Advanced Dive Medicine Recompression therapy Treatment Tables

Question 1

Purpose of therapy

Answer 1

Decrease bubble size, restart blood flow, relieve local pressure
Reduce bubble by maximizeing inert off gassing gradient/O2 usage
Allow Time @ depth for bubble absorption

Question 2

Authority to initiate recompression therapy

Answer 2

Dive SUP, consult DMO Asap.

Question 3

Modification of TT with CO/OIC approval

Answer 3

DMO, 16uo/16u1 Undersea medical officer UMO

Question 4

Oxygen Tables

Answer 4

5,6,6A,4,7,9

Question 5

Air Tables

Answer 5

1A, 2A, 3

Question 6

Special notes with TT-4 and 8

Answer 6

TT-4 can be used with or without 02, TT-8 for deep blowups greater than :60 deco missed

Question 7

TT5 Indications for Use

Answer 7

Type I DCS EXCEPT Cutis mamorata - When no NEURO issues are found on surface or @ 60
Asymptomatic ommited D
Exceeded SURD S/I for 2 periods or less
Follow up for residual symptoms
resolved symptoms after in water recompression
HBO therapy - CO/Gas

Question 8

TT5 Consideration

Answer 8

Neuro @ 60 if relief is not within :10 or abnormal use TT6
O2 breathing starts @ 60
DMO determines Ortho is cause then stay on TT5

Question 9

TT6 Indications for use

Answer 9

AGE, Type II, Type I not relieved in :10, Cutis, Severe CO/CN/Smoke inhalation, Asymptomatic Omitted D deeper than 30 more than 2 Periods :07 S/I, Symptomatic Omitted D, Un-resloved in water symptoms, recurrence of symptoms shallower than 60.

Question 10

TT6A Indications for use

Answer 10

Unchanged or worsening symptoms of AGE/DCS w/ :20 @ 60
FSW
Asymptomatic Omitted D
Symptomatic Omitted D

Question 11

TT4 Indications for use

Answer 11

AGE/DCS patient would benefit from additional time @depth of significant relief 165FSW or shallower
SEVERE DCS type II or AGE

Question 12

TT7 Indications for use

Answer 12

Extension @ 60FSW of TT6/TT6A or 4
Considered heroic if deco from 60FSW will cause death
coma, apnea, paralysis

Question 13

TT5 extensions and tender O2 requirements

Answer 13

2 :20 extensions @ 30 FSW No air brake between them or prior to ascent.
Tender breaths O2 during ascent from 30 ft stop to surface
Previous tender HBO in 18 hours :20 O2 prior to ascent

Question 14

TT6 extensions and tender O2 requirements

Answer 14

2 :20 O2 :05 airbrake @ 60 FSW, or 2 :60 O2 :15 airbrake @ 30 FSW
Unmodified or 1 extension @ 30FSW Tender breaths O2 last :30 @ 30FSW and to surface
modified tender breaths :60 last O2 period and to surface
Previous tender HBO in 18 hours additional :60 O2 @ 30FSW prior to ascent

Question 15

TT6A extensions and tender 02 requirements

Answer 15

Extensions same as TT6
Tender breaths o2 last :60 @30FSW and to surface
More than 1 Extension tender breaths :90 min of last 02 period
Previous tender HBO in 18 hours additional :60 O2 @ 30FSW prior to ascent

Question 16

TT4 O2 and extended considerations

Answer 16

Patient starts O2 @ 60FSW :25 O2 :05 airbrake minimum 4 O2 periods (more @ DMO Discretion)
Both patient/tender breathe O2 for at least 4 hours (eight :25 O2, :05 air periods), no later than 2 hours before ascent from 30FSW

Question 17

TT7 02 and extended considerations

Answer 17

Consult DMO, Minimum 12 hours @ 60FSW
Patient breaths 02 for :25 airbrakes :05 for 4 periods then 2 hours of air.
Conscious patient breaths 8 periods, DMO discretion
beyond
Tender breaths chamber air throughout TX and DECO.