title: First Aid Oxygen Treatment for Decompression Illness in the Goat After Simulated Submarine Escape.
abstract: BACKGROUND
  Personnel responding to a distressed submarine incident require information on likely casualty levels and the severity and progression of decompression illness (DCI). Recompression may not be immediately available. First aid oxygen (FAo₂) can be administered; however, there is no direct evidence of its efficacy in this scenario.
  
  
  METHODS
  Trials were conducted between 2004 and 2006. Goats exposed to raised pressure for 24 h ('saturation') were either returned directly to atmospheric pressure (Phase A, N = 40) or exposed to simulated submarine escape at a depth of 656 ft (200 m; assumed seawater density = 1019.72 kg · m(-3); Phase B, N = 39). The pressure during saturation was selected to provoke 50% DCI. Cases of DCI were randomly assigned to receive FAo₂or air.
  
  
  RESULTS
  DCI cases were: limb pain in 39 subjects, neurological in 6, respiratory in 4, and pulmonary barotrauma in 1 subject. In Phase A, 5/12 subjects in the FAo₂group and 0/11 in the air control group achieved permanent resolution of DCI. In Phase B, 6/8 subjects in the FAo₂group and 5/8 in the air control group achieved permanent resolution. In both Phases, levels of venous gas bubbles reduced sooner with FAo₂. Of three cases of neurological DCI receiving FAo₂, two showed permanent resolution. In total, four cases of respiratory DCI occurred; none of these resolved, with three being treated with FAo₂and one in the air control.
  
  
  CONCLUSIONS
  Oxygen can be an effective first aid measure for DCI following submarine escape. However, it should not be used as a replacement for recompression therapy.
authors.affiliation: Maritime Life Support, QinetiQ Haslar, Haslar Road, Gosport, UK.
authors.forename: Geoff A M
authors.initials: GA
authors.lastname: Loveman
authors.forename: Fiona M
authors.initials: FM
authors.lastname: Seddon
authors.forename: Karen M
authors.initials: KM
authors.lastname: Jurd
authors.forename: Julian C
authors.initials: JC
authors.lastname: Thacker
authors.forename: Arran S
authors.initials: AS
authors.lastname: Fisher
mesh_terms: D000818:Animals; D003665:Decompression Sickness / Q000628:therapy*; D005392:First Aid / Q000379:methods*; D006041:Goats; D010102:Oxygen Inhalation Therapy / Q000379:methods*; D011897:Random Allocation; D013366:Submarine Medicine; D013997:Time Factors; D018608:Ultrasonography, Doppler; D014680:Veins