Which therapy is considered definitive for decompression sickness?

• A. Hyperbaric oxygen therapy
• B. Antibiotics
• C. Observation only
• D. Pain control

Answer: (A)

Hyperbaric oxygen therapy is the definitive treatment for decompression sickness because it directly addresses the gas bubbles that form after rapid ascent. Delivering 100% oxygen at increased ambient pressure compresses and reduces the size of nitrogen bubbles (Boyle’s law) and accelerates nitrogen washout from tissues and blood, while the elevated oxygen content improves tissue oxygenation and microcirculation. This combination mitigates mechanical obstruction, ischemia, and the inflammatory response caused by these bubbles, addressing the underlying problem rather than just symptoms. Supportive care like analgesia and IV fluids helps with comfort and perfusion but does not dissolve the bubbles. Antibiotics are not needed unless there’s a concurrent infection, and observation alone won’t treat the gas emboli. If hyperbaric therapy isn’t available immediately, provide 100% oxygen and arrange rapid transfer to a facility with hyperbaric capabilities.