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What is decompression sickness? -

Decompression sickness (DCS) refers to injuries caused by a rapid decrease in the pressure that surrounds you, of either air or water.

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What is decompression sickness? -

DCS is most commonly associated with scuba diving and deep sea divers who ascend to the surface too quickly.

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How does it occur? -

During decompression, dissolved gases emerge from solution as bubbles inside the body tissues and vascular system.

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What divers breathe -

When submerged, divers breathe compressed air that contains nitrogen gas at the same pressure as the surrounding water.

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Dangers of a rapid ascent -

If a diver swims to the surface too quickly, in other words makes a rapid ascent, the nitrogen can form tiny bubbles in the blood and/or body tissues.

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Surfacing too quickly -

Likewise, if a diver makes a rapid ascent while holding their breath the resulting reduction in the ambient pressure can cause their lungs to overinflate.

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Effects of DCS -

This can cause the lung's tiny air sacs (alveoli) to rupture, allowing air bubbles to escape directly into the blood stream.

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Arterial gas embolism -

These air bubbles can block the flow of blood to different parts of the body, a very serious condition known as arterial gas embolism (AGE).

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How DCS affects the body -

Since bubbles can migrate to any part of the body, DCS can produce numerous symptoms, and its effects may vary from joint pain and rashes to paralysis and even death.

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"The bends" -

Typically, DCS causes bubbles to settle in major joints like knees or elbows, causing individuals to bend over in excruciating pain, hence the condition's common name, "the bends."

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Risk factors -

The bends accounts for about 60% to 70% of all DCS cases. And the risk of decompression sickness increases if, for example, you have a heart defect.

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When not to enter the water -

Entering the water dehydrated can promote the onset of DCS. So, too, can being obese.

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Dangers of fatigue and overexertion -

It's unwise to dive when you're fatigued. Similarly, if you overexert yourself while submerged the risk of DCS increases.

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Age considerations -

There is no upper age limit for scuba diving. However, as you age you will have an increased risk for decompression sickness.

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Diving in cold water -

Cold temperature dives pose a risk of DCS. While a relatively warm state promotes inert gas elimination during the ascent and stop phase of your dive, thus reducing overall decompression stress, cold water during this phase will reduce inert gas elimination, effectively prolonging and possibly increasing decompression stress.

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Risks of flying -

Taking a flight directly after diving is dangerous. According to Divers Alert Network (DAN), a minimum 12-hour surface interval is recommended for a single no-decompression dive, a minimum 18-hour surface interval for multi-day repetitive diving, and 48 hours after diving involving compulsory decompression, or using heliox and trimix during saturation diving (explained later).

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Altitude limits -

If a flight involves an altitude greater than 980 ft (300 m), flying should be avoided for four to six weeks to avoid recurrence of symptoms.

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Saturation diving -

DCS can result from other causes of depressurization. These include decompression from saturation. Saturation diving, undertaken by professionals, involves working at extreme depths for long periods.

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Commercial diving dangers -

The diver's bloodstream is saturated with a carefully composed blend of gases, for example heliox and trimix, that allows them to withstand the pressure of the surrounding water and avoid decompression sickness. The end of a saturation dive signals the beginning of a meticulously planned decompression procedure that if not followed by the book can result in DCS.

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Indicators of DCS -

The symptoms of decompression sickness may appear rapidly. Fatigue, weakness, and pain in muscles and joints are early indicators.

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Cause and effect -

Headache, lightheadedness or dizziness, and a confused state of mind are also indicative of DCS.

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Other common symptoms -

Other common symptoms of DCS include vision problems, such as double vision, stomach or chest pain, shock, and vertigo.

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First aid -

Divers with suspected DCS should be kept lying flat and given 100% oxygen if it is available. Keeping the casualty horizontal prevents conditions worsening with bubbles traveling to the brain.

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Hyperbaric oxygen chamber -

The optimal treatment for DCS is recompression therapy using a hyperbaric oxygen chamber.

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Recompression therapy -

Hyperbaric oxygen therapy, also known as recompression therapy, involves the patient being placed inside a sealed chamber where air pressure is three times higher than normal.

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What does recompression therapy do? -

Hyperbaric oxygen therapy does four things: it compresses (shrinks) the bubbles; increases the rate at which nitrogen is removed from the body; reduces the inflammation created by the bubbles; and improves the oxygen supply to body tissue and the vascular system. This process is done gradually over a number of days.

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How to prevent DCS -

To prevent decompression sickness, most divers make a safety stop for a few minutes before ascending to the surface, adhering to strict decompression schedules. Saturation divers make use of a submersible hyperbaric chamber to avoid pausing during their ascent.

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DCS can happen unexpectedly -

It's important to note that DCS may occur even if a person dives within the limits of their dive computer or decompression tables and even if they complete a safety stop.

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Fitness routine -

Besides being aware of the risk factors involved with DCS, divers need to maintain a certain level of physical fitness. For example, regular aerobic exercise should already be part of a diver's routine before arriving for their dive physical and subsequent diving.

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Fit to dive -

In fact, it's incumbent upon any diver to make sure they are physically and mentally fit enough to take to the water.

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In the clear -

By following basic rules and making decisions about acceptable risk, a scuba diver should enjoy a trouble-free undersea experience.

Sources: (PADI) (DAN) (National Institutes of Health) (Harvard Health) (CDC) (Healthline) (Scubanomics)

See also: Top water sports to enjoy this summer

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