Decompression Illness (DCI) Explained
The assessment checklist and examination videos below are provided to aid the examination of divers with suspected inner ear decompression sickness. Use of the HINTS clinical examination and the HOOYAH screening tool can help differentiate IEDCS from central causes of vestibular symptoms, and inner ear barotrauma.
Management of divers with IEDCS
Recompression treatment should be initiated as soon as possible and continued until there has been resolution of symptoms or a plateau + 1 additional treatment. Bedside tests to assess residual symptoms may include:
- Timed sharpened Rombergs (using stopwatch)
- Presence of nystagmus
- Dynamic gait index
- Heel-toe walking
It is important to start vestibular rehabilitation as soon as possible to aid recovery and initiate central compensation. Any exercise that triggers symptoms will aid in this process. The balance retraining booklet can be given to the diver at presentation to start as soon as possible with further exercises suggested as their symptoms allow. Please see the ‘Vestibular Rehabilitation’ section for more information. Encouraging the diver to keep a diary of activities/ situations that trigger their symptoms can help guide the focus of the rehab exercises. For example, how do they feel in a busy supermarket, on uneven ground, as a passenger in a car, or in low light environments?