Zusammenfassung
Obwohl wir im Rettungsdienst sehr selten mit Tauchunfällen konfrontiert sind, ist es wichtig, mit dem Tauchen in Verbindung stehende Erkrankungen zu erkennen bzw. durch das Szenario „Tauchunfall“ nicht andere Erkrankungen zu übersehen oder falsch zu interpretieren. Die zielführende Therapie bei einer schweren Dekompressionserkrankung ist eine hyperbare Oxygenation. Wegen der geringen Verfügbarkeit von Druckkammern in Deutschland müssen die korrekten einsatztaktischen Entscheidungen frühzeitig getroffen werden.
Abstract
Diving accidents are potentially life-threatening events requiring immediate and proper medical treatment. Decompression illness (DCI) comprises decompression sickness (DCS) and arterial gas embolism (AGE). Common to both is the formation of gas bubbles in the blood and tissues caused by a rapid decline in ambient pressure when surfacing from scuba diving. There might also occur barotraumata of air-filled cavities such as the middle ear or the paranasal sinuses. Due to the wide range of possible symptoms especially of decompression illness (DCI) the correct detection of a diving accident can be difficult and may delay adequate treatment. Vice versa diseases not related to diving may be misinterpreted as diving accidents. Prehospital therapy primarily means the administration of highly concentrated oxygen and fluid substitution with cristalloids. The definite care for DCI involves treatment with hyperbaric oxygen in a pressurized treatment chamber. For this reason as well as air physiological particularities the transportation of the patient is also a logistic challenge and time consuming. In conclusion the detection, treatment and transportation of the patient to an adequate treatment facility demands elaborate strategies and considerations implying the knowledge of the diving pathophysiological specifics.
Schlüsselwörter
Tauchunfall - Barotrauma - Dekompressionskrankheit - normobare Sauerstofftherapie - hyperbare Oxygenation
Key words
diving accident - barotrauma - decompression sickness - normobaric oxygen therapy - hyperbaric oxygen therapy
