We offer specialised Medical Care for Commercial and Recreational Scuba Divers suffering from or suspecting any level of DCI (Decompression Illness).
With our 24-hour EMS (Emergency Response System) in place, the Hyperbaric Therapy Treatment area within the Panacea Medical Center employs fully trained Hyperbaric Physicians and Nurses, Certified Technicians and experienced ECHCO Chamber Operators and ECHM In-Chamber Medical Attendants.
Our Emergency Standby Response is throughout the year 24/7. We follow internationally recognised treatment profiles based on US Navy, Royal Navy, COMEX, UHMS and European Undersea & Baromedical Society (EUBS) protocols.
These Internationally acclaimed and recognised bodies set the benchmarks for Decompression Illness (DCI) and HBOT treatments globally. All protocols are applied on the Physician’s recommendation depending on the severity of and the resolution to signs and symptoms. The patient will be given treatments ideally until all symptoms are completely resolved, symptoms have stabilised or if necessary alternative treatments are required.
Do not ration any Oxygen Administration to try and make it last longer.
If Oxygen is administered then signs and symptoms of DCI may appear to resolve, however it is still important to continue Oxygen therapy until advised otherwise by a Qualified Diving Physician.
Decompression Illness has no definitive presentation or test to confirm its presence. Symptoms can be vague and subtle and any area of the body can be involved. If at any time you are concerned about any signs or symptoms after diving call the 24 hour helpline on +357 99 51 88 37.
The two most frequent serious diving related accidents are Arterial Gas Embolism (AGE) and Decompression Sickness (DCS). These conditions are more normally referred to as Decompression Illness (DCI).
DCS is thought to result from inert gas bubbles growing in tissues and causing damage, while AGE results from bubbles travelling through the body's arterial circulation and causing tissue damage by blocking blood flow.
Decompression Illness mainly affects divers, although aviators, astronauts and compressed air workers can also suffer from DCI.
Both conditions require the same First Aid treatment. Symptoms of Decompression Illness can occur immediately on surfacing and normally within 48 hours. However symptoms can sometimes develop more than 48 hours after diving especially where the victim has travelled to altitude or flown soon after diving.
The signs and symptoms of both injuries are very similar and can be hard to differentiate between them, therefore do not lose time trying to establish exactly what type of DCI it is, always get professional attention at the earliest opportunity.
Symptoms of DCI:
Signs of DCI:
Severe DCI is easy to spot but in milder cases one of the most common symptoms is denial. A minor joint ache or an abnormal sensation in an extremity is put down to another cause such as overexertion, heavy lifting or a tight fitting wetsuit which often leads to a delay in seeking treatment.
Remember, if you feel unwell or have any symptoms of DCI after a dive that until proven otherwise, you may be suffering from DCI and you should obtain advice from a diving physician.
Delays in seeking treatment often result in cases where the symptoms of DCI take longer to resolve. Ignoring mild symptoms of DCI is dangerous as these symptoms can quickly develop into more serious symptoms such as paralysis.
The only definitive treatment for DCI is Recompression Therapy in a Hyperbaric Chamber. Early Oxygen First Aid is very important in managing a case of DCI and may reduce the symptoms; however this should never change the treatment plan. Even if DCI symptoms resolve after initial oxygen breathing, they may reappear again later. Because of this, always consult a Dive Physician in cases of suspected DCI even if the symptoms and signs appear to have resolved.
HBOT for DCI works by re-pressurising the patient so that the inert gas bubbles that are causing the problem are made smaller and they can be re-dissolved back into the body tissues. By breathing Oxygen, a large pressure diffusion gradient is established. As the patient is slowly brought back to surface the inert gases are able to gradually diffuse out of the body.
There are various treatment tables that control the exact combination of depths and time for recompression therapy. The most common table used is the USN TT6 (United States Navy, Treatment Table). This consists of 3 x 20 minute periods of breathing Oxygen at 60 feet with 5 minute air breaks in between, followed by a 30 minute ascent to 30 feet, followed by 2 x 60 minute periods of breathing Oxygen with 2 x 15 minute air breaks in between (often amended to 6 x 20 minute Oxygen periods for Recreational Divers), finally a 30 minute ascent is carried out to the surface, Oxygen is breathed on all the ascents. This means the therapy will take 4 hours and 45 minutes (excluding the descent time to 60 feet) however the diving physician in charge of the treatment can extend the table at 60 and 30 feet for up to 2 additional Oxygen breathing periods if they feel it will be beneficial for the patient.
If there are still symptoms after the initial treatment then follow up treatments are indicated. These follow up treatments may use the same or different treatment tables depending on circumstances and will continue until there is a full resolution of the symptoms or there is a plateau in treatment where there seems to be no further improvement.
In cases of severe neurological DCI a more aggressive treatment than a USN TT6 may be indicated, such as the COMEX 30 treatment table. This table involves initial treatment at 30 metres but due to Oxygen toxicity concerns a mixture of 50% Helium and 50% Oxygen (Heliox) is breathed until 18 metres is reached where 100% Oxygen can then be breathed with controlled safety factors in place.
The Panacea Medical Center is the only hyperbaric facility in Cyprus able to offer this advanced (and potentially) life saving treatment.
If in doubt contact the helpline on +357 99 51 88 37