What are the causes of decompression sickness. How can divers prevent the bends. What are the symptoms of decompression sickness. How is the bends diagnosed and treated. Who is at higher risk for developing decompression illness.

What is Decompression Sickness (The Bends)?

Decompression sickness, commonly known as “the bends,” is a condition that can affect scuba divers, deep-sea divers, and individuals exposed to rapid changes in air pressure. This potentially serious condition occurs when dissolved gases, primarily nitrogen, form bubbles in the blood and tissues as pressure decreases too quickly.

The term “the bends” originated from the characteristic posture adopted by afflicted individuals due to severe joint pain, often causing them to bend over in discomfort. Understanding the mechanics, risks, and prevention of decompression sickness is crucial for anyone engaging in activities that involve pressure changes.

The Science Behind Decompression Sickness

To comprehend decompression sickness, it’s essential to understand the underlying physiological processes:

• During a dive, the body absorbs nitrogen from compressed air due to increased pressure at depth.
• As a diver ascends, the surrounding pressure decreases.
• If the ascent is too rapid, nitrogen can’t be eliminated properly and forms bubbles in tissues and blood.
• These bubbles can cause various symptoms and potentially lead to serious health complications.

The formation of nitrogen bubbles in the body is analogous to opening a carbonated beverage. When you open a soda can, the sudden pressure decrease causes dissolved gas to come out of solution, forming bubbles. Similarly, in decompression sickness, nitrogen bubbles emerge from the bloodstream and tissues, potentially causing damage to blood vessels and obstructing normal blood flow.

Risk Factors for Decompression Sickness

Several factors can increase an individual’s susceptibility to decompression sickness:

• Age: Being over 30 years old
• Gender: Females may be at higher risk
• Physical condition: Low cardiovascular fitness and high body fat percentage
• Lifestyle factors: Alcohol consumption and tobacco use
• Health status: Fatigue, seasickness, or sleep deprivation
• Environmental factors: Diving in cold water
• Pre-existing conditions: Heart defects, lung disease, or current injuries

Individuals with certain heart defects, such as patent foramen ovale, atrial septal defect, or ventricular septal defect, are at particularly high risk. These conditions can allow bubbles to bypass the lungs’ filtering system and enter the arterial circulation, potentially leading to more severe complications.

How do heart defects increase the risk of decompression sickness?

Heart defects that create abnormal openings between heart chambers can exacerbate the effects of decompression sickness in several ways:

1. They allow venous blood (and potentially nitrogen bubbles) to bypass the lungs and enter the arterial system directly.
2. This can lead to a higher concentration of nitrogen bubbles in vital organs and tissues.
3. In severe cases, large air bubbles (embolisms) may enter the arteries, potentially causing a stroke.

Recognizing the Symptoms of Decompression Sickness

Decompression sickness can manifest in various ways, and symptoms may appear immediately after surfacing or up to 24 hours later. Common symptoms include:

• Joint pain (often severe and described as a deep ache)
• Dizziness and vertigo
• Headache
• Cognitive impairment or confusion
• Extreme fatigue
• Tingling or numbness in extremities
• Weakness in arms or legs
• Skin rashes or mottling

In more severe cases, decompression sickness can lead to neurological symptoms, respiratory difficulties, or even loss of consciousness. It’s crucial to recognize these symptoms early and seek immediate medical attention if decompression sickness is suspected.

Can decompression sickness affect different body systems?

Yes, decompression sickness can impact various body systems:

• Musculoskeletal system: Joint pain and muscle aches
• Nervous system: Numbness, paralysis, or cognitive changes
• Cardiovascular system: Chest pain or irregular heartbeat
• Respiratory system: Shortness of breath or “chokes”
• Skin: Itching, rashes, or mottled appearance

Diagnosing Decompression Sickness

Diagnosing decompression sickness primarily relies on the patient’s diving history and presenting symptoms. Unlike many other medical conditions, blood tests and joint X-rays typically do not reveal definitive signs of decompression sickness. This makes it crucial for divers to be aware of their dive profiles and any unusual symptoms they experience after surfacing.

Healthcare providers specializing in dive medicine often use a combination of the following to diagnose decompression sickness:

• Detailed dive history, including depth, duration, and ascent rate
• Physical examination focusing on neurological and cardiovascular systems
• Symptom onset timing and progression
• Exclusion of other potential causes with similar symptoms

In some cases, advanced imaging techniques such as MRI or CT scans may be used to detect bubbles or assess potential tissue damage, particularly in cases of suspected neurological involvement.

