Proposing short-term observation units for the management of decompression illness.

Decompression illness (DCI) is a potentially life-threatening disease, often requiring hyperbaric oxygen therapy (HBO2) for symptom resolution. Once treated, current guidelines recommend an observation period of at least six hours for patients with neurological symptoms in case of relapse. Surveys have shown a symptom relapse rate as high as 38.5%, with half of those occurring in the first twenty-four hours. We propose that a short-term observation unit (OU) would be an ideal setting for these patients to be monitored. To evaluate this, we did a retrospective study of patients presenting with DCI at a major hyperbaric facility. One hundred and two consecutive patients were evaluated with DCI diagnosis and receiving HBO2. Forty-two (41.2%) patients had neurological sequelae; ten required more than one treatment for refractory symptoms or relapse. Thirty-eight of the forty-two patients received up to three treatments, which can be done within the time requirements of short-term observation. We conclude that OUs would provide a safe and efficient disposition for patients after receiving HBO2.

PMS in the workplace. An occupational health nurse's guide to premenstrual syndrome.

1. Premenstrual syndrome (PMS) is defined as the cyclic recurrence of physical, psychological, or behavioral symptoms that appear after ovulation and resolve with the onset of menstruation. These symptoms can be severe enough to disrupt personal relationships, social activities, or job performance. 2. The exact cause of PMS is unknown. The best tool to diagnose PMS is a daily symptoms rating calendar. To have the diagnosis of PMS, the symptoms must be severe enough to disrupt normal daily activities. 3. The occupational health nurse can provide information about first line treatment modalities for PMS symptoms including dietary modifications, nutritional supplements, aerobic exercise, and stress management skills. 4. More research is needed about PMS in the workplace and the effect of treatments on outcomes such as job attendance and work performance.