Introduction: There is a time line for divers who develop decompression illnesses (DCI) from the completion of their dive to the initiation of recompression. The time to treatment is influenced by many factors; two being the time before acknowledgement that the diver has a pressure-related illness and the time taken for transfer from that point to commencment of recompression.
Method: Time to onset of symptoms, and time from onset of symptoms to treatment were analysed for 233 divers, 202 recreational and 31 professional, presenting within 24 h of onset of symptoms to the Dunstaffnage Hyperbaric Unit between 1990 and 2009, who were transported by air, sea or road.
Results: Divers with severe DCI had significantly shorter times for onset of symptoms (95% confidence intervals 0.9 to 2.3 h longer for mild/moderate compared to severe DCI) and were transferred for treatment approximately twice as fast as those with mild/moderate symptoms (inter-quartile ranges: recreational divers, 2.25-5.63 h for mild/moderate DCI versus 1.54-3.25 h for severe DCI; professional divers, 2.63-11.13 h for mild/moderate DCI versus 2.25-2.92 h for severe DCI). Although choice of transport was most likely influenced both by location and disease severity, transfer modality did not significantly affect time to treatment for divers with severe DCI. In addition, no differences in time to treatment were observed between professional and recreational divers irrespective of disease severity.
Conclusions: The data suggest that transport was optimised to fit the particular circumstances of the patient and that divers treated for DCI in Scotland may benefit from there being a single, integrated, co-ordinated clinical service.