A Confident Diagnosis of DCI

Once a diagnosis of DCI (either DCS, AGE or maybe both) BMM's Doctors will usually (PROVIDING THEIR ARE NO OTHER MITIGATING MEDICAL CONCERNS PRESENT) prescribe the following course of action.

1. First Treament: USNTT6 (Implement Table Extensions if required and modify or use a CATALINA table if Oxygen Toxicity becomes a problem) 

2. Reassess the patient on treatment completion.

3. Second Treatment: USNTT6 (if symptoms are present) USNTT5 (if the patient is asymptomatic) The USNTT5 is what we call a washout since most of our diver patients will be flying home within a week.

4. Reassess the patient on treatment completion.

Repeat the above procedures. 

Depending on the severity of the case and the patients condition (other complications including the ability of the patient to handle oxygen) the above (general) prescription will be modified on site by HST's Doctors.

If BMM's Doctors are Unsure (ie DCI Signs & Symptoms are present BUT could be attributed to other medical conditions)

They will usually prescribe what we call a Rule Out USNTT6 or "Trial by Oxygen" (IF) the other mitigating concerns are considered less threatening to the patients health. 

Our doctors always err on the side of caution. If in doubt according to SSS Recompression Chamber Network protocol we treat. It is in the patients best interest.

If BMM's Doctors believe it is something other than DCI

BMM's doctors will not dismiss the patient out of hand. We will put them on what we call Bend watch. 

We will ask them to either lodge within or close to our facilities and if they develop sure signs and symptoms then we will be in a position to immediately recompress them because our staff are on standby to be called out at any time.

Treatment Tables

The most commonly used tables are the United States Navy Treatment Table 6 (USNTT6) and the United States Navy Treatment Table 5 (USNTT5): there are other tables, which are used for very unusual cases, seldom (if ever) seen in recreational divers. The Tables dictate the duration of treatment, treatment pressure (ie depth), the gas to be breathed and the descent / ascent rates.

United States Navy Treatment Table Six (USNTT6)

The USNTT6 is initiated by pressurizing the chamber to 60 fsw or 3 atmospheres, and breathing oxygen for intervals of 20 minutes oxygen and 5 minutes air.

Later the ascent begins on pure oxygen until the next static depth (30 fsw) - another intermittent gas period takes place before the final ascent to surface on oxygen. The length of the USNTT6 is 4 hours 45 minutes. This table can be extended an additional 50 min at 60 fsw and 150 min at 30 fsw if necessary. 

For this table & the USNTT5 the ascent rate will not exceed one foot per minute and descent will take place at 20 feet per minute. 

United States Navy Treatment Table Five (USNTT5)

The USNTT5 is a shorter table, it follows the same trend of pressure, oxygen, oral fluid, and air, but its length is only 2 hours 15 minutes. 

It is mainly used as follow up treatment to our USNTT6's to treat any residual symptoms or 'Wash Out' the patients system along with providing oxygen therapy to damaged area's of the body. 

After Treatment

After every Hyperbaric Treatment, the patient should drink plenty of fluids, avoid hot showers or baths, non-prescribed medications, caffeine, carbonated beverages, alcohol, strenuous exercise, oily spicy foods, avoid exposure to higher elevations (more than 1000 ft) or fly until 72 hours after the last treatment or cleared by the doctor.