TOWARDS NEW PARADIGMS FOR THE TREATMENT OF HYPOBARIC DECOMPRESSION-SICKNESS

Altitude induced (hypobaric) decompression sickness (DCS) has long bee n treated with ground level oxygen and U.S. Navy Treatment Tables 5 an d 6. These treatment tables originate from surface excursion diving an d, when implemented, require significant resource allocation. Although they are effective treatment regimens, these tables were not develope d for treating hypobaric DCS which has an etiology similar to saturati on diving DCS. In this review, different treatment options for hypobar ic DCS are presented. These options include more aggressive use of gro und level oxygen and treatment tables using a maximum pressure of 2 at mospheres (ATA). Specific attention is given to USAF Table VIII, an ex perimental hypobaric DCS treatment table, and space suit overpressuriz ation treatment. This paradigm shift for DCS treatment is based on a p rojected increase in hypobaric DCS treatment From exposure to low pres sure during several operational conditions: cruise flight in the next generation aircraft (e.g., F-22); high altitude, unpressurized flight by special operations forces; and the extraordinary amount of extraveh icular activity (EVA) required to construct the international space st ation. Anticipating the need to treat DCS encountered during these and other activities, it is proposed that 2 ATA or less hyperbaric oxygen (HBO) treatment conjoined with new collapsible chamber technology can be used to address these issues in a safe and cost effective fashion.