This tends to be in the upper parts of the body. When the skin is involved it becomes itchy, mottled and swollen. Pain can range from slight to unbearable, tends to be localised and characterized by a dullness, rather than a sharp pain. Joint pain ('the bends') occurs in about two-thirds of occurrences. The commonest site for signs and symptoms are the elbows, ankles, knees and shoulders. Damage to the lining of vessels (endothelium) may occur. This can cause pain and failure of the tissue and organ.īubbles can trigger the formation of a blood clot with aggregation of platelets and activation of the clotting cascade. The lack of blood flow means that the tissues are starved of oxygen and tissue death and necrosis may occur. The signs, symptoms and any subsequent damage will depend on the tissues supplied by the blocked vasculature. The formation of bubbles is thought to cause temporary blockage of arteries, capillaries and veins. Recompression duration is dependent upon response to treatment as well as severity signs. Oral or intravenous fluids should be given to treat dehydration and other life support measures should be taken. A higher risk option is in-water recompression. Usually, recompression occurs in a recompression chamber using oxygen. A treatment which has been shown to be effective for minor DCS is recompression on air. Signs and symptoms involving the brain, heart and spinal cord should be managed with hyperbaric oxygen. Mild cases may settle down spontaneously. A non-rebreather mask or other specialised gas delivery system should be used to maximise oxygen delivery. Patients suspected of DCS should be given 100-percent oxygen to breathe as soon as possible. This approximates to 1000 divers in the US every year. These use an algorithm to model gas exchange in the body.ĭCS is rare, with an estimated incidence of 2.0 dives. The schedules are taken from dive computers, software or tables. Many divers will schedule a brief safety stop at 3m, 4.6 m or 6 m, depending on their training regime. Decompression stops may be scheduled, depending on the dive. It is recommended that's divers ascend at about 10 m per minute. As a result most divers use a dive computer or table to measure their exposure and manage their decompression in order to avoid problems. When it does occur it can have life-changing consequences meaning that people take it very seriously. This means that the condition does not occur often. The risk is reduced by following simple decompression techniques. It can also happen during other periods of decompression such as flying in an aeroplane which is unpressurised at altitude. It is similar to when the lid of a fizzy drink bottle is loosened and the pressure released this is when the bubbles form. This happens usually during ascent when the pressure drops. It occurs when gas which has been dissolved in the blood comes out of solution and turns into bubbles inside the body. MB ChB, College of Emergency Medicine Certificate Of Training In Good Clinical Practice In Researchĭecompression sickness (DCS) is also known as 'the bends' or caisson disease. If you have any suggestions for additions or updates please leave a comment below. Medical Screening And Examination For Fitness To Dive The sections include īarotrauma, including damage to ears, sinuses and lungs Here I will cover some of the major topics, including recognition, prevention and management. It is important that people are trained and educated in all safety procedures and know how to look after themselves and each other. Having worked as both an Emergency Doctor and a Dive Doctor I know that diving, when not done correctly, can be very dangerous but when done safely it is the most wondrous thing the sense of adventure and exploration can be overwhelming.
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