Triage and Treatment of Mass Casualty Decompression Sickness After Depressurization at 6400 m.

Decompression sickness is a condition that results from an abrupt change from a higher to a lower pressure. It is described most commonly in divers; however, it can occur in aviation incidents, which this case report will discuss. Following an acute cabin depressurization incident, 36 patients presented to a small outpatient clinic with multiple symptoms, including fatigue, headache, nausea, vomiting, and dizziness. These patients were evaluated, triaged, and some were able to be successfully treated with supplemental oxygen in clinic. Eight of the patients had symptoms that were either persistent or concerning enough that they were referred to the dive medical clinic, where the dive medical team diagnosed six of the patients with Type II decompression sickness and referred them for hyperbaric oxygen chamber therapy. All patients who received hyperbaric therapy experienced at least some relief of symptoms, with most reporting some residual fatigue after the therapy. This case provided both lessons in triage and management of multiple patients in a small outpatient clinic, as well as the challenges in making the diagnosis of decompression sickness.