Prevention Strategies for Decompression Sickness

Preventing decompression sickness is paramount for all divers. By following established safety guidelines and best practices, the risk of developing this condition can be significantly reduced:

1. Adhere to dive tables or use dive computers to plan safe ascent rates and decompression stops.
2. Ascend slowly and steadily, typically no faster than 30 feet (9 meters) per minute.
3. Perform safety stops at 15-20 feet (4.5-6 meters) for 3-5 minutes, even on dives within no-decompression limits.
4. Avoid flying for at least 24 hours after diving, as the reduced pressure in aircraft cabins can exacerbate bubble formation.
5. Stay well-hydrated before, during, and after diving to promote efficient gas elimination.
6. Abstain from alcohol consumption before and immediately after diving.
7. Avoid hot tubs, saunas, or hot baths following dives, as heat can increase bubble formation.
8. Maintain good physical fitness and manage body weight to reduce risk factors.

How does proper hydration help prevent decompression sickness?

Adequate hydration plays a crucial role in preventing decompression sickness by:

• Improving blood flow and circulation, which aids in nitrogen elimination
• Reducing blood viscosity, allowing for more efficient gas exchange
• Helping to maintain proper body temperature regulation
• Supporting overall physiological function during and after dives

Treatment Options for Decompression Sickness

When decompression sickness is suspected, prompt medical attention is essential. The primary treatment modalities include:

1. Hyperbaric Oxygen Therapy (HBOT): This is the gold standard treatment for decompression sickness. Patients are placed in a hyperbaric chamber where they breathe 100% oxygen under increased pressure. This helps to:
   • Reduce bubble size and promote reabsorption
   • Improve oxygenation of tissues
   • Reduce inflammation and swelling
2. Emergency First Aid:
   • Administer high-flow oxygen (100% if possible) to the patient
   • Maintain blood pressure and provide intravenous fluids
   • Position the patient on their left side with the head slightly lowered
3. Supportive Care:
   • Pain management
   • Monitoring of vital signs and neurological status
   • Treatment of any secondary complications

The duration and intensity of treatment depend on the severity of symptoms and the individual’s response to therapy. Some patients may require multiple hyperbaric treatments over several days.

Why is hyperbaric oxygen therapy effective for treating decompression sickness?

Hyperbaric oxygen therapy is highly effective because it:

• Increases the pressure around the body, compressing existing bubbles
• Floods the system with oxygen, displacing nitrogen from tissues
• Promotes the dissolution of nitrogen bubbles back into the bloodstream
• Enhances the body’s natural healing processes by delivering high concentrations of oxygen to damaged tissues

Long-Term Effects and Recovery from Decompression Sickness

The long-term prognosis for individuals who have experienced decompression sickness can vary widely depending on the severity of the initial injury and the timeliness of treatment. Some key points to consider regarding recovery and potential long-term effects include:

• Many divers who receive prompt treatment make a full recovery with no lasting effects.
• Joint pain, the most common symptom, may persist for days or weeks even after treatment.
• In some cases, neurological symptoms may take longer to resolve or may result in permanent deficits.
• Individuals who have experienced decompression sickness are at higher risk for future episodes and may need to modify their diving practices.

Recovery time can range from a few days to several months, depending on the severity of the case. During this period, it’s crucial for affected individuals to:

1. Follow all medical advice and attend follow-up appointments
2. Refrain from diving until cleared by a diving medicine specialist
3. Gradually return to physical activities under medical supervision
4. Be vigilant for any recurring or new symptoms

Can individuals safely return to diving after experiencing decompression sickness?

Many divers can return to the sport after recovering from decompression sickness, but with important considerations:

• A thorough medical evaluation is necessary before resuming diving activities
• More conservative dive profiles may be recommended to reduce risk
• Additional safety precautions, such as longer surface intervals, may be necessary
• Some individuals with severe cases or underlying health conditions may be advised to avoid further diving

Advancements in Decompression Sickness Research and Prevention

The field of dive medicine continues to evolve, with ongoing research aimed at improving our understanding of decompression sickness and developing more effective prevention and treatment strategies. Some areas of current interest include:

• Development of more accurate decompression algorithms for dive computers
• Investigation of genetic factors that may influence susceptibility to decompression sickness
• Exploration of pre-conditioning techniques to enhance divers’ resilience to pressure changes
• Research into biomarkers that could indicate increased risk or early onset of decompression sickness
• Advancements in hyperbaric chamber technology and treatment protocols

These ongoing efforts hold promise for making diving safer and more accessible to a broader range of individuals. As our knowledge expands, dive training and safety guidelines continue to be refined to incorporate the latest scientific findings.

How might future technologies impact decompression sickness prevention?

