The risk of DCI for recreational divers with a PFO is quite low, but one of the questions the workshop tried to answer was how to identify the divers who are at risk and what to do about it if they are.
The guidelines state that divers who have had more than one episode of DCI with cerebral, spinal, vestibulo-cochlear or cutaneous manifestations should be tested for a PFO by experts in the field.
Divers at risk of DCI with a PFO have three options to reduce such risk.
The first is to stop diving, the second is to dive conservatively and avoid straining themselves after the dive, and the third is to close the PFO, even if this does not guarantee that a DCI will never occur again.
After a PFO closure, the minimum time that a diver needs to stop diving is at least three months.
The tests should confirm that the hole has completely closed, and also the patient must have stopped taking anti-platelet medications.
It is important to keep in mind that DCI is caused primarily by a significant dive exposure (depth, time, and ascent rate). Anyone engaging in extreme diving is at risk of getting DCI, even if they do not have a PFO.
DAN Europe is a not-for-profit worldwide organisation that provides emergency medical advice and assistance for underwater diving injuries. It also promotes diving safety through research, education, products and services