Hyperbaric treatment schedules

Hyperbaric treatment schedules or hyperbaric treatment tables, are planned sequences of events in chronological order for hyperbaric pressure exposures specifying the pressure profile over time and the breathing gas to be used during specified periods, for medical treatment. Hyperbaric therapy is based on exposure to pressures greater than normal atmospheric pressure, and in many cases the use of breathing gases with oxygen content greater than that of air.

A large number of hyperbaric treatment schedules are intended primarily for treatment of underwater divers and hyperbaric workers who present symptoms of decompression illness during or after a dive or hyperbaric shift, but hyperbaric oxygen therapy may also be used for other conditions.

Most hyperbaric treatment is done in hyperbaric chambers where environmental hazards can be controlled, but occasionally treatment is done in the field by in-water recompression when a suitable chamber cannot be reached in time. The risks of in-water recompression include maintaining gas supplies for multiple divers and people able to care for a sick patient in the water for an extended period of time.

Recompression of diving casualties presenting symptoms of decompression sickness has been the treatment of choice since the late 1800s. This acceptance was primarily based on clinical experience.John Scott Haldane's decompression procedures and the associated tables developed in the early 1900s greatly reduced the incidence of decompression sickness, but did not eliminate it entirely. It was, and remains, necessary to treat incidences of decompression sickness.

During the building of the Brooklyn Bridge, workers with decompression sickness were recompressed in an iron chamber built for this purpose. They were recompressed to the same pressure they had been exposed to while working, and when the pain was relieved, decompressed slowly to atmospheric pressure.

Although recompression and slow decompression were the accepted treatment, there was not yet a standard for either the recompression pressure or the rate of decompression. This changed when the first standard table for recompression treatment with air was published in the US Navy Diving Manual in 1924. These tables were not entirely successful - there was a 50% relapse rate, and the treatment, though fairly effective for mild cases, was less effective in serious cases.

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