Emerging technologies could revolutionize decompression sickness prevention in several ways:

• Wearable devices that monitor real-time physiological data to predict bubble formation
• Advanced dive computers with AI-driven decompression models
• Improved breathing gas mixtures that reduce inert gas loading
• Personalized dive planning based on individual risk factors and genetic profiles

As research progresses, these innovations may significantly reduce the incidence of decompression sickness and enhance overall diving safety.

Decompression Sickness – Harvard Health

What is it?

Decompression sickness, also called generalized barotrauma or the bends, refers to injuries caused by a rapid decrease in the pressure that surrounds you, of either air or water. It occurs most commonly in scuba or deep-sea divers, although it also can occur during high-altitude or unpressurized air travel. However, decompression sickness is rare in pressurized aircraft, such as those used for commercial flights.

When you scuba dive with compressed air, you take in extra oxygen and nitrogen. Your body uses the oxygen, but the nitrogen is dissolved into your blood, where it remains during your dive. As you swim back toward the surface after a deep dive, the water pressure around you decreases.

If this transition occurs too quickly, the nitrogen does not have time to clear from your blood. Instead, it separates out of your blood and forms bubbles in your tissues or blood. It is these nitrogen bubbles that cause decompression sickness. The condition is called the bends because the joint and bone pains can be so severe they double you over.

What happens inside your body during decompression sickness is similar to what happens when you open a carbonated drink. When you open the can or bottle, you decrease the pressure surrounding the beverage in the container, which causes the gas to come out of the liquid in the form of bubbles. If nitrogen bubbles form in your blood, they can damage blood vessels and block normal blood flow.

Factors that put you at higher risk of decompression sickness include:

• Heart muscle birth defects, including patent foramen ovale, atrial septal defect, and ventricular septal defect
• Being older than 30
• Being female
• Low cardiovascular fitness
• High percentage of body fat
• Use of alcohol or tobacco
• Fatigue, seasickness or lack of sleep
• Injuries (old or current)
• Diving in cold water
• Lung disease

Someone with an abnormal hole or opening in the heart from a birth defect is at especially high risk of developing serious symptoms from decompression illness. Because bubbles create high blood pressure in the lungs, blood and bubbles from your veins may flow more readily through the heart’s opening. This means your blood can re-circulate into arteries without first getting oxygen. An opening in the heart can also allow a relatively large air bubble (called an air embolism) to circulate into your arteries. An air embolism can cause a stroke.

People with asthma or another lung disease may have thin-walled air pockets in their lungs called bullae. These pockets do not empty quickly when the persons exhales. As they return to the surface after a deep dive, air in the bullae may expand. If a bulla ruptures, it could cause a collapsed lung or allow a large air bubble (air embolism) to enter the arteries.

Symptoms

Symptoms of decompression sickness include:

• Joint pain  
• Dizziness
• Headache
• Difficulty thinking clearly
• Extreme fatigue
• Tingling or numbness
• Weakness in arms or legs
• A skin rash

Diagnosis

Your diving history and symptoms are key factors in diagnosing decompression sickness. Blood tests and joint X-rays usually do not show any signs of the problem.

Expected duration

Joint pain, the most common symptom from decompression sickness, can last for days or weeks.

Prevention

To minimize the risk of decompression sickness while diving:

• Dive and rise slowly in the water, and don’t stay at your deepest depth longer than recommended. Scuba divers typically use dive tables that show how long you can remain at a given depth.
• Do not fly within 24 hours after diving.
• Don’t drink alcohol before diving.
• Avoid hot tubs, saunas or hot baths after diving.
• Make sure you are well hydrated, well rested and prepared before you scuba dive. If you recently had a serious illness, injury or surgery, talk to your doctor before diving.

Some people should avoid diving altogether, or should consider special risks. If you have a heart defect, it is not safe to dive. If you have asthma, a history of a ruptured lung at any time in your life or another lung disease, discuss diving safety with a doctor before deciding whether to dive. A person who requires insulin to treat diabetes may have wide swings in blood glucose levels during a dive, and caution is advised. Avoid diving if you have a groin hernia that has not been repaired, since expanding gas in the hernia can cause symptoms.

Treatment

Emergency treatment for decompression sickness involves maintaining blood pressure and administering high-flow oxygen. Fluids also may be given. The person should be placed left side down and if possible the head of the bed tilted down.

The optimal treatment is the use of a hyperbaric oxygen chamber, which is a high-pressure chamber in which the patient receives 100% oxygen. This treatment reverses the pressure changes that allowed gas bubbles to form in the blood stream. The treatment drives nitrogen back into its liquid form so that it can be cleared more gradually from the body over a period of hours.

