Recognizing the Signs of Decompression Sickness: A Diver’s Essential Guide

Diving into the underwater world is an incredible experience, isn’t it? But it’s also an activity that comes with inherent risks. One of the most serious concerns for any diver is decompression sickness, often called “the bends”. Understanding what causes it and, more importantly, how to recognize the signs of decompression sickness, could literally save your life or the life of your dive buddy. This guide will delve deep into what you need to know, from the physics of diving to the practical steps you can take if you suspect someone has this serious condition.

What Exactly is Decompression Sickness (DCS)?

To really grasp what decompression sickness is, we need to briefly touch on the science of diving. As you descend into the depths, the pressure around you increases. When this happens, your body absorbs more nitrogen from the air you’re breathing. It’s a bit like how a soda bottle absorbs carbon dioxide, the deeper you go, the more gas dissolves into your fluids and tissues. When you ascend, if done too quickly, the absorbed nitrogen comes out of solution and forms bubbles. These bubbles are not only painful; they can be extremely dangerous. This, in essence, is decompression sickness, or DCS. It is also referred to as the bends because the pain associated with the bubbles in and around your joints can force you to bend over in pain. The bubbles tend to affect the central nervous system, circulatory system and musculoskeletal system.

The bubbles associated with decompression sickness can be compared to opening a bottle of soda. If you open it very slowly, the carbon dioxide gas slowly releases out of solution without creating bubbles. However, if you open a soda bottle very quickly the carbon dioxide will rush out of solution creating many bubbles, much the same way nitrogen bubbles appear in the human body. If you go scuba diving, you’re under the equivalent of a huge amount of water pressure. At depth, our bodies absorb nitrogen, which we normally breathe without a problem. It’s when we ascend too quickly, that this nitrogen isn’t released slowly. Instead, it forms bubbles. Think of it like opening a soda bottle too fast; these nitrogen bubbles can wreak havoc on your body. It’s a real risk, making it crucial to understand the symptoms of DCS. These bubbles can cause a myriad of problems, from joint pain to neurological damage.

Recognizing Decompression Sickness Symptoms

Decompression sickness symptoms can vary widely, depending on the severity and location of the bubbles. However, it’s extremely important to remember that even mild symptoms can progress quickly into more serious conditions. Here are some signs that you need to be aware of:

General Warning Signs

• Pain: The hallmark of decompression sickness is often severe joint pain. It’s not just any pain; it’s often described as deep, throbbing, and hard to ignore. It can feel like a deep ache that may move around to different locations. It is also very commonly described as pain centered around the joints.
• Fatigue: If you feel exceptionally tired or weak after a dive, more so than you’d normally expect, this could be a sign of DCS. It’s different from the usual post-dive tiredness; it can feel like extreme exhaustion that lasts for many hours.
• Unusual Tingling or Numbness: Ever experienced that “pins and needles” sensation? If you have it after a dive, especially if it is accompanied by any other symptoms it could be a warning sign. It can affect your arms, legs, or any other body part.
• Weakness: Feeling unusually weak, particularly in your arms or legs, is another worrying sign. This could be a loss of strength or function of any specific limb.

Specific Signs and Their Potential Severity

The specific signs can give us clues to what areas of the body are most affected by the nitrogen bubbles. Symptoms may also vary from person to person based on many different factors.

