What Researchers Did
This review examined the practice of in-water recompression (IWR) for divers suspected of decompression illness (DCI) in remote locations, comparing it to conventional first aid and assessing its theoretical benefits and risks.
What They Found
There are no direct data establishing the benefits of IWR compared to conventional first aid, but its theoretical advantage is a very short delay to recompression. In military and experimental diving, where recompression delays were typically less than two hours, over 90% of DCI cases resolved completely during the first treatment. IWR oxygen-breathing protocols generally use shallower maximum depths of 9 metres' sea water (191 kPa) and are shorter (1-3 hours) than standard treatments, with historical data suggesting similar effectiveness to deeper pressures.
What This Means for Canadian Patients
For Canadian divers experiencing decompression illness in remote areas, in-water recompression (IWR) is a risky first aid option that could offer faster recompression than waiting for transport to a chamber. However, it carries a significant risk of oxygen convulsions and drowning, and is not recommended for mild symptoms or severely impaired divers. It's crucial to weigh these risks against the potential benefits, especially when professional medical care is far away.
Canadian Relevance
This study is not Canadian. However, it covers decompression sickness, which is a Health Canada-recognised indication for hyperbaric oxygen therapy.
Study Limitations
A major limitation is the lack of direct data establishing the benefits of in-water recompression compared to conventional first aid with surface oxygen and transport to a recompression chamber.