What causes decompression sickness. Decompression Sickness: Causes, Risks, and Manifestations in Diving and High-Altitude Activities
What are the main causes of decompression sickness. How does decompression illness affect divers and other individuals. What are the risk factors associated with decompression sickness. How do arterial gas embolism and decompression sickness differ. What are the common manifestations of decompression sickness.
Understanding Decompression Illness: A Comprehensive Overview
Decompression illness (DCI) is a complex condition associated with a reduction in ambient pressure surrounding the body. It encompasses two distinct yet related conditions: decompression sickness (DCS) and arterial gas embolism (AGE). Both can have serious consequences for those affected, particularly in diving and high-altitude activities.
DCS results from the formation of bubbles in body tissues, causing localized damage. AGE, on the other hand, occurs when bubbles enter arterial circulation, potentially blocking blood flow at the small vessel level and causing tissue damage. Understanding the differences between these two conditions is crucial for proper diagnosis and treatment.
Who is at risk for decompression illness?
DCI primarily affects individuals engaged in activities involving pressure changes, such as:
- Scuba divers
- Aviators
- Astronauts
- Compressed-air workers
While the main risk factor is a reduction in ambient pressure, several other factors can increase the likelihood of developing DCI.
Risk Factors for Decompression Sickness in Diving
Understanding the risk factors associated with DCS is essential for divers and medical professionals alike. The known risk factors for divers include:
- Deep or long dives
- Cold water exposure
- Heavy exercise at depth
- Rapid ascents
Rapid ascents are particularly significant in contributing to the risk of AGE. However, there are other factors that may increase DCI risk, although conclusive evidence of association is still lacking:
- Obesity
- Dehydration
- Heavy exercise immediately after surfacing
- Pulmonary disease
It’s important to note that individual risk factors are not yet fully understood. Some divers may experience DCI more frequently than others, even when following identical dive profiles.
Can any dive profile result in decompression illness?
Yes, almost any dive profile can potentially result in DCI, regardless of how safe it may appear. The interplay of known and unknown risk factors can influence the probability of DCI in various ways. This is why the evaluation of a diver for possible decompression illness is conducted on a case-by-case basis, taking into account the diver’s signs, symptoms, and dive profiles.
The Mechanism of Decompression Sickness
DCS, also known as “the bends” or caisson disease, results from inadequate decompression following exposure to increased pressure. The severity of DCS can vary from mild cases that do not pose an immediate threat to serious injuries requiring prompt treatment.
How does nitrogen absorption contribute to decompression sickness?
During a dive, body tissues absorb nitrogen (and/or other inert gases) from the breathing gas in proportion to the surrounding pressure. As long as the diver remains at pressure, this absorbed gas does not cause problems. However, if the pressure is reduced too quickly, the nitrogen may come out of solution and form bubbles in the tissues and bloodstream.
These bubbles can form even when divers follow accepted guidelines, not just when prescribed limits are violated. Bubbles forming in or near joints are believed to be the cause of joint pain, commonly referred to as “the bends.”
What happens in severe cases of decompression sickness?
In cases with high levels of bubble formation, complex reactions can occur in the body. The spinal cord and brain are often affected, leading to various symptoms:
- Numbness
- Paralysis
- Impaired coordination
- Disorders of higher cerebral function
If a large number of bubbles enter the venous bloodstream, it can result in congestive symptoms in the lungs and potentially lead to circulatory shock.
Arterial Gas Embolism: A Serious Form of Decompression Illness
Arterial Gas Embolism (AGE) is considered the more serious form of DCI. It occurs when a diver ascends without exhaling, causing air trapped in the lungs to expand and potentially rupture lung tissue. This injury, known as pulmonary barotrauma, releases gas bubbles into the arterial circulation.
How does arterial gas embolism affect the body?
Once in the arterial circulation, gas bubbles are distributed to body tissues in proportion to blood flow. The brain, receiving the highest proportion of blood flow, is the main organ where bubbles may interrupt circulation if they become lodged in small arteries.
AGE can occur even if the ascent was completely normal, although it’s more likely in cases of panicked ascents or when a diver holds their breath during ascent. Individuals with pulmonary diseases, such as obstructive lung disease, may have an increased risk of AGE.
What are the immediate signs of arterial gas embolism?
In severe cases of AGE, a diver may:
- Surface unconscious and remain so
- Lose consciousness within 10 minutes of surfacing
These situations are true medical emergencies and require rapid evacuation to a treatment facility. However, AGE can also present with milder symptoms of neurological dysfunction, such as:
- Tingling or numbness sensations
- Weakness without obvious paralysis
- Difficulty in thinking without apparent confusion
In these milder cases, there is time for a more thorough evaluation by a diving medical specialist to rule out other causes.
