What is the recommended management for suspected in-flight decompression sickness with symptoms?

• A. Descent, administer 100% oxygen, and arrange hyperbaric treatment after landing
• B. Maintain altitude and monitor symptoms
• C. Administer only air or humidified air
• D. Ignore symptoms and continue flight

Answer: (A)

Decompression sickness during flight occurs when rapid exposure to reduced ambient pressure causes dissolved nitrogen to form bubbles in tissues and blood. The best immediate management is to descend to a lower altitude, provide 100% oxygen, and arrange hyperbaric treatment after landing. Descending increases ambient pressure, helping bubbles shrink or dissolve and reducing ongoing bubble formation. Administering 100% oxygen accelerates nitrogen washout from tissues and improves oxygen delivery to affected areas. Hyperbaric treatment after landing is the definitive therapy to recompress and further reduce bubble size, reversing symptoms.

Staying at altitude keeps the low pressure that sustains or worsens bubbles, while giving only air provides insufficient oxygen and slows nitrogen elimination. Ignoring symptoms delays proper treatment and can lead to serious complications.