It is not recommended that divers with decompression sickness attempt to treat themselves with deep diving.

When to call a professional

If you experience symptoms of decompression sickness after scuba diving or flying, get to a doctor as soon as you can. Hyperbaric treatment is most successful if given within several hours after symptoms start.

Prognosis

Most cases of decompression sickness respond well to a single treatment with hyperbaric oxygen. Your doctor may suggest repeated treatments if you continue to experience symptoms, especially neurological symptoms.

Additional info

Undersea & Hyperbaric Medical Society

https://www.uhms.org/

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For nearly a century, Mercedes-Benz has made it our mission to move the world. Through our employees and their achievements, we’ve created a company we can all be proud of.

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  Brand history: 130 years of Mercedes-Benz

  Illustrations provided by the press service of Mercedes-Benz RUS

  The Mercedes-Benz brand for motorists from all over the world is not only one of the most recognizable and significant car manufacturers in the world, but also directly associated with the very concept of “car”. And this is justified at least by the historical significance of the brand: exactly 130 years ago, the German engineer Karl Benz officially filed a patent for a “vehicle with a gasoline engine.”

  The event that marked the beginning of the history of not only the German brand, but the entire world automobile industry, occurred on January 29, 1886. It was on this day that a German engineer and innovator named Benz received patent No. 37435 for his creation – the world’s first car with a gasoline engine.

  Of course, Benz’s invention was very different from the modern image of the car: in fact, he installed a four-stroke engine he developed from scratch on a tricycle.

  In the same year, independently of Benz, design engineer Gottlieb Daimler created his own motorized carriage. Daimler assembled a single cylinder four-stroke internal combustion engine. It was supposed to be installed in carriages. Daimler was assisted in the development of the new technology by engineer Wilhelm Maybach. Karl Benz, Gottlieb Daimler and

  Wilhelm Maybach

  Both engineers founded private companies with the help of partners and investors. Benz founded Benz & Cie in Mannheim in October 1883, and Daimler founded the Daimler-Motoren-Gesellschaft (DMG) brand in November 1890. From 1901, Daimler’s company began to produce cars under the Mercedes brand.

  The legendary brand got its name from the nickname of the daughter of the Austrian businessman Emil Jellinek named Adriana (Mercedes is the girl’s nickname). Her father, Honorary Vice Consul in Monaco, was wealthy and interested in modern technology. At his request in 189In the year 7, Gottlieb Daimler installed a 6 horsepower two-cylinder engine on a vehicle. After the success of this project, he ordered 4 more copies and sold them at a profit.

  The same Mercedes She had a four-cylinder engine with a volume of almost 6 liters. and a power of 35 hp. The car was characterized by a wide wheelbase, a low center of gravity and an inclined steering column.

  A honeycomb-type cooler has also become a distinguishing feature of the brand. The car weighed 900 kg and had a top speed of 80 km/h. The model was designed by Wilhelm Maybach himself.

  The first cars and engines of the Mercedes brand

  The merger of the two most famous German manufacturers at that time took place in 1926. Thanks to the deal, the industrialists not only managed to survive in the difficult post-war period, but also significantly expanded their business.

  The united concern was named “Daimler-Benz AG”, and another outstanding German designer Ferdinand Porsche became the first head, and later – the creator of another legendary Porsche brand.

  All cars produced after the merger are named Mercedes-Benz, in honor of the company’s most successful car and its creator, Karl Benz.

  The Daimler-Benz AG logo becomes a three-pointed star, which is framed by a wreath – the legacy of the Benz logo. In the future, this wreath will be turned into a regular circle, which is still used today. One of the simplest (and recognizable) logos in history has become a symbol of luxury and wealth.

  Mercedes logo

  The collaboration between Benz and Daimler turned out to be one of the longest in the history of the automotive industry, as both companies in this combination survived until 1998. Their first joint car was the K.

  At the same time, the Mercedes CCK and SSKL, designed by Hans Niebel, appeared. In addition to the typical sports versions, the manufacturer also offers convertibles and production models with rally-adapted bodywork.

  Daimler-Benz AG produces one legendary series after another. So, under the leadership of Ferdinand Porsche, the “S” series, a new generation of sports cars, appeared. The most famous car and the progenitor of the S-series was the car that was popularly nicknamed the “Death Trap”. Having received the name “Mercedes-Benz 24/100/140”, the car had a powerful six-cylinder engine and developed a high speed for those times – up to 140 km / h.

  The 18/80 HP model, known as the Nürburg 460 (1928), also received fame, equipped with an eight-cylinder engine with a displacement of 4622 cc. cm and a maximum power of 80 liters. With. at 3400 rpm; the 500K and 540K roadsters (30s) and the 770 model called Grosser Mercedes, whose first generation was built from 1930 to 1938. The model had a luxurious salon in which Adolf Hitler moved.