• Neurological Symptoms:
  • Headache: While you might get a headache after a dive for various reasons, if it’s severe, throbbing, or accompanied by other DCS symptoms, you need to take it seriously.
  • Vision Changes: If you have blurry vision, double vision, or any other visual disturbances, this can indicate the involvement of the central nervous system in DCS.
  • Dizziness and Vertigo: Feeling like you’re spinning or having trouble with your balance? It is also very commonly associated with DCS.
  • Seizures and Loss of Consciousness: These are severe neurological symptoms that require immediate medical intervention.
  • Confusion and Difficulty Thinking: The diver may present themselves as confused or having a hard time thinking or responding to simple questions.
• Respiratory and Circulatory Symptoms:
  • Chest Pain: Pain in the chest, coupled with breathing problems or coughing, requires immediate medical attention.
  • Cough and Shortness of Breath: DCS can present with symptoms that are similar to pneumonia, but the key differentiator is the fact that the person went diving recently.
  • Shock: In severe cases, DCS can lead to shock, a very dangerous condition.
• Skin-Related Symptoms:
  • Rashes and Mottling: Unusual skin rashes or mottling (discoloration) can be a sign.
  • Itching: While itching alone might not indicate DCS, if accompanied by other symptoms, it can be an early warning sign.
• Other less common symptoms:
  • Urinary or Bowel issues: You may be suffering from DCS if you are having any urinary or bowel issues
  • Auditory issues: Ringing or buzzing in your ears after a dive is something to take note of and to mention to medical staff if you seek treatment.

Recognizing Subtle Symptoms

Sometimes, symptoms of decompression sickness might be very mild, and it is very important not to dismiss these as insignificant. Divers might think they’re just tired or slightly sore, or even just not feeling well. However, even these subtle signs can be a signal of a significant issue. Never downplay any symptoms and remember early treatment is key to a full recovery. The sooner you recognize that something is off, the better. It is best to seek medical assessment if you are unsure about any symptoms that have developed after a dive.

Factors That Increase the Risk of Decompression Sickness

While it’s impossible to completely eliminate the risk of DCS, you can take steps to reduce it. Knowing the factors that increase the risk is the first step. Here are a few:

• Dive Profile
  • Depth and Duration: The deeper you dive and the longer you stay at depth, the more nitrogen your body absorbs. This is why deep, long dives carry a higher risk of DCS.
  • Repetitive Dives: Doing multiple dives within a short time can increase your overall nitrogen load. These dives can be on the same day, or over the course of several days.
  • Rapid Ascents: Ascending too quickly doesn’t give your body enough time to release the nitrogen safely, making the risk of bubble formation much higher. Rapid ascents are the number one cause of decompression sickness.
  • Deep Dives: Keep in mind that the deeper the dive, the greater the nitrogen absorbtion. Therefore when planning deep dives extra care must be taken.
• Individual Predisposition:
  • Age: Older divers can be at a higher risk.
  • Fitness and Health: Being out of shape, overweight, or having pre-existing health issues can increase your risk.
  • Body Composition: Divers with more body fat tend to have a higher risk.
  • Dehydration: Being dehydrated can exacerbate DCS. Make sure to drink plenty of water before and after any dive.
  • Pre-existing Conditions: Certain conditions like heart disease can put a diver at higher risk of DCS.
• Environmental Conditions:
  • Cold Water: Cold water can constrict blood vessels, potentially hindering nitrogen release.
  • Strong Currents: If you are struggling against strong currents, you are exerting yourself more and more likely to get DCS.
  • Rough Seas: Diving in rough seas can add extra stress and risk.
• Equipment and Diving Practices:
  • Proper Dive Gear: Make sure your gear is in great condition, this may be a lifesaving precaution.
  • Following Safety Procedures: Not cutting corners on dive procedures can make all the difference.
  • Use of Dive Computers: It is imperative that you use your dive computer correctly, and that you always follow the parameters that it provides.

I know this is a lot to take in, but understanding these factors can make a huge difference. Always be aware of these conditions when planning your next dive. Remember, preparation and knowledge are your best defenses against decompression sickness.

Responding to and Preventing Decompression Sickness

Okay, so now you have an idea of what causes decompression sickness and how to spot it. But what happens if you or a buddy start showing symptoms? What steps should you take? Let’s dive in!

