Isobaric Treatment of Decompression Illness

Hyperbarics International has been teaching diving and clinical hyperbaric medicine for over 40 years. In that time, the understanding of physiology and pathophysiology has changed dramatically, thereby changing the approach to treating diving injuries and decompression illness.

Hyperbaric Treatment Chamber

For many years diving related injuries were treated at pressures equivalent to deeper depths. In 1965 Captain Charles Waite found that the period of the most bubble dissipation occurred between 60-90 feet. Thus, the hydrostatic pressure component of treating bubbles at 165 feet became irrelevant, and isobaric (constant pressure) counter diffusion became the leading method used in hyperbaric treatments. In addition to 60 feet being an optimal depth for dissipation of bubbles, it was also found that oxygen becomes highly toxic to the central nervous system at depths greater than 60 feet. As there is no gain in efficacy at deeper treatment depths, most hospital based chambers treating recreational divers will generally never exceed 60 feet. While there are more hyperbaric treatment facilities in operation today, it can still take an average of 4-6 hours to get a recreational scuba diver to one of these facilities.

Getting a diver suffering from any type of decompression illness (DCI) to a hyperbaric treatment facility in a timely manner is very important. Within just 10-15 minutes, gas bubbles can activate the clotting process in a person’s blood. This clotting can preclude venous and/or arterial blood flow in the region of perfusion, leading to more serious injury. Further injury can result from the body’s release of basal-active substances which lead to inflammation, swelling, reduction of blood flow, and white cell migration which can lead to further tissue injury. Fortunately, many of the initial effects of DCI are reversible with rapid access to proper treatment.

You can learn more about isobaric counter diffusion, and other issues pertaining to the treatment of treating diving casualties, through our Diver Medical Training Course and other courses.

Diving With Enriched Air Nitrox

What is Nitrox?

The term Nitrox refers to air that is enriched with oxygen. The first breath that we took when we came into this world was a form of Nitrox called normoxic Nitrox. Normoxic refers to air that contains the same amount of oxygen as the ambient air around us (roughly 21%).

For years, the Navy and commercial divers have been using different combinations of oxygen and nitrogen during their diving operations. In 1970 Dr. Morgan Wells brought Nitrox into use for scientific diving by making it available through an open circuit demand scuba system. Using the Enriched Air Diving (EAD) concept, he devised the NOAA Nitrox mix which utilizes 32% oxygen. Air that contains more oxygen than ambient air is considered hyperoxic. Upon retiring from NOAA in 1985, Dick Rutkowski began teaching NOAA Nitrox diving to the recreational diving community.

At this time Mr. Rutkowski and several other members of the diving community- Tom Mount, Bill Deans, and Brent Gillum- formed the International Association of Nitrox Divers (IAND), now the International Association of Nitrox and Technical Divers (IANTD). These pioneers sought to promote the physiological advantage that enriched air nitrox provides to divers. This was especially helpful as the mid 1980’s saw a boom of ships being scuttled to promote artificial reef systems.

In addition to increasing the bottom time and no decompression limits of recreational scuba divers, these hyperoxic gas mixes are also beneficial in hyperbaric medical treatments. Using higher oxygen concentrations under pressure, as is done in hyperbaric treatment, helps the oxygen to better perfuse tissues to promote healing or rid the body of nitrogen gas bubbles. Our Hyperbaric Medical Training programs will teach you how the use of Nitrox can treat diving injuries as well as medical conditions. Explore our site to learn more about our Hyperbaric Medical Training programs, or click here to download your registration form.

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