Page 98 - JSOM Spring 2026

only curative option. In our case, evacuation was constrained draft. DN provided an expert review of the article and subspe-
by aircraft limitations, as descending to a lower altitude out- cialist oversight for the entirety of the case report.
side our established operating area would have rendered aerial
extraction impossible, possibly prolonging our extraction time Disclaimer
further. Even a “no-gear” descent required a physical capabil- The views expressed in this article are those of the authors
ity that the patient did not possess, with significant dyspnea and do not necessarily reflect the official policy or position of
on exertion with even 10m. Furthermore, The Advanced Tac- the Department of the Air Force, Department of Defense, or
tical Paramedic Handbook (utilized by our unit), recommends the U.S. Government. This work was conceived and conducted
minimizing patient exertion due to risk of exacerbation. independently by the authors without external influence or
15
Additionally, while not an immediate solution, consideration sponsorship.
should have been given to empiric antibiotic treatment for
triggering/concomitant respiratory infection in this scenario. Disclosures
The authors declare no competing financial or non-financial
Portable hyperbaric chambers are lightweight devices that can interests.
be easily transported and, if used correctly, achieve the equiv-
alent of 5,000 feet (about 1,500m) of descent. In our case, a
9
timely decision to evacuate was prioritized over utilizing the Funding
chamber due to the patient’s potential for decompensation, This work was conceived and conducted independently by the
inability to equalize middle ear pressures (leading to sinus authors without external influence or sponsorship.
block), the high potential for a need to abort treatment (wors-
ening symptoms due to rapid re-decompression), and the nar- References
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96 | JSOM Volume 26, Edition 1 / Spring 2026