What is the recommended treatment for suspected decompression sickness in flight or on arrival?

• A. Decompress slowly and continue flight
• B. Administer 25% oxygen and hydrate
• C. Administer 100% oxygen, minimize exertion, and arrange rapid medical transfer for hyperbaric oxygen therapy
• D. Wait for symptoms to resolve

Answer: (C)

When decompression sickness is suspected in flight or on arrival, the priority is to rapidly address the nitrogen bubbles and support tissue oxygenation. Administering 100% oxygen provides the highest oxygen tension to tissues and accelerates nitrogen washout from the tissues, helping to reduce bubble size and limit ischemic injury. In addition, minimizing exertion lowers bubble movement and the risk of further injury caused by physical activity.

Arranging rapid medical transfer to a facility capable of hyperbaric oxygen therapy is essential because HBOT is the definitive treatment. The increased ambient pressure helps shrink the bubbles and delivers high concentrations of oxygen to affected tissues, improving outcomes. Waiting for symptoms to resolve or continuing flight with only partial oxygen, or delaying transfer, can allow symptoms to worsen and increase risk of complications.