, immobilization/no unnecessary movement, fluid administration and telephone consultation with a diving medicine specialist are recommended. Hyperbaric oxygen therapy (HBOT) remains unchanged as the established treatment in severe cases, as there are no therapeutic alternatives. The basic treatment scheme recommended for diving accidents is hyperbaric oxygenation at 280 kPa.

Ein Tauchunfall im Sinne dieser Leitlinie ist ein potenziell lebensbedrohliches oder gesundheitsschädigendes Ereignis, hervorgerufen durch Abfall des Umgebungsdruckes beim Tauchen oder aus sonstiger hyperbarer Atmosphäre mit und ohne Tauchgerät. Diese nationale S2k-Leitlinie legt den aktuellen Stand der Erkenntnisse und der konsentierten Empfehlungen in der Diagnostik und Behandlung von Patienten nach Tauchunfällen dar. Die Behandlung von Apnoetauchern sowie Kindern und Jugendlichen unterscheidet sich prinzipiell nicht.Milde Symptome sind nur die auffällige Müdigkeit und ein Hautjucken ohne sichtbare Hautveränderungen.Wesentliche Bedeutung bei der Versorgung von Tauchunfällen hat die frühzeitige Atmung von 100%igem Sauerstoff. Weiterhin werden die Ruhiglagerung/keine unnötige Bewegung, eine moderate Flüssigkeitsgabe und eine Taucherärztliche Telefonberatung empfohlen.Die hyperbare Sauerstofftherapie (HBOT) ist bei schweren Dekompressionsunfällen unverändert ohne therapeutische Alternative. Als Behandlungsschema wird grundsätzlich eine HBOT bei 280 kPa empfohlen.

Keywords: arterial gas embolism; decompression illness; decompression sickness; diving accident; hyperbaric oxygen therapy; oxygen.

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Conflict of interest statement

See Attachment 2

Figures

Table 1
Table 1. Parameters of the care workflow with performance indicators for process quality
Figure 1
Figure 1. Classification of diving accidents
Figure 2
Figure 2. Flow diagram “First aid in diving accidents”
Figure 3
Figure 3. Modified “US Navy Treatment Table 6”
Figure 4
Figure 4. Flow diagram “Initial hyperbaric oxygen treatment in diving accidents”
See this image and copyright information in PMC

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