Is centralization in emergency rural medicine always right? Lessons learned from two cases of decompression sickness

Rural Remote Health. 2011;11(2):1711. Epub 2011 May 26.

Abstract

The cases of two patients with decompression sickness (DS) are described to add to the discussion about whether centralization, especially when accompanied by air-medical transport, is always justifiable in island emergency medicine. One patient received hyperbaric oxygen (HBO) treatment on another island after island-to-island transfer by boat; the other received HBO treatment on a ship that was anchored, by chance, close to the island where he became ill. Both cases had a good outcome. Island-to-island transport and within-island treatment, rather than island-to-urban-center transport, was effective, indicating that treatment centralization may not be the most effective protocol all cases. A DS treatment strategy is proposed for use in this geographic area; however, DS occurring on remote islands highlights the wider issue of the centralization of health services.

Publication types

  • Case Reports

MeSH terms

  • Centralized Hospital Services
  • Decompression Sickness / diagnosis
  • Decompression Sickness / therapy*
  • Emergency Medicine
  • Humans
  • Hyperbaric Oxygenation*
  • Japan
  • Middle Aged
  • Rural Health Services*
  • Ships
  • Transportation of Patients / methods*
  • Treatment Outcome