Mitchell Simon J, Bennett Michael H, Bryson Phillip, Butler Frank K, Doolette David J, Holm James R, Kot Jacek, Lafère Pierre
Department of Anaesthesiology, University of Auckland, Auckland, New Zealand.
Department of Anaesthesiology, School of Medicine, University of Auckland, Private Bag 92019, Auckland, New Zealand,
Diving Hyperb Med. 2018 Mar 31;48(1):45-55. doi: 10.28920/dhm48.1.45-55.
Guidelines for the pre-hospital management of decompression illness (DCI) had not been formally revised since the 2004 Divers Alert Network/Undersea and Hyperbaric Medical Society workshop held in Sydney, entitled "Management of mild or marginal decompression illness in remote locations". A contemporary review was initiated by the Diver's Alert Network and undertaken by a multinational committee with members from Australasia, the USA and Europe. The process began with literature reviews by designated committee members on: the diagnosis of DCI; first aid strategies for DCI; remote triage of possible DCI victims by diving medicine experts; evacuation of DCI victims; effect of delay to recompression in DCI; pitfalls in management when DCI victims present at hospitals without diving medicine expertise and in-water recompression. This was followed by presentation of those reviews at a dedicated workshop at the 2017 UHMS Annual Meeting, discussion by registrants at that workshop and finally several committee meetings to formulate statements addressing points considered of prime importance to the management of DCI in the field. The committee placed particular emphasis on resolving controversies around the definition of "mild DCI" arising over 12 years of practical application of the 2004 workshop's findings, and on the controversial issue of in-water recompression. The guideline statements are promulgated in this paper. The full workshop proceedings are in preparation for publication.
自2004年在悉尼举办的潜水员警报网络/水下与高压医学会研讨会（题为“偏远地区轻度或边缘性减压病的管理”）以来，减压病（DCI）的院前管理指南尚未正式修订。潜水员警报网络发起了一项当代综述，并由一个来自澳大拉西亚、美国和欧洲的跨国委员会进行。该过程始于指定委员会成员对以下方面的文献综述：DCI的诊断；DCI的急救策略；潜水医学专家对可能的DCI受害者进行远程分诊；DCI受害者的后送；DCI延迟再压缩的影响；DCI受害者在没有潜水医学专业知识的医院就诊以及水中再压缩时管理中的陷阱。随后，在2017年UHMS年会上的一次专门研讨会上介绍了这些综述，该研讨会的参会者进行了讨论，最后召开了几次委员会会议，以制定针对在该领域DCI管理中被认为至关重要的问题的声明。委员会特别强调解决在应用2004年研讨会结果的12年实际过程中出现的围绕“轻度DCI”定义的争议，以及水中再压缩这一有争议的问题。本文公布了指南声明。完整的研讨会记录正在准备出版。