Manifestations of Decompression Sickness
The manifestations of DCS can vary widely in severity and presentation. Understanding these symptoms is crucial for early detection and treatment.
What are the most common symptoms of decompression sickness?
The most frequently reported manifestations of DCS include:
- Joint pain
- Numbness or tingling
- Muscular weakness
- Inability to empty a full bladder
Severe cases of DCS are typically easy to identify due to the apparent nature of the signs and symptoms. However, it’s important to note that most cases of DCS manifest subtly, often presenting as minor joint aches or paresthesia (an abnormal burning or prickling sensation).
The Importance of Prompt Treatment for Decompression Illness
Timely treatment of decompression illness is crucial for the best possible outcome. The sooner treatment begins, the better the chance for a full recovery.
Why is early treatment critical for decompression sickness?
Early treatment is essential because:
- It can prevent the progression of symptoms
- It reduces the risk of long-term complications
- It improves the chances of a complete recovery
Even in cases where symptoms appear to resolve spontaneously, seeking medical evaluation is crucial. Untreated DCS or AGE can lead to residual damage, potentially making future incidents more severe or harder to treat.
Prevention and Safety Measures for Decompression Illness
While it’s impossible to completely eliminate the risk of decompression illness, there are several measures that can be taken to reduce the likelihood of its occurrence.
How can divers reduce their risk of decompression sickness?
Divers can take the following precautions:
- Strictly adhere to dive tables or computer recommendations
- Ascend slowly and perform safety stops
- Avoid pushing the limits of no-decompression diving
- Stay well-hydrated before and after diving
- Avoid alcohol consumption before and immediately after diving
- Maintain good physical fitness
- Avoid heavy exercise immediately before or after diving
Additionally, divers should be aware of their personal risk factors and adjust their diving practices accordingly.
Advancements in Decompression Illness Research and Treatment
Ongoing research in the field of diving medicine continues to enhance our understanding of decompression illness and improve treatment protocols.
What recent advancements have been made in treating decompression illness?
Recent advancements include:
- Improved recompression chamber protocols
- Development of more sophisticated dive computers
- Better understanding of the physiological processes involved in bubble formation
- Research into pharmacological interventions to reduce bubble formation
These advancements are helping to make diving safer and improving outcomes for those affected by decompression illness.
Decompression illness remains a significant concern in diving and other activities involving pressure changes. By understanding the causes, risk factors, and manifestations of this condition, individuals can take appropriate precautions and seek timely treatment when necessary. As research continues, we can expect further improvements in prevention strategies and treatment methods, making these activities safer for all participants.
Decompression Illness – Divers Alert Network
Decompression illness, or DCI, is associated with a reduction in the ambient pressure surrounding the body. DCI encompasses two diseases, decompression sickness (DCS) and arterial gas embolism (AGE). DCS results from bubbles in body tissues causing local damage. AGE occurs when bubbles enter arterial circulation, traveling through the arteries and potentially causing tissue damage by blocking blood flow at the small vessel level.
Who Gets Decompression Illness?
Decompression illness affects scuba divers, aviators, astronauts and compressed-air workers. The main risk factor for DCI is a reduction in ambient pressure, but other risk factors will increase the likelihood of DCI occurring. The known risk factors for divers are deep or long dives, cold water, heavy exercise at depth, and rapid ascents.
Rapid ascents contribute significantly to the risk of AGE. Other factors that may increase DCI risk but lack conclusive evidence of association are obesity, dehydration, heavy exercise immediately after surfacing, and pulmonary disease. We don’t yet fully understand possible individual risk factors. Some divers get DCI more frequently than others despite following the same dive profile.
Almost any dive profile can result in DCI, no matter how safe it seems. The risk factors, both known and unknown, can influence the probability of DCI in many ways. Evaluation of a diver for possible decompression illness is done on a case-by-case basis. The diver’s signs, symptoms and dive profiles are all considered when making a diagnosis.
Decompression Sickness
DCS (also called the bends or caisson disease) results from inadequate decompression following exposure to increased pressure. In some cases, it is mild and not an immediate threat. In other cases, a serious injury occurs. The sooner the treatment of an injury begins, the better the chance for a full recovery.
During a dive, the body tissues absorb nitrogen (and/or other inert gases) from the breathing gas in proportion to the surrounding pressure. As long as the diver remains at pressure, the gas presents no problem. If the pressure is reduced too quickly, the nitrogen may come out of solution and form bubbles in the tissues and bloodstream. Bubbles may occur as a result of violating prescribed limits, but it can also happen even when following accepted guidelines.
