The Magazine for Underwater Professionals
Successful decompression illness (DCI) study day held in Hull
This April, the medical lecture theatre at Hull Royal Infirmary, East Yorkshire, UK, played host to a professional development day entitled DCI Study Day – Optimising Outcomes. The day was organised by Gerard Laden and the medical team from the Hull Hyperbaric Unit in cooperation with Mimir Marine, the Hull-based company with a global responsibility for the hyperbaric rescue of saturation divers following vessel abandonment.
Around 120 delegates were present with live telecast links to a team of six doctors on Malta along with contact with the Maltese island of Gozo and Croatia. Speakers and chairs were present from Norway, the Netherlands, Germany and the UK, with 15 presentations made to an enthusiastic audience of medics and offshore diving operations managers.
Highlights included a fascinating presentation from Dr Sebastian Klapa of the Maritime Medicine section in the Institute of Experimental Medicine at the Christian-Albrechts-Universität in Kiel, Germany. He highlighted a case of DCI induced hypovolemic shock with a slow but life-threatening evolution; a case easily missed outside of a hospital base facility. Other talks included submarine mass casualty escape medical management followed by individual case reports, including cerebral DCI, severe cord injury and the need to appreciate that there is much we can not see and do not understand.
Steve Sheppard, diving operations manager for Helix Well Ops, described how being well electronically connected and having policies, plans and procedures in place does not necessarily help people – i.e., there is always a need for a Plan B, and a Plan C! Possibilities to “optimise outcomes” were reviewed with a presentation on the drug lidocaine by Dr Robert Weenink from the Department of Anaesthesiology at the Academic Medical Centre Amsterdam, the Netherlands; the difficult task of reviewing steroids in DCI management fell to Dr Vincent Hong, consultant anaesthetist/ intensivist from the Hull unit; and Bruce Mathew, consultant neurosurgeon at Hull, discussed lumbar drains in severe cord injury – a theme being that the US Navy Treatment Table 6 is no panacea and that we all have a responsibility to remain open and thoughtful about optimising patient outcomes.
The usefulness of dive computers to help investigators understand what has happened during an incident was discussed by Dr Martin Sayer. Dr James Francis reviewed the importance of recording treatments in detail, and how this helps guide treatment and protects the treatment provider in poor outcome cases.
The overall consensus on the meeting was very positive and the audience was very appreciative of the effort made by the team to organise the day.