Miskito Fishermen Divers and Decompression Illness — Effects of Delay

The purpose of this study was to help clinicians understand the impact of delayed recompression treatment of decompression illness (DCI) among Miskito fishermen divers. This study reviewed clinical manifestations of decompression sickness (DCS), the impact of in-water recompression, evacuation and hyperbaric treatment on outcomes of DCI in Miskito fishermen divers treated in the hyperbaric chamber at Clínica La Bendición, in La Ceiba, Honduras, during 2010 and 2011.

This study concluded that despite long delays to recompression treatment, most injured Miskito divers recovered significantly after standard hyperbaric oxygen treatment. The duration of delay, the distribution of motor weakness and the natural evolution of symptoms before admission did not seem to affect final outcome.

This study was completed in 2011.

Miskito fishermen of Honduras dive for lobster and conch at fishing grounds far offshore. Miskito divers are not formally trained and do not seem to follow generally considered safe dive practices. Instead, their daily dive routine is risky, and they often incur severe forms of decompression illness (DCI). Management of DCI includes first aid surface oxygen and recompression in hyperbaric chamber as a standard treatment. It is generally accepted that delayed recompression may reduce the chances of complete relief or may impair treatment efficacy. However, Miskito fishermen have no onboard equipment or facilities for proper management of DCI, and if injured, must travel for days back to La Ceiba to receive standard treatment. These delays to treatment are much longer than those usually seen in recreational divers with DCI. Previously published reports suggest that the degree of recovery is inversely proportional to the duration of treatment delay. Though this may apply mainly in mild DCI cases in recreational diving, it is not known how long treatment delays may impact severe neurological cases as those usually seen in Miskito divers. The purpose of this study was to help clinicians understand the impact of delayed treatment on patient outcomes and help guide clinical management in such cases. The treating clinician has reported to this office that the number of DCI cases, just in this population, is typically over one hundred cases per year.

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