In adult and pediatric decompression sickness, which intervention is part of initial management?

• A. Administer a rapid IV bolus of dextrose
• B. Apply high flow oxygen
• C. Place patient in Trendelenburg position
• D. Take no action

Answer: (B)

In decompression sickness, the immediate priority is delivering high-flow oxygen. Giving 100% oxygen increases the amount of oxygen dissolved in the blood and tissues while creating a diffusion gradient that speeds the elimination of inert gas, mainly nitrogen, from bubbles and tissues. This helps shrink bubbles, improves tissue oxygenation, and reduces ischemia while you arrange definitive care with hyperbaric oxygen therapy.

Other options don’t address the underlying gas bubbles or can cause harm: a rapid IV dextrose bolus isn’t a treatment for decompression sickness and can affect fluid and electrolyte balance; placing the patient in a Trendelenburg position offers no clinical benefit and can worsen respiratory or circulatory status; doing nothing would allow symptoms to progress. Therefore, high-flow oxygen is the appropriate initial intervention.