DDRC Healthcare, Plymouth, Devon

Emergencies & Hyperbaric Referrals
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Advice for paramedics & medic personnel

IMMEDIATE MANAGEMENT - advice for paramedics & medic personnel

Assess Airway & Breathing

Rapid ascent can lead to pneumothorax or emphysema

Administer 100% oxygen continuously as part of ventilation management

Never administer Entonox to a person who is suspected of suffering from Decompression Illness (DCI or the bends).

Continue oxygen therapy despite any apparent clinical improvement. 

Keep the patient warm and out of the wind. 

Circulation

Administer IV fluids: 1000ml 0.9% Saline (Hartmann's if available)

Administer PO fluids (non-caffeinated) if no IV access and the patient can tolerate oral fluids

Monitor pulse and blood pressure

Disability

Monitor level of consciousness

Examine neurologically for any gross weakness or sensory loss

Other Points

Symptoms can rapidly deteriorate. Reassess frequently for change. 

Do not give analgesia or other medication (except for resuscitation purposes) unless discussed with a Diving Physician. 

If unstable, or problem identified on Primary Survey, discuss with a Diving Physician regarding transfer to a Hyperbaric Unit or nearest Emergency Department. 

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