What is decompression sickness and how can you treat it?
Only oxygen or helium and oxygen mixtures should be used in the therapy of decompression sickness in helium and oxygen diving. When therapy has been delayed, intravenous fluids and steroids are important adjuncts.
Does mild decompression sickness go away on its own?
Feb 07, 2022 · Treatment / Management. All decompression sickness cases should have initial treatment with 100% oxygen until HBO therapy is available. Neurological, pulmonary, and mottled skin lesions should be treated with HBO therapy even if seen several days after development. Fluid administration is indicated, as this helps minimize dehydration.
How do you treat decompression sickness?
Hyperbaric oxygen therapy (HBOT) is the prescribed treatment for this condition because it can immediately address the associated symptoms. Decompression sickness allows nitrogen and other gasses to get into the bloodstream. These bubbles of gasses cause dangerous symptoms and significant pain throughout the body, usually referred to as “the bends.”.
How serious is decompression sickness?
The definitive treatment for DCS is hyperbaric oxygen (HBO) therapy, or the delivery of pure oxygen at a pressure substantially higher than that of atmospheric pressure. HBO therapy reduces the size of any bubbles and improves gradients which …
What is the remedy for decompression sickness or bends?
All cases of decompression sickness should be treated initially with 100% oxygen until hyperbaric oxygen therapy (100% oxygen delivered in a high-pressure chamber) can be provided.
What is the remedy for victims who have developed decompression sickness?
Recompression therapy may be beneficial for up to 48 hours or longer after diving and should be given even if reaching the nearest chamber requires significant travel. While awaiting transport and during transport, oxygen is administered with a close-fitting face mask, and fluids are given by mouth or intravenously.
How do hyperbaric chambers help decompression sickness?
Hyperbaric oxygen therapy is used to treat decompression sickness in scuba divers. During these treatments, you breathe pressurized oxygen while you lie inside a clear plastic tube. This helps your body remove the nitrogen that can build up during a dive and make you sick. Side effects from the treatment are rare.
How does hyperbaric oxygen therapy treat decompression sickness?
Hyperbaric oxygen therapy is the primary treatment