b'ChapterHow to Manage Decompression and Ruptured LungConscious Patient Position the patient flat. Do not allow the patient to be upright or stand. Dispersed bubbles in the tissues could become trapped in the heart or move up the carotid arteries into the brain, which may lead to a stroke if the patient were to sit up. Maintain absolute rest and keep the patient calm as possible.Contact 000 emergency services and also consult with Diver Emergency Service1800 088 200 for further advice.Provided you are trained in its use or if you are located in a remote area, administer 100%Oxygen. This will reduce the size of the nitrogen bubbles in the blood.The patient may need to be transferred to a decompression chamber.The patient may drink small amounts of fluids but no alcohol.Closely monitor patient for response, airway, normal breathing while waiting for Ambulance.Record dive details (including signs, symptoms, timinmgs and first aid given)Unconscious PatientApply DRSABCD and ensure patient is in the recovery position.Administer 100% Oxygen if you are trained in its use.Contact 000 emergency services/DES 1800 088 200.Prepare for resuscitation.Closely monitor patient for response, airway, normal breathing while waiting for Ambulance. Ear and Sinus BarotraumaEar and sinus barotrauma develops when pressure in the ears is unable to equalise. This can lead to earache and hearing loss along with facial pain and nose bleeds. Dizziness, nausea and vomiting can occur when the inner ear becomes affected.A horizontal / supine or flat posture without leg elevation is recommended in a diver suspected of DCI as it has been shown to increase the rate of gas elimination.It may also reduce the likelihood of arterial bubbles circulating to the brain. A conscious diver having increased breathing difficulty when laying flat can be placed into the recovery position. An unconscious diver should be managed in the recovery position.Administration of 100% oxygen reduces the size and number of gas bubbles in the blood and tissues by helping to eliminate the inert gas (an inert gas in general, doesnt react with anything).250 Underwater Diving Emergencies'