Bubbles forming in or near joints are the presumed cause of joint pain (the bends). With high levels of bubbles, complex reactions can take place in the body. The spinal cord and brain are usually affected, causing numbness, paralysis, impaired coordination and disorders of higher cerebral function. If large numbers of bubbles enter the venous bloodstream, congestive symptoms in the lung, and eventually circulatory shock, can occur.
Arterial Gas Embolism
If a diver ascends without exhaling, air trapped in the lungs expands and may rupture lung tissue. This injury, called pulmonary barotrauma, involves release of gas bubbles into the arterial circulation. Circulation distributes them to body tissues in proportion to the blood flow. Since the brain receives the highest proportion of blood flow, it is the main organ in which bubbles may interrupt circulation if they become lodged in small arteries.
This circulation interruption is AGE, considered the more serious form of DCI. The diver may have made a panicked ascent or held their breath during ascent. However, AGE can occur even if the ascent was completely normal. Pulmonary diseases such as obstructive lung disease may increase the risk of AGE.
A diver may surface unconscious and remain so or lose consciousness within 10 minutes of surfacing. These cases are true medical emergencies and require rapid evacuation to a treatment facility.
AGE may involve minor symptoms of neurological dysfunction, such as sensations of tingling or numbness, weakness without obvious paralysis, or complaints of difficulty in thinking but no apparent confusion. In these cases, there is time for a more thorough evaluation by a diving medical specialist to rule out other causes.
Like DCS, mild symptoms may appear to be due to causes other than diving, which can delay treatment. Symptoms may resolve spontaneously, and the diver may not seek treatment. The consequences of this are similar to untreated DCS. Residual brain damage may occur, making it more likely there will be residual symptoms after a future AGE — even after treating the later instance.
Manifestations
DCS
The most common manifestations of DCS are joint pain and numbness or tingling. The next most common are muscular weakness and inability to empty a full bladder. Severe DCS is easy to identify because the signs and symptoms are apparent. However, most DCS manifests subtly with a minor joint ache or paresthesia (an abnormal burning or tingling sensation) in an extremity.
Signs and Symptoms
DCS
- Unusual fatigue
- Skin itch
- Pain in joints or arm, leg or torso muscles
- Dizziness or vertigo
- Ringing in the ears
- Numbness, tingling and/or paralysis
- Shortness of breath
- A blotchy rash
- Muscle weakness or paralysis
- Difficulty urinating
- Confusion, personality changes or bizarre behavior
- Amnesia
- Tremors
- Staggering
- Coughing up bloody, frothy sputum
- Unconsciousness or collapse
Note: Signs and symptoms usually appear within 15 minutes or up to 12 hours after surfacing. In severe cases, symptoms may appear before surfacing or immediately afterward. Delayed onset of symptoms is rare but can happen, especially if air travel follows diving. In many cases, these symptoms are ascribed to another cause such as overexertion, heavy lifting or even a tight wetsuit. Sometimes these symptoms remain mild and resolve by themselves, but they may increase in severity until it is obvious that something is wrong and help is needed.
AGE
- Dizziness
- Visual blurring
- Areas of decreased sensation
- Chest pain
- Disorientation
- Bloody froth from mouth or nose
- Paralysis or weakness
- Convulsions
- Unconsciousness
- Cessation of breathing
- Death
Preventing Decompression Illness
DCS
Recreational divers should dive conservatively, whether they are using dive tables or computers. Experienced divers sometimes select a table depth (rather than actual depth) of 10 feet (3 meters) deeper than called for by standard procedure. This practice is recommended for all divers, especially when diving in cold water or under strenuous conditions. Divers should be cautious about approaching no-decompression limits, especially when diving deeper than 100 feet (30 meters).
Avoiding the risk factors described above will decrease the risk of DCS. Flying or other exposure to altitude too soon after diving can also increase the risk of decompression sickness as explained in Flying After Diving.
AGE
Always relax and breathe normally during ascent. Lung conditions such as asthma, infections, cysts, tumors, scar tissue from surgery, or obstructive lung disease may predispose a diver to AGE. If you have any of these conditions, consult a physician with experience in diving medicine before you dive.
Treatment
The treatment for decompression illness is recompression. Early management of AGE and DCS is the same. It is essential that a diver with AGE or severe DCS to be stabilized at the nearest medical facility before being transported to a chamber.
Early oxygen first aid is essential and may reduce symptoms, but this should not change the treatment plan. Symptoms of AGE and severe DCS often resolve after breathing oxygen from a cylinder, but they may reappear later. Always contact DAN or a physician trained in dive medicine in cases of suspected decompression illness — even if the signs and symptoms appear resolved.
