What are the risks of decompression sickness. How can divers prevent the bends. What are the symptoms of decompression illness. When should you seek treatment for the bends.

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 occasionally individuals exposed to high-altitude or unpressurized air travel. This potentially dangerous condition occurs when a rapid decrease in surrounding pressure causes dissolved nitrogen to form bubbles in the body’s tissues and bloodstream.

The term “the bends” originates from the severe joint and bone pains that can cause affected individuals to double over. Understanding the mechanics of this condition is crucial for anyone engaging in activities that involve pressure changes.

The Science Behind Decompression Sickness

During a dive, the body absorbs nitrogen from compressed air. As long as a diver remains at depth, this extra nitrogen stays dissolved in the blood and tissues. However, problems arise when ascending too quickly. The rapid pressure decrease causes the nitrogen to come out of solution, forming bubbles that can cause various symptoms and potentially serious health issues.

This process is similar to opening a carbonated beverage. When you pop the cap, you decrease the pressure inside the container, causing gas bubbles to form in the liquid. In the human body, these bubbles can damage blood vessels and obstruct normal blood flow, leading to the symptoms associated with decompression sickness.

Risk Factors for Decompression Sickness

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

• Age (being older than 30)
• Gender (females are at higher risk)
• Low cardiovascular fitness
• High body fat percentage
• Alcohol or tobacco use
• Fatigue, seasickness, or lack of sleep
• Current or old injuries
• Cold water diving
• Lung disease
• Heart defects (e.g., patent foramen ovale, atrial septal defect, ventricular septal defect)

Individuals with heart defects are at particularly high risk due to the potential for bubbles to bypass the lungs and enter the arterial circulation, potentially causing more severe symptoms.

Recognizing the Symptoms of Decompression Sickness

Identifying the symptoms of decompression sickness is crucial for prompt treatment. Common symptoms include:

• Joint pain (the most frequent symptom)
• Dizziness
• Headache
• Cognitive difficulties
• Extreme fatigue
• Tingling or numbness
• Weakness in arms or legs
• Skin rash

It’s important to note that symptoms can vary in severity and may not appear immediately after surfacing. Some divers may experience symptoms hours after their dive, emphasizing the need for vigilance even after leaving the water.

How is Decompression Sickness Diagnosed?

Diagnosing decompression sickness primarily relies on the diver’s history and reported symptoms. Unlike many medical conditions, blood tests and joint X-rays typically do not reveal signs of decompression sickness. This makes it crucial for divers to be honest and thorough when describing their dive profile and any symptoms they’re experiencing.

Preventing Decompression Sickness

Prevention is key when it comes to decompression sickness. Here are some essential strategies divers can employ to minimize their risk:

1. Ascend slowly and follow recommended dive tables
2. Avoid flying within 24 hours after diving
3. Abstain from alcohol before diving
4. Skip hot tubs, saunas, or hot baths post-dive
5. Ensure proper hydration and rest before diving
6. Consult a doctor if you have a recent history of illness, injury, or surgery

For individuals with certain medical conditions, diving may pose additional risks. Those with heart defects should avoid diving altogether. Individuals with asthma, a history of lung rupture, or other lung diseases should consult with a doctor before considering diving. Diabetics requiring insulin and those with unrepaired groin hernias should also exercise caution.

Treatment Options for Decompression Sickness

When decompression sickness occurs, prompt and appropriate treatment is essential. The primary emergency treatment involves:

• Maintaining blood pressure
• Administering high-flow oxygen
• Providing fluids
• Positioning the patient on their left side with the head tilted down

The optimal treatment for decompression sickness is recompression therapy in a hyperbaric chamber. This involves placing the patient in a pressurized environment to reduce bubble size and help eliminate excess nitrogen from the body. The earlier this treatment begins, the better the outcome for the patient.

Long-term Effects and Recovery

The duration and severity of decompression sickness symptoms can vary. Joint pain, the most common symptom, may persist for days or even weeks. In some cases, individuals may experience long-term effects, particularly if treatment is delayed or if the condition is severe. Regular follow-ups with a diving medicine specialist may be necessary to monitor recovery and address any lingering symptoms.

Decompression Sickness in High-Altitude Environments

While decompression sickness is most commonly associated with diving, it can also occur in high-altitude environments. This is sometimes referred to as “altitude sickness” or “mountain sickness,” although the underlying mechanism is similar to that experienced by divers.

Pilots of unpressurized aircraft, mountain climbers, and individuals rapidly ascending to high altitudes may be at risk. The symptoms can be similar to those experienced by divers, including joint pain, dizziness, and breathing difficulties. Prevention strategies for high-altitude decompression sickness include gradual ascent, proper acclimatization, and in some cases, the use of supplemental oxygen.

