Decompression
sickness
Decompression sickness (DCS)
is a type of injury that occurs when there is a rapid decrease in pressure
surrounding the body.
It usually occurs in
deep-sea divers who ascend to the surface too quickly. But it can also occur in
hikers descending from a high altitude, astronauts returning to Earth, or in
tunnel workers who are in an environment of compressed air.
With decompression sickness,
gas bubbles can form in the blood and tissues. If you believe you’re
experiencing decompression sickness, it’s important to seek medical attention
immediately. This condition can be fatal if it’s not treated quickly.
Who commonly
experiences this?
While DCS can affect anyone
moving from high altitudes to low altitudes, such as hikers and those who work
in aerospace and aviation flights, it’s most common in scuba divers.
Your risk for decompression
sickness increases if you:
have a heart defect
are dehydrated
take a flight after diving
have overexerted yourself
are fatigued
have obesity
are elderly
dive in cold water
In general, decompression
sickness becomes more of a risk the deeper you dive. But it can occur after a
dive of any depth. That’s why it’s important to ascend to the surface slowly
and gradually.
If you’re new to diving,
always go with an experienced dive master who can control the ascent. They can
make sure it’s done safely.
Decompression
sickness symptoms
Common symptoms of DCS may
include:
fatigue
weakness
pain in muscles and joints
headache
lightheadedness or dizziness
confusion
vision problems, such as
double vision
stomach pain
chest pain or coughing
shock
vertigo
More uncommonly, you may
also experience:
muscle inflammation
itching
rash
swollen lymph nodes
extreme fatigue
Experts classify decompression
sickness with symptoms affecting the skin, musculoskeletal, and lymphatic
systems as type 1. Type 1 is sometimes called the bends.
In type 2, a person will
experience symptoms affecting the nervous system. Sometimes, type 2 is called
the chokes.
How long does it take
for DCS to happen?
The symptoms of
decompression sickness may appear rapidly. For scuba divers, they may start
within an hour after a dive. You or your companion may appear visibly ill. Look
out for:
dizziness
a change in gait when
walking
weakness
unconsciousness, in more
serious cases
These symptoms indicate a
medical emergency. If you experience any of these, contact your local emergency
medical services immediately.
CONTACT EMERGENCY SERVICES
Call local emergency services
or DAN’s 24-hour emergency line at +1-919-684-9111.You can also contact the
Diver’s Alert Network (DAN), which operates an emergency phone line 24 hours a
day. They can assist with evacuation assistance and help you locate a
recompression chamber nearby.
In more mild cases, you may
not notice symptoms until a few hours or even days after a dive. You should
still seek medical care in those cases.
How does decompression
sickness happen?
If you move from an area of
high pressure to low pressure, nitrogen gas bubbles can form in the blood or
tissues. The gas is then released into the body if the outside pressure is
relieved too quickly. This can lead to obstructed blood flow and cause other
pressure effects.
What to do
Contact emergency
services
Watch for symptoms of
decompression sickness. These are a medical emergency, and you should seek
emergency medical services immediately.
Contact DAN
You can also contact DAN,
which operates an emergency phone line 24 hours a day. They can assist with
evacuation assistance and help you locate a hyperbaric chamber nearby. Contact
them at +1-919-684-9111.
Concentrated oxygen
In more mild cases, you may
not notice symptoms until a few hours or even days after a dive. You should
still seek medical care. In mild cases, treatment may include breathing 100
percent oxygen from a mask.
Recompression therapy
The treatment for more
serious cases of DCS involves recompression therapy, which is also known as
hyperbaric oxygen therapy.
With this treatment, you’ll
be taken to a sealed chamber where air pressure is three times higher than
normal. This unit may fit one person. Some hyperbaric chambers are larger and
can fit several people at once. Your doctor may also order an MRI or a CT scan.
If recompression therapy is
started promptly after a diagnosis, you may not notice any effects of DCS
afterward.
However, there can be
long-term physical effects, such as pain or soreness around a joint.
For severe cases, there may
also be long-term neurological effects. In this case, physical therapy may be
required. Work with your doctor, and keep them informed about any lasting side
effects. Together, you can determine a care plan that’s right for you.
Prevention tips for
diving
Do your safety stops
To prevent decompression
sickness, most divers make a safety stop for a few minutes before ascending to
the surface. This is usually done around 15 feet (4.5 meters) below the
surface.
If you’re diving very deep,
you may want to ascend and stop a few times to ensure your body has time to adjust
gradually.
Talk to a dive master
If you’re not an experienced
diver, you’ll want to go with a dive master who is familiar with safe ascents.
They may follow the guidelines for air compression as outlined by the United
States Navy.
Before you dive, talk to the
dive master about an adjustment plan and how slowly you need to ascend to the
surface.
Avoid flying that day
You should avoid flying or
going up to high elevations for 24 hours after diving. This will give your body
time to adjust to the change in altitude.
Additional preventive
measures
Avoid alcohol 24 hours
before and after diving.
Avoid diving if you have
obesity, are pregnant, or have a medical condition.
Avoid back-to-back dives
within a 12-hour period.
Avoid diving for 2 weeks to
a month if you’ve experienced symptoms of decompression sickness. Return only
after you’ve undergone a medical evaluation.
The takeaway
Decompression sickness can
be a dangerous condition, and it needs to be treated immediately. Luckily, it’s
preventable in most cases by following safety measures.
For scuba divers, there’s
protocol in place to prevent decompression sickness. That’s why it’s important
to always dive with a group led by an experienced dive maste
Jan Ricks Jennings, MHA,
LFACHE
Senior Consultant
Senior Management Resoucres,
LLC
October 30, 2022
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