Delays in seeking treatment elevate the risk of residual symptoms. Over time the initially reversible damage may become permanent. After a delay of 24 hours or more, treatment may be less effective, and symptoms may not respond. Even if there has been a delay, consult a diving medical specialist before making any conclusions about possible treatment effectiveness.
After Treatment
There may be residual symptoms after treatment. Soreness in and around an affected joint is common and usually resolves in a few hours. If the DCI was severe, there could be significant residual neurological dysfunction. Follow-up treatments, along with physical therapy, can help. The usual outcome is eventual complete relief from all symptoms with prompt treatment.
With severe DCS, you may have a permanent residual effect such as bladder dysfunction, sexual dysfunction or muscular weakness, to name a few.
In some cases of neurological DCS, there may be permanent damage to the spinal cord, which may or may not cause symptoms. However, this type of injury may decrease the likelihood of recovery from a subsequent bout of DCS.
Untreated joint pain that subsides could cause small areas of bone damage (osteonecrosis). If this happens through repeated instances of DCS, there may be enough damage to cause the bone to become brittle, or for joints to collapse or become arthritic.
Responding to DCI
Determine the Urgency of the Injury
Make an initial evaluation at the dive site. You can suspect decompression illness if you notice any of the signs or symptoms listed above within 24 hours of surfacing from a dive. While waiting for professional medical care or evacuation, take as detailed a history as possible and try to evaluate and record the diver’s neurological status. Base your response on one of these three categories depending upon the symptoms: emergency, urgent or timely.
If necessary, you can administer first aid within the scope of your training, as described below.
Emergency
Symptoms are severe and appear within an hour or so of surfacing. The diver may lose consciousness. Symptoms might progress, and the diver is obviously ill. The diver may be profoundly dizzy or have trouble breathing. Neurological symptoms may manifest as altered consciousness, abnormal gait or weakness.
If necessary (e.g., if the diver isn’t breathing and has no pulse), begin CPR and take immediate action to have the diver evacuated. Check for foreign bodies in the airway. If they need ventilatory or cardiac resuscitation, the injured diver should be lying on their back. Vomiting in this position is dangerous; if it happens, turn the diver to the side until the airway is clear and resuscitation can resume in the supine position. While awaiting evacuation, take as detailed a history as possible and try to evaluate and record the diver’s neurological status.
Use supplemental oxygen while administering breaths to increase the percentage of oxygen breathed by the injured diver. Even if CPR is successful and the diver regains consciousness, continue administering 100 percent oxygen until the diver arrives at a medical facility and health care professionals assume care.
Urgent
The only noticeable symptom is severe pain that is unchanging or has progressed slowly over a few hours. The diver does not appear to be in distress except for the pain, and the neurological signs and symptoms are not evident without a careful history and examination.
Administer 100 percent oxygen and give fluids by mouth. Do not attempt to treat the pain with analgesics until advised to do so by medical personnel. Continue providing oxygen until arrival at the medical treatment facility.
Timely
Symptoms are either not visible or have progressed slowly for several days. The main signs or symptoms are vague complaints of pain or an abnormal sensation, which could indicate something other than DCI. Obtain as complete a diving history as possible and do a neurological evaluation. Then go to the nearest medical facility for evaluation.
Get the Dive History
If possible, obtain and document the following information for all suspected cases of decompression illness:
- All dives (depth, time, ascent rates, surface intervals, breathing gases) for 48 hours preceding the injury. Also note problems or symptoms at any time before, during or after the dive.
- Symptom onset times and progression after surfacing from the last dive
- All first aid measures (including times and method of emergency oxygen delivery) and their effect on symptoms
- Results of an on-site neurological examination
- All joint or other musculoskeletal pain including location, intensity and changes with movement or weight-bearing maneuvers
- Description and distribution of any rashes
- Any traumatic injuries before, during or after the dive.
On-Site Neurological Examination
Information regarding the injured diver’s neurological status will be useful to medical personnel. Examination of an injured diver’s central nervous system soon after an accident may be valuable to the treating physician.
The exam is easy to learn, and individuals with no medical experience can perform it. Do as much of the examination as possible, but do not let it interfere with prompt evacuation to a medical treatment facility. (Find the instructions at On-Site Neurological Examination.)
Medical Evaluation
Call local EMS to get the diver to the nearest medical facility.
Returning to Diving after DCI
For recreational divers, whose livelihood is something other diving, a conservative approach will help minimize the chance that a diving injury will recur.
- After pain-only DCI without neurological symptoms, you can consider a return to diving after a minimum of two weeks.
- With minor neurological symptoms, consider returning after six weeks.
- If you had severe neurological symptoms or have any residual symptoms, you should not return to diving.