What to Do if You Suspect Decompression Sickness

If you suspect decompression sickness, quick action is paramount. It’s not something you can “wait out” or hope gets better on its own. Here’s what you need to do:

• Immediate Actions:
  • Stop Diving Immediately: If you or your dive buddy are experiencing symptoms of DCS, the first thing you need to do is stop diving and do not re-enter the water again.
  • Administer 100% Oxygen: If available, immediately administer 100% oxygen. This helps the body eliminate nitrogen and helps with symptoms.
  • Keep the Diver Calm and Still: Try to keep the diver calm, relaxed, and as still as possible. This reduces any more stress to the body and it will help them stay as relaxed as possible.
  • Hydration: Make sure the diver is drinking plenty of water to stay hydrated. This helps the body flush out toxins and can reduce symptoms.
• Seeking Professional Medical Attention:
  • Contact Emergency Services: If the symptoms are severe it is imperative to contact emergency services such as 911 or your local emergency number right away.
  • Contact the Divers Alert Network (DAN): DAN is an amazing resource. They have a wealth of knowledge and are extremely helpful. Don’t hesitate to contact them.
    DAN Website
  • Hyperbaric Chamber: A hyperbaric chamber is often the most effective treatment for decompression sickness. These chambers apply pressure that allows the bubbles to re-dissolve into the blood stream, and can lead to much faster recovery.
  • Emergency Evacuation Procedures: It is important to know the emergency evacuation procedure for your current location. This may involve contacting a boat captain for help, or reaching a nearby hospital. Make sure to have all this information readily available.

Don’t delay treatment! Decompression sickness is not something to play around with. Symptoms can worsen, so quick treatment is crucial. Seeking medical care fast can minimize long term damage.

Preventing Decompression Sickness: Key Safety Practices

Prevention is always better than cure, right? Here are some key practices that can help minimize the risk of decompression sickness:

• Plan Your Dives: Plan your dives carefully and try not to go outside your normal limitations.
• Maintain a Safe Ascent Rate: Ascend at a slow, controlled pace, usually around 30 feet per minute or as recommended by your dive computer.
• Follow Your Dive Computer: Treat your dive computer as your best friend. It will give you valuable information and prevent many issues.
• Take Safety Stops: Take the recommended 3-5 minute safety stop at around 15 feet. This allows your body to get rid of the nitrogen in your system before you reach the surface.
• Stay Hydrated: Drink plenty of water before, during, and after your dives.
• Avoid Alcohol and Heavy Exertion Post-Dive: Alcohol can dehydrate you and heavy exercise can worsen symptoms after a dive.
• Maintain Physical Fitness: Being in good physical condition makes you less susceptible to DCS.
• Pre-Dive Health Check: Be honest with yourself about your own personal health and how you are feeling before a dive.
• Dive Within Your Limits: Know your personal limitations and don’t push them for any reason.
• Proper Training: Make sure to always receive proper dive training from an authorized organization.
• Nitrox Diving: Using enriched air nitrox can reduce the amount of nitrogen in your body, reducing your risk for decompression sickness.

Frequently Asked Questions About Decompression Sickness (DCS)

Here are some frequently asked questions (FAQ) about decompression sickness:

Key Takeaways

• Early Recognition: Knowing the signs of DCS can make a huge difference.
• Immediate Action: Stop diving, administer oxygen, and seek medical help immediately.
• Preventive Measures: Following safe dive practices and staying hydrated can greatly reduce risk.
• Knowledge is Power: Continue to educate yourself on safe diving practices.

Conclusion

The underwater world is a beautiful place, but it deserves our respect and caution. Understanding and recognizing the signs of decompression sickness is a crucial part of being a responsible diver. By educating yourself, following safety procedures, and being prepared, you can continue to enjoy diving safely for many years to come. Remember, diving is an amazing sport that carries risk, but you can mitigate those risks by making sure you are well educated and follow all safe practices. Do not dive if you are not feeling well and always make sure to plan and perform your dive safely, and within your own limitations. I hope this information is useful and keeps you safe.

External Resources for Further Learning:

• PADI (Professional Association of Diving Instructors)
• NOAA (National Oceanic and Atmospheric Administration)

I hope this blog post is helpful and keeps you safe while diving! Happy diving!