title: Decompression sickness in urban divers in France.
abstract: BACKGROUND
  Decompression sickness (DCS) can occur in SCUBA divers. DCS is treated with oxygen, preferably given under hyperbaric conditions. Although Paris (France) is located at a distance from the sea or lakes, some injured divers require hyperbaric oxygen treatment (HBOT) in this city, sometimes within a specific time frame. Thus, this study investigated the epidemiology and outcomes of such urban divers.
  
  
  OBJECTIVE
  We conducted an observational study of SCUBA divers admitted to the Raymond Poincaré Hyperbaric centre near Paris from 1993 to 2003.
  
  
  METHODS
  We prospectively enrolled 69 consecutive SCUBA divers presenting DCS. Common risk factors were reported, especially aeroplane flight and training dives. Symptoms are very often atypical (63%) and onset time of symptoms is often too long (59% after 2 h) due to denial of symptoms. First aid is generally inadequate, with only 23% of victims receiving oxygen, fluid loading and aspirin together. HBOT was given for 42 (61%) patients although their examination results were considered as normal.
  
  
  CONCLUSIONS
  Diving pits and diving travel agencies should do more to warn divers of the need for treatment with normobaric oxygen and hydration pending HBOT. Moreover, hyperbaric physicians should better clarify HBOT indications for both symptoms of late onset and atypical presentations.
authors.affiliation: General Intensive Care Unit, Hyperbaric Medicine Department, Raymond Poincaré Hospital, University of Versailles SQY, Garches, France. jacques.bessereau@ap-hm.fr
authors.forename: Jacques
authors.initials: J
authors.lastname: Bessereau
authors.forename: Nicolas
authors.initials: N
authors.lastname: Genotelle
authors.forename: Pierre-Marie
authors.initials: PM
authors.lastname: Brun
authors.forename: Jérôme
authors.initials: J
authors.lastname: Aboab
authors.forename: Marion
authors.initials: M
authors.lastname: Antona
authors.forename: Hichem
authors.initials: H
authors.lastname: Chenaitia
authors.forename: Anne
authors.initials: A
authors.lastname: Huon
authors.forename: Djillali
authors.initials: D
authors.lastname: Annane
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D003665:Decompression Sickness / Q000175:diagnosis* / Q000453:epidemiology; D004242:Diving / Q000009:adverse effects / Q000706:statistics & numerical data*; D005260:Female; D005602:France; D006304:Health Status; D006801:Humans; D008297:Male; D008487:Medical History Taking / Q000379:methods; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult