Decompression Sickness: Causes; signs & Symptoms; Treatment; and Prevention (According to a scuba instructor)
Decompression sickness (“DCS”), or “the bends,” can surface (no pun intended) in various ways. Symptoms of DCS range from a mild annoyance to a potentially crippling life altering, or ending, event. So, what is DCS and how do we treat and even prevent it from occurring? Read on…it just may save your life.
What is DCS
So let’s start off with what exactly is DCS. Put very simply, It’s the harmful effects of nitrogen bubbles in the body.
Cause
As mentioned above, nitrogen is the culprit causing DCS. The air that we breath is made up of 78% nitrogen, which is of no issue when we are at the surface. Once we start to descend, and add pressure to our bodies, we are absorbing and storing more nitrogen in our bodies. See Henry’s Law. This is called “ingassing,” which will continue until the pressure of nitrogen is balanced between the nitrogen in the air we are breathing and the nitrogen in our bodies.
That nitrogen built up in our bodies can cause DCS when we stay down too long an come up too fast. After our dive is over and we start to ascend, we begin to “offgass.” That is as we ascend the pressure is becoming less on our bodies and now that stored up nitrogen starts to release from the blood and tissue.
Offgassing does not happen instantaneously. It takes time as the nitrogen stored in our body tissues passes to the blood, then from the blood to our lungs and finally from our lungs to being exhaled. If we have too quick of an ascent, then the nitrogen can come out of the body tissue too rapidly and form bubbles, just like quickly opening up a shaken up can of soda.
Signs and symptoms
Signs and symptoms can occur quickly or can take hours. Generally, they will occur between 45 minutes to an hour of surfacing. what signs and symptoms of DCS show up directly depends on where the nitrogen bubbles form. Some symptoms include extreme fatigue, rash, ringing in ears/hearing loss, difficulty urinating, confusion, difficulty breathing, joint pain, numbness/paralysis and death.
Needless to say, getting DCS can be a very painful event. In fact, the pain can be so bad it causes people to bend over. Hence, DCS is also known as “the bends.”
Treatment
If you suspect someone has DCS, the first thing you will want to do is get them on 100% oxygen. This helps the nitrogen to become reabsorbed into the blood and tissue. Next contact Divers Alert Network (“DAN”) (1-919-684-911) for guidance in getting the individual to a healthcare treatment center, even if they are feeling better with the oxygen.
Once you get the individual to a treatment center, it will be determined if they will need to go into a recompression chamber. This is a chamber where the pressure can be increased, pursuant to treatment protocols, to drive the nitrogen back into the blood and tissue of the diver. The pressure will then be slowly released to help the person offgass at a more appropriate speed. A “chamber run” can take hours and the injured party may need multiple runs to treat their condition depending on severity.
I mentioned DAN above. This is an agency that helps with scuba medical emergencies. For a little over $100 a year you can get diver’s insurance through DAN, which is highly recommended if you are going to be out diving. Why so? well, not every location you will be diving at may have a recompression chamber available. This means you may have to be transported by air to where the closest chamber is. Regular health insurance will typical not cover this. One treatment in a recompression chamber is about $15,000. Regular insurance will typically not cover this as well. Trust Scuba Jay here. if diving, buy the insurance!
Prevention
Follow a safe diving plan that is a non-decompression dive or NDL. This basically means do not do a dive that turns your precautionary safety stop(s) into a mandatory one. So, in short, do not stay down too long and do not come up too quickly (NAUI recommends 1ft every 2 seconds, or 30ft per minute). Speaking of safety stops, while precautionary, take them. Other little things like hydrating, avoiding alcohol use and strenuous activities after diving also help.
Another important thing to remember is that you should never fly within 24 hours of your last dive. The reason is once you get on the plane the door is closed and the cabin is pressurized to thousands of feet above sea level. This means if there is any residual nitrogen in your system, it will come rushing out as the pressure is lowered on your body. I can’t think of too many things that could be worse than having DCS on a plane!!
It needs to be noted that you can do everything right and still get DCS, just like you can do everything right driving, but still get into an accident. There are certain things that serve as predispositions for DCS, including body weight (fat likes to absorb nitrogen), age, alcohol consumption / dehydration and smoking (all affect your body’s circulation and ability to expel nitrogen) and scar tissue (old injuries can trap the nitrogen from escaping).
Wrapping things up
Hopefully this gives you more of an understanding of what is DCS and how to treat and help to prevent it. The best things that you can do is follow your training and plan and execute safe dives. Also, make sure you are diving with reputable dive operators that have the proper training and equipment, like oxygen, in case of an emergency. Let’s be careful out there!
If You’re Looking For other Scuba Diving Tips, Check Out The Below.
- Carbon Monoxide Toxicity
- Oxygen Toxicity
- Hand Signals
- Nitrogen Narcosis
- Middle Ear Squeeze
- Scuba Gift Ideas
- Mask Fog
- Carbon Dioxide Toxicity
- Scuba Tank Markings
- Reverse Block
“How boring would the world be if everywhere and everyone were the same. Safe travels and good adventures.” Scuba Jay