The Role of Technology in Preventing Decompression Sickness

Advancements in diving technology have significantly contributed to the prevention of decompression sickness. Modern dive computers use complex algorithms to calculate a diver’s nitrogen saturation levels in real-time, providing more accurate and personalized decompression schedules than traditional dive tables.

These devices can alert divers when they’re ascending too quickly or approaching their no-decompression limits. Some advanced models even factor in water temperature, exertion levels, and previous dives to provide a more comprehensive risk assessment.

While these tools are invaluable, it’s crucial to remember that they are aids, not substitutes for proper training and judgment. Divers should still understand the principles behind decompression theory and be prepared to make conservative decisions based on their personal risk factors and diving conditions.

Emerging Research and Future Directions

The field of diving medicine continues to evolve, with ongoing research into the mechanisms of decompression sickness and potential new treatment approaches. Some areas of current interest include:

• The role of nitric oxide in bubble formation and resolution
• Genetic factors that may influence susceptibility to decompression sickness
• The potential use of oxygen-enriched breathing gases to reduce decompression stress
• Development of more effective pre-conditioning techniques to increase decompression tolerance

As our understanding of decompression physiology improves, we may see new strategies for prevention and treatment emerge, further enhancing diving safety.

Education and Training: The First Line of Defense

While understanding the science behind decompression sickness is important, proper education and training remain the most effective tools for prevention. Comprehensive dive training programs cover not only the technical aspects of diving but also emphasize risk assessment, emergency procedures, and the importance of conservative diving practices.

Continuing education courses, such as those focused on deep diving, nitrox use, and decompression procedures, can further enhance a diver’s knowledge and skills. Regular refresher courses are also valuable, especially for divers who don’t dive frequently.

Additionally, dive operators and instructors play a crucial role in promoting safe diving practices. Pre-dive briefings should always include reminders about proper ascent rates, safety stops, and the importance of staying within no-decompression limits.

The Importance of Physical Fitness in Diving

Maintaining good physical fitness is not just about enhancing diving enjoyment; it’s also a key factor in reducing the risk of decompression sickness. Regular cardiovascular exercise can improve blood flow and gas exchange, potentially reducing the risk of bubble formation.

Moreover, better physical condition can help divers manage stress and exertion underwater, leading to more controlled breathing and potentially lower gas consumption. This, in turn, can contribute to safer diving profiles and reduced decompression stress.

It’s important to note that while fitness is beneficial, it doesn’t make a diver immune to decompression sickness. Even the fittest divers need to adhere to safe diving practices and respect their personal limits.

The Global Impact of Decompression Sickness Research

Research into decompression sickness has implications that extend far beyond recreational diving. The principles developed through this research have applications in various fields, including:

• Aerospace medicine: Helping astronauts safely transition between the pressurized environment of spacecraft and the vacuum of space
• Hyperbaric medicine: Treating a range of conditions unrelated to diving, such as carbon monoxide poisoning and difficult-to-heal wounds
• Occupational health: Improving safety for workers in pressurized environments, such as tunnel construction and underwater welding
• Marine biology: Enhancing our understanding of how marine mammals avoid decompression sickness during deep dives

As research in this field continues to advance, it’s likely to yield insights that benefit not only divers but also contribute to broader medical and scientific knowledge.

The Psychological Aspects of Decompression Sickness

While much attention is given to the physiological aspects of decompression sickness, the psychological impact shouldn’t be overlooked. Divers who have experienced “the bends” may develop anxiety about future diving, potentially leading to overly conservative behavior or even abandonment of the sport.

On the other hand, some divers may develop a false sense of invulnerability if they’ve pushed limits without experiencing problems. This psychological aspect underscores the importance of comprehensive diver education that addresses not only the physical risks but also the mental and emotional aspects of safe diving practices.

Support groups and counseling services specifically for divers who have experienced decompression sickness can be valuable resources for addressing these psychological challenges and helping divers return to the sport safely and confidently.

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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  Mercedes-Benz was founded in 1926 by Karl Benz, Gottlieb Daimler, Wilhelm Maybach and Emil Jellinek, whose daughter Mercedes is our original namesake.

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  With offices in 93 locations worldwide and a corporate headquarters in Stuttgart, Germany, our global presence continues to grow.

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  From the crumple zone in 1959 to the airbag in 1980 and PRE-SAFE® braking in 2002, Mercedes-Benz has invented many of the automotive technologies we see today.

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Bertha Benz: The First Driver

She forged the road ahead and paved it for us all. Discover the story of Bertha Benz and her historic first drive.

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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

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