You should always consult with a physician before returning to diving. Even if symptoms were not severe and they resolved completely, if you have had multiple instances of decompression illness, you must make special considerations. If you are getting DCI when other divers who dive the same profile are not, you may have elevated susceptibility. In these cases, consult a dive medicine specialist to determine if you can safely resume diving.
Ed Thalmann, M.D.
What to Know About Decompression Sickness
Decompression sickness is a type of injury that occurs when there’s 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 (DCS), 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.
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.
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.
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.
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.
Contact emergency services
Call local emergency services or DAN’s 24-hour emergency line at +1-919-684-9111.
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.
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.
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.
Was this helpful?
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 master.
causes, symptoms and treatment of decompression sickness
Contents
- 1 Decompression sickness: causes, symptoms and treatment of decompression sickness
- 1. 1 Decompression sickness decompression sickness: what is it?
- 1.2 Occurrence of decompression sickness
- 1.3 Symptoms of decompression sickness
- 1.4 Treatment of decompression sickness and decompression sickness
- 1.5 Complications of decompression sickness
- 1.6 How to prevent decompression sickness illness
- 1.7 Rules for safe diving
- 1.8 How to choose the right diving equipment?
- 1.8.1 Choice of mask and fins
- 1.8.2 Suitable suit
- 1.8.3 Breathing regulator
- 1.8.4 Accessories
- 1.8.5 Handbooks and training
900 33
- 1.9 Who is at risk for decompression sickness? illness?
- 1.10 Special considerations for deep water diving
- 1.10.1 Relevant training required
- 1.10.2 Periodic stops to restore pressure
- 1.10.3 The need to control the depth of the dive
- 1.10.4 Use of appropriate equipment
- 1.11 Types of decompression sickness
9 0005 1. 12 Related videos:
- 1.13 Q&A:
- 1.13.0.1 What is decompression sickness?
- 1.13.0.2 How does decompression sickness develop?
- 1.13.0.3 How does a person feel when suffering from decompression sickness?
- 1.13.0.4 What factors influence the likelihood of developing decompression sickness?
- 1.13.0.5 What kind of care should be provided if decompression sickness is suspected?
- 1.13.0.6 Is it possible to prevent decompression sickness?
Decompression sickness, or decompression sickness, is a serious illness that can occur in deep divers. The article will talk about the causes, symptoms and methods of treatment of this disease.
Decompression sickness or decompression sickness is a disease that results from prolonged exposure to deep water or air. It can manifest itself in underwater divers, pilots or workers working at great depths.
This condition is caused by decompression – a decrease in pressure on the body due to reduced ambient pressure. This results in the release of gases into the tissues that are normally dissolved in blood and other bodily fluids. As a result, the gas lingers in the tissues and is difficult to be excreted from the body, which causes serious disturbances in the functioning of organs and systems.
In this article we will look at the symptoms, causes and ways to prevent this disease, as well as give advice on the treatment of decompression sickness and the measures that must be taken to prevent its occurrence.
Health is the most important thing. Therefore, you should never forget about precautions and follow safety rules in order to avoid decompression sickness and other dangers that may lie in wait for us in extreme conditions.
Decompression sickness decompression sickness: what is it?
Decompression sickness Decompression sickness is a disease that occurs in people working in a small deck (caisson) at great depths. It develops due to a sharp change in pressure, which leads to the formation of gas bubbles in the tissues and blood of the body. Polar and marine explorers, as well as the military, may experience decompression sickness.
Symptoms of decompression sickness
- Pain in joints and muscles;
- Feeling of numbness in the limbs;
- Dizziness and headache;
- Hearing and visual impairment.
Prevention and treatment of decompression sickness
One of the most effective ways to prevent decompression sickness is to follow the rules of decompression (transition to a higher level of pressure), which depend on underwater work and depth. In case of symptoms, it is necessary to consult a doctor as soon as possible, who will prescribe a course of oxygen and other types of therapy.
Given that decompression sickness is a very serious condition, do not ignore the symptoms when working at great depths. Follow the rules of decompression and get regular medical check-ups to prevent any possible complications and maintain your health.
Occurrence of decompression sickness
Decompression sickness is a disease that occurs in people who quickly rise to the surface from depths where gas pressure was higher. This leads to the appearance of microbubbles of gas in the blood and tissues of the human body.
Decompression sickness can present with various symptoms: joint pain, itchy skin, headache, nausea, etc. However, it can lead to serious complications such as paralysis and loss of consciousness.
Decompression sickness can be avoided by observing the rules for bringing to the surface from the depths, as well as regularly taking decompression therapy courses.
