Asperin for DCS

[Paulo]

A few years back, I did a Diver First Responder type course with an agency that I am no longer afiliated.

One of the things that is "qualified" you to do afterwards, was to prescribe asperin for any diver that was experiencing signs of DCS. This was to be paired with O2.

The thinking at the time was:
1. It couldnt hurt.
2. If you had a medical condition that contraindicated asperin, then you wouldnt be diving.

I have not heard much about it since then. Anything I have heard has been non-commital or general disagreement with the practice.

Is it still considered appropriate to give someone with DCS asperin?

[Divemouse]

Asperin causes me to haemorrhage into my intestines and I'm allowed to dive.

[Adrian]

I recall Simon Mitchell advising against aspirin as a preventative (as blood thinner) as it would make small (spinal?) bleeds worse if they were to happen. Sounds like it could introduce a complication during treatment.

[Rich1280]

Aspirin is an anti platelet medication, as well as being in the non steroidal anti inflammatory drug family. Other NSAIDs aren’t anti platelet, so if you wanted to mediate the inflammatory response, which is linked to DCS, a safer bet would be a different one. Ibuprofen, naproxen etc are over the counter meds in most places now, and Tenoxicam is the recommended one if you end up in the chamber.

I’d probably not give it for DCS, it’s other actions are potentially not helpful whereas if I wanted to give an anti inflammatory I’d give ibuprofen or something. If you’re bent enough to need the chamber, it’s probably not going to make a significant difference in the immediate phase, but a loading dose could help for down the line, but I’d wait on best practice for which nsaid it should be.

Fluids would be helpful, keeping a rough track of fluid in and out as well.

Rich (Paramedic with special interest in physiology and dive medicine)

[Divemouse]

I'm definitely not allowed to take ibuprofen.

[Tim Digger]

There were in the past theories that since DCI is an embolic disease that is caused by platelet white cell microbubble occlusion of small blood vessels, that previous treatment with a platelet disaggregating drug might be preventative. As far as I know no serious studies on this have been carried out and opinion as to risk versus benefit in this situation has shifted. I take aspirin, I dive! I stay well within NDLs I have not been bent as far as I know.

[Ihsaan]

The thinking at the time was:
1. It couldnt hurt.
2. If you had a medical condition that contraindicated asperin, then you wouldnt be diving.

Bad advice on both counts.

You don’t know if the diver is allergic to it or if they have an ulcer which can bleed if you give aspirin. Some asthmatics with asthma mild enough to let them dive can have a severe asthma attack from aspirin.

You can take regular aspirin for many conditions and be fit to dive.

[cazyoung]

On all first aid courses I have been on it has always been stated unless you are qualified to do so medication should not be offered to anyone as that is prescribing.

[Stig]

On all first aid courses I have been on it has always been stated unless you are qualified to do so medication should not be offered to anyone as that is prescribing.

Aspirin has been made an exception to that rule in recent years for suspected heart attacks.
From the 10th Edition First Aid Manual:

Assist the casualty to take one full dose aspirin tablet (300mg). Advise him to chew it slowly.

[Divemouse]

Advise him to chew it slowly

That would certainly distract him from the heart attack!