Emergency Underwater Oxygen Recompression

NOTE: This procedure is an emergency procedure for remote areas only and is not a replacement for chamber therapy.  It must only be used for acute pain, limb, joint or skin decompression illness.

It is not intended for severe decompression illness or an arterial gas embolism.  Placing an unconscious diver on a demand valve and returning him or her to the water can never be acceptable or condoned. The technique was developed in Australia by the Royal Australian Navy School of Underwater Medicine as a result of acute decompression illness occurring in areas very remote from a proper recompression facility.

Method
The preparation
  • A large oxygen cylinder as used in hospitals is needed.
  • This is fitted to a two-stage regulator, the first-stage gauge indicating cylinder pressure and the second stage indicates delivery pressure. This should be set to 550 kPa.
  • A 12 m length of clean hosing is attached to the second-stage outlet.
  • The other end of the hose is attached to a non-return valve on a full face mask (e.g. Kirby Morgan or AGA) inlet.
  • The diver must be fully dressed and negatively weighted so that there is no difficulty in maintaining depth under water. A tendency to drift upward is contraindicated.
  • The attendant will breathe air using conventional scuba. Adequate full spare cylinders plus attached demand valves must be available on the shot line.
  • A shot line clearly marked in metres and adequately weighted is suspended from a buoy large enough to easily support two divers.
  • If the recompression cannot be done in a sheltered, quiet area, the buoy must be tethered close to the boat.
  • Hand and foot loops and a seating system must be fitted to the shot line to assist the diver and the attendant.

The recompression
  • The diver and the attendant descend to 9 m.
  • A timed stay of 30 minutes is done in mild cases, 60 minutes in worse cases and 90 minutes if improvement does not occur.
  • Ascent is then commenced at 12 minutes per metre. This is more readily accomplished by spending 11.5 minutes at each metre mark and then ascending over 30 seconds to the next mark.

If necessary, this recompression may be repeated twice daily.  READ MORE IN OUR TECHINICAL DIVING SECTION.

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