Symptoms of decompression sickness
Decompression sickness, or decompression sickness, is a serious condition that often develops in divers and underwater workers. It is caused by an incorrect distribution of inert gases in tissues and blood with a decrease in pressure in the environment.
Symptoms of decompression sickness may include severe pain in the joints, muscle weakness, numbness and burning in the extremities, dizziness, headache, nausea and vomiting, as well as depression and disorders of the nervous system.
In some cases, symptoms may appear immediately after surfacing, while in other cases they may take several hours or even days to develop. Symptoms may also depend on which part of the body is affected and how far it has progressed.
- Pain in joints and bones: these symptoms can appear in different parts of the body and may be accompanied by swelling, redness and fever at the site of the lesion.
- Nervous symptoms: These include dizziness, headache, visual and hearing disturbances, tinnitus, unsteady gait, etc.
- Respiratory symptoms: These include stiffness and pain in the chest, lack of air, rapid breathing, etc.
If you notice symptoms of decompression sickness, contact your doctor immediately. The sooner the disease is diagnosed, the better the chances of its successful treatment and the avoidance of serious complications.
Treatment of decompression sickness and decompression sickness
Decompression sickness and decompression sickness result from a sudden change in atmospheric pressure, which can occur when diving to depth or entering open space after working at depth. The treatment of these diseases should be immediate and comprehensive, including both medications and special procedures.
- First of all, you should seek medical help at a specialized medical institution.
- Special oxygen chambers and hyperbaric oxygen therapy will help improve blood circulation and metabolism.
- Additionally, anti-inflammatory drugs, antibiotics and other drugs may be prescribed, depending on the specific symptoms and complexity of the disease.
- It is important to take into account the specifics of the individual case and to recommend to the patient a sufficiently long period of rest after treatment.
Self-treatment is not recommended, as improper treatment can lead to negative consequences and even death. In case of signs of decompression sickness and decompression sickness, it is imperative to seek medical help and be persistent in demanding quality treatment. Early treatment and a competent approach to restoring health can significantly reduce the consequences of the disease and ensure a full recovery process.
Complications of decompression sickness
Complications of decompression sickness may vary, but they are all associated with violation of decompression rules and non-compliance with safety procedures when working underwater. One of the most serious complications of the central nervous system is symptomatic decompression sickness, which can lead to paralysis, loss of consciousness, and in some cases death.
In addition, with decompression sickness, the development of complications from the bone tissue is possible. Decompression sickness can cause bone destruction, which can lead to osteonecrosis, osteomyelitis, and other bone and joint disorders.
To avoid the complications of decompression sickness, it is necessary to strictly follow all safety rules for working underwater and decompression tables to bring the body back to normal after diving. It is also important not to exceed the recommended diving depth and not stay underwater for too long.
- Important to remember: decompression sickness is a serious disease that can lead to complications, including death.
- At the first signs of decompression sickness, you should immediately consult a doctor to avoid serious complications.
- To avoid decompression sickness, you must strictly follow the safety rules and decompression tables , and also do not exceed the recommended diving depth and do not stay underwater for too long.
How to Prevent Decompression Sickness
Decompression sickness, also known as decompression sickness, is a serious condition that can occur when air pressure changes dramatically when diving to depth. It can lead to a variety of symptoms, including joint and muscle pain, dizziness, and difficulty breathing. However, you can take some steps to prevent this disease.
- Keep yourself in good shape: Being physically fit can reduce your risk of developing decompression sickness. Exercise and don’t smoke.
- Follow the correct lifting procedure: When lifting, follow the correct procedure. Do not rise to the surface too quickly.
- Avoid alcohol and drugs that can affect blood pressure: When ascending, avoid taking any alcoholic beverages or drugs that can affect blood pressure, as this may increase the risk of decompression sickness.
In any case, it is recommended that you take scuba diving training and certification. Never risk your health and life, be provided with qualified assistance if necessary.
Dive Safety Rules
When preparing for a dive, you should be familiar with weather conditions, local conditions of the water and hazards. It is important to connect with your dive partner and check your equipment as well as your partner’s.
When ascending to the surface, make sure that breathing is smooth and rhythmic. Do not suddenly switch to a more intense breathing rhythm. It is important to remember that when lifting from a depth, you must follow the rule of safe lifting: do not climb faster than 9-10 meters per minute and make mandatory stops at different depths.
The safety of other divers must also be kept in mind. It is necessary to easily communicate with a partner and help him if necessary. It is strictly forbidden to leave a partner unassisted or to follow him if he admitted to being uncomfortable or incapable of continuing the dive.
- Familiarize yourself with the weather and local conditions
- Check your equipment and your partner’s equipment
- Monitor your feelings and the condition of your equipment
- Ascent to the surface – smooth and rhythmic
- Observe the rule of safe ascent
- Help partner and not leave him without help
How to choose the right diving equipment?
