Pulmonary barotrauma in submarine escape trainees and the treatment of cerebral arterial air embolism.

The reports of all dysbaric incidents occurring during submarine escape training at the Royal Navy's training facility in HMS Dolphin during 1954-84 were reviewed. All cases treated for unequivocal arterial gas embolism were used to assess the effectiveness of various treatments. Presentation and accident rates were analysed. As training techniques and treatments have varied over the years, the data were not uniform thus making comparison of treatments difficult. Both long air tables and RN Table 63 (USN6A) appear to offer effective treatment. There was insufficient data to assess the efficacy of prophylactic steroids in preventing relapse. It was concluded that the current recommendations for treating AGE by commencing on RN Table 63 with a change to RN Table 54 in the event of no response or of relapse should remain unchanged.