Advanced high pressure hyperbaric techniques in tunnelling.

Work in compressed air and diving are both occupational activities that have been around since the mid-19th century, and those undertaking their work under elevated pressure. Meeting the demand to go to "higher pressure for longer" in tunneling has lagged in diving, but both activities have found it necessary to adopt mixed gas breathing and saturation exposure techniques. This paper explains how work in hyperbaric conditions at high pressure is undertaken in tunneling and is illustrated by the hyperbaric activity likely to be involved in constructing a large-diameter road tunnel below a body of water such as an estuary.

Specialist advice may improve patient selection for decompression therapy following diving accidents: a retrospective observational study.

Background: Even in a landlocked country like Switzerland recreational diving is becoming more and more popular. Smaller lakes in the Alps are located at an altitude of 2500 m above sea level. The incidence of diving accidents among all helicopter emergency service missions and the consecutive medical knowledge about decompression injuries is low.

[Diving - fitness to dive: a challenge for the family doctor].

A certificate for divers should be based on expertise and risk assessment. The doctor needs knowledge of the divers history, diving technique, motivation and risk exposure.

Telemedicine in the management of diving accidents: correlation of phone-assessed symptom severity with clinical findings.

Introduction: The object of this study was to evaluate to what extend the severity of decompression illness (DCI) assessed by a diving medicine specialist over the phone correlates with actual clinical findings.

Methods: The phone protocols of calls received by a diving medical hotline between January 2008 and December 2009 were analysed. Each case was followed up after completion of the treatment and categorized into one out of four severity groups according to the same standard protocol used for categorisation at the time of the initial hotline call.

Problems of a preclinical treatment algorithm for diving accidents: analysis of the Swiss hyperbaric situation.

Following recent changes in the medical infrastructure in Switzerland, the number of hyperbaric facilities fell from ten to two, and the existing algorithms for telemedical assistance of divers required review. A retrospective study of decompression illness (DCI) from 2004 to 2008 showed that many divers were asymptomatic at the start of hyperbaric treatment. Because of this and recent publications, we may need to modify in the future the decision to recompress a diver.

Diving Accident Guidelines of the German Society for Diving and Hyperbaric Medicine: Summary version.

The following is a synopsis of the German Diving Accident Guidelines, which may be found on www.gtuem.org in German and English.