Selecting a mask and fins
When choosing a mask, attention must be paid to its tightness and glass size in order to ensure a good view underwater. Fins should support the foot, not create discomfort and provide good maneuverability.
Suitable suit
A reliable, sealed suit should provide comfort in cold water, protect against injury and provide buoyancy. The choice of material depends on the conditions of bathing and the specific needs of the diver.
Breathing regulator
It is difficult to determine the capacity of the breathing regulator, so it is recommended to turn to professionals. The main requirement is the reliability and safety of work.
Accessories
For more comfort and safety, additional items may be required: a diving computer, ballast compensators, lighting, etc. In this case, it is important not only to choose the right equipment, but also not to overload yourself.
References and training
Remember that it is important not only to buy equipment, but also to know how to use it. Therefore, before buying or using it, refer to reference materials and training courses for complete information about safe diving.
Who is at risk for decompression sickness?
Decompression sickness decompression sickness is a disease that can occur in people who frequently undergo long, deep dives in water, such as when diving or working underwater. This mainly concerns professional divers and workers on oil platforms, but the risk of getting sick also increases with recreational diving and other outdoor activities in the water.
It is also worth considering that the risk of decompression sickness and decompression sickness increases if the decompression procedure is not performed correctly, which prevents the development of the disease. Therefore, it is important to follow the recommendations of the instructor or safety specialist during the dive and not violate the safety rules when immersing in water.
Features of deep water diving
The need for appropriate training
Diving in deep water requires special attention to physical and psychological preparation. Appropriate training should be provided, including training in breathing techniques, studying the characteristics of the internal environment of the caisson and safety rules.
Periodic stops to restore pressure
When diving to great depths, it is necessary to make periodic stops at various levels to restore pressure. Otherwise, the risk of developing decompression sickness increases.
The need to control diving depth
When diving in deep waters, depth is one of the most important parameters. It is necessary to accurately control the depth and time spent in the depths. Loss of control can lead to various complications, such as decompression sickness.
Using the right equipment
When diving in deep water, you must use the right equipment. It is important to choose the right wetsuit, shoes, ribbed ballast, flashlight and other necessary items. Preparing for a dive begins with choosing equipment that can provide safety and comfort when going to great depths.
Types of decompression sickness
Decompression sickness is a group of diseases that can occur when there is a sudden change in atmospheric pressure. There are several types of decompression sickness, each of which manifests itself in its own way.
- Decompression sickness – occurs in submerged people who rise to the surface too quickly. Its symptoms: pain in the joints and muscles, convulsions, nausea, dizziness, heart rhythm disturbances.
- Flight decompression sickness – occurs in pilots who are at high altitude without a suit or when it is not properly used. Its symptoms: weakness, nausea, dizziness, depression of consciousness.
- Burn disease – occurs when using a hyperbaric chamber. Its symptoms: severe headaches, nausea, convulsions, impaired coordination of movements.
All types of decompression sickness are serious and can lead to complications if not treated promptly. Therefore, if you suspect decompression sickness, seek immediate medical attention.
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Q&A:
What is decompression sickness?
Decompression sickness is a decompression sickness that develops in workers who periodically dive to depths of 20 to 50 meters in bodies of water used to fill and drain groundwater.
How does decompression sickness develop?
Decompression sickness develops as a result of a rapid transition from high pressure at depth to atmospheric pressure at the surface. When lifting, poorly dissolved gases in the tissues (mainly nitrogen) come out of solution with the formation of gas bubbles, which can cause various symptoms and complications.
What does a person feel when suffering from decompression sickness?
Symptoms of decompression sickness may include joint and muscle pain, weakness, dizziness, incoordination, nausea, vomiting, shortness of breath, convulsions, and loss of consciousness.
What factors influence the likelihood of decompression sickness?
Factors that may increase the likelihood of developing decompression sickness include deep diving, long dive duration, repeated dives over a day or several days, insufficient decompression time between dives, high water temperature, significant effort.
What kind of assistance should be provided if decompression sickness is suspected?
If a person is suspected of having decompression sickness, medical attention should be provided immediately. Treatment includes decompression, oxygen therapy, extraction of gas bubbles from the circulatory system, and symptomatic therapy.
Is it possible to prevent decompression sickness?
Decompression sickness can be prevented by following safe diving practices and training. In addition, it is important to monitor the depth of the dive, the duration and frequency of the dives, and to provide suitable breaks between them for decompression.
