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