  Advertising 770

  The first model and mass production of the diesel Mercedes 260D was launched from 1936 to 1940. The 2.5 liter diesel engine had a power of 45 hp. With. Some of the cars of this brand were subsequently used by the German army.

  World War II almost destroyed the Daimler-Benz AG business. All production facilities of the company were practically destroyed. Factories in Stuttgart, Sindelfingen and Mannheim literally turned into a pile of rubble. In 1945, after the final meeting of the board of directors, a report was even issued, the result of which was the idea that the Daimler-Benz concern no longer exists.

  However, despite all the difficulties, Daimler-Benz AG recovered quickly enough and in 1947 launched the 170 model, which had an engine capacity of 1767 m³, 4 cylinders and a power of 52 hp. With. A car that was completely different from previous models was the Mercedes 300 – a limousine formed on a frame with crossed beams. It was equipped with a three-liter six-cylinder engine with 115 hp. s., and its special version was created for the first German Federal Chancellor Konrad Adenauer.

  Among the cars produced by Mercedes-Benz after the Second World War, the 300 SL Coupe stands out with its characteristic “winged” doors that opened with part of the roof. It was the first sports car built after the war. The road version of this unusual vehicle was released in 1954.

  Mercedes-Benz 300 SL Coupe

  In February 1954, the 300 SL appeared. March 1957 years began to produce the model 300 SL Roadster, beloved by Elvis Presley.

  Cars produced in the 70-90s became iconic for the brand.

  In 1975-1986, the Mercedes W123, popularly known as the “barrel”, was formed. In the 80s, the 190 model debuted, which was produced in the years from 1982 to 1993 and replaced by the C class. At the same time, the popular Mercedes W124 appeared, which was produced until 1997. After that, the W210 appears on the market, since 2002 it has been replaced by the W211, W212 versions. It is these models that are called class E.

  Mercedes-Benz W211

  In 1998, Mercedes buys back shares of the American company Chrysler. As a result, Daimler-Benz has gained a chance to get wider access to the US market. This agreement changed the corporate name of the company to Daimler Chrysler, the cooperation continued for almost 10 years. The decision to break off cooperation was influenced by the results of the poor financial condition of Chrysler. After the sale of the shares of the American concern, the company returns the name Daimler AG.

  Today, the company manufactures Mercedes A, B, C and E class models. The brand’s modern cars are renowned for their safety and are still considered the most prestigious in the world. Mercedes S Class even entered the Book of Records as “the most durable car that has ever been released. ”

  Andrey Rodionov, Head of Corporate Communication at Mercedes-Benz RUS JSC

  – When 130 years ago Karl Benz applied for a patent for “a vehicle powered by a gasoline engine” it meant the birth of the automobile. In the same year, Gottlieb Daimler created his own car. Thus began the 130-year success story of Mercedes-Benz, we entered the age of speed and the global automotive industry was born.

  The patent became part of the UNESCO Memory of the World program, among such well-known works as the Gutenberg Bible, Magna Carta and Symphony No. 9 in D minor by J.S. Bach. And it is no accident: the inventions of Karl Benz and Gottlieb Daimler, thanks to their ingenuity and entrepreneurial flair, revolutionized the field of transportation, opening up new opportunities for people.

  Today’s innovations are based on the same values ​​as 130 years ago: safety, comfort, efficiency and faith in success. Thanks to them, the brand demonstrates a dynamic growth in global sales, and in Russia in 2015 it is a confident leader in the premium segment. Mercedes-Benz delights its fans with the premieres expected in Russia – this is the new intelligent E-Class, the chic GLS, the sporty SL and SLC. And, of course, new special offers.

  Mercedes-Benz ads have also always stood out for their trademark execution and creativity – the brand has never spared money on marketing.

  Advertisement for the BlueEFFICIENCY system (the system is a technical solution for optimizing fuel consumption and emissions).

  A billboard was placed at Johannesburg Airport, which was originally just a white surface and the Mercedes-Benz logo. After a while, air pollutants accumulated on the billboard, and the message was clearly visible on the white base: “If more cars had BlueEFFICIENCY, you would not be able to read this.”

  Mercedes-Benz B-Class Prints Designed by Shanghai Berlin Agency

  “Left Brain, Right Brain” advertising campaign , right hemisphere”)

  Mercedes image ad for breast cancer

  2010

  2011

  2013

  2014 Marilyn Monroe

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  PETROL decoding. What is BENZ.