Decompression sickness – a directory of diseases – HealthInfo
Description |
Decompression sickness (caisson sickness) is a condition in which bubbles form from gases dissolved in the blood and tissues, blocking the flow of blood, causing pain and other symptoms. Gas bubbles form when a person moves from a high-pressure environment to a low-pressure environment, such as when rising from a dive. |
Symptoms |
The most common symptom is pain. Usually it occurs in the joints of the arms or legs or near the joints, but often the patient finds it difficult to accurately describe both the location and nature of the pain and uses such expressions as “deep” and “irritation within the bone.” In other cases, the pain is acute and the patient clearly indicates its localization. At first, the pain is mild or intermittent, but gradually becomes more severe. Usually the affected joint is painless on palpation, not inflamed, and its mobility is not impaired. Neurological symptoms range from mild numbness to impaired brain function. The spinal cord is especially often affected: if oxygen treatment and recompression are not started quickly, then after minor symptoms (such as weakness or tingling in the arm or leg), irreversible paralysis can occur. Sometimes the inner ear is affected, which is accompanied by severe dizziness. Less common symptoms include itching, skin rash and severe fatigue. Marbling of the skin, a very rare symptom, may precede or accompany the development of dangerous conditions that require recompression. Abdominal pain may be caused by the formation of gas bubbles in the vessels of the abdominal organs, but girdle pain may indicate damage to the spinal cord. Long-term effects of decompression sickness include bone destruction (dysbaric osteonecrosis, aseptic bone necrosis), especially in the humerus and femur, accompanied by constant pain and severe disability. These injuries are much more common among people working in a compressed air environment than among divers, probably due to the fact that the former are exposed to longer periods of high pressure and do not always receive proper treatment. Such damage (often gradually worsening over several months or years) can be caused by even one incorrect decompression. By the time symptoms appear, it is too late to take preventive measures. Irreversible neurological damage, such as partial paralysis, usually results from late or inadequate treatment of spinal cord injury. However, sometimes the damage is too severe and difficult to repair even with adequate treatment. If the spinal cord is damaged, the condition of a person is facilitated by repeated sessions of oxygen treatment in a pressure chamber. Spinal cord injury caused by decompression is much more likely to be reversible than if it was caused by other causes. Pulmonary decompression sickness is a rare and dangerous condition caused by gas bubbles blocking many of the blood vessels in the lungs. In some people, the condition resolves without treatment, but in others it progresses rapidly to circulatory failure and, if not recompressed promptly, leads to death. Early symptoms are chest discomfort and coughing after taking a deep breath or inhaling tobacco smoke. |
All symptoms: cough, joint pain, paralysis of the limbs, bone pain, numbness, tingling, weakness or even paralysis of the legs, difficulty breathing |
Causes |
The classic symptoms and the transition from high pressure to low pressure (when ascending from depth) make it possible to suspect decompression sickness and immediately begin treatment. Decompression sickness rarely occurs if the diver follows the “no decompression” limit or strictly follows the decompression table regimen. However, divers are not always able to accurately estimate the depth, duration and decompression time of a dive. Many divers, mistakenly believing that decompression tables have a large margin of safety, do not follow them exactly. Newer rate of ascent manuals that are intended for divers give safer limits, but they can also be misinterpreted. So, decompression tables and computers, as a rule, do not take into account the characteristics of the body of women and the elderly. Many divers, while generally following tables or computers as they ascend, make an additional stop of a few minutes at a depth of approximately 5 m below the surface to increase safety. Repetitive diving can also cause decompression sickness. After each dive, an excess of gas remains in the body, so with each subsequent dive, its amount increases. If the interval between dives is less than 12 hours, the diver should follow the instructions in the manuals, such as decompression tables, which take into account additional gas accumulation. Diving in waters located at high altitudes, as well as air travel after such a dive, require special precautions. Thus, before flying or traveling at high altitude, after several days of diving, it is usually recommended to spend 24 hours at normal altitude. |
Diagnostics |
The classic symptoms and the transition from high pressure to low pressure (when ascending from depth) make it possible to suspect decompression sickness and immediately begin treatment. |
Treatment |
Decompression sickness requires recompression in a hyperbaric chamber, in which the pressure is gradually increased so that the gas bubbles decrease in size and dissolve. Accordingly, normal blood circulation and oxygen supply to damaged tissues are restored. After recompression, the pressure is gradually, with stops, reduced, and at this time excess gases are removed from the body. The victim must be urgently transported to a medical facility with a pressure chamber. All other procedures can be carried out during transport, or they can be postponed without risk to the life of the victim. Transport should not be delayed, even if the symptoms seem mild, as more serious problems may develop later. Recompression usually makes sense no matter how much time has passed since the injury. “Unnecessary” recompression carries much less risk than any other intervention in the hope that the victim’s condition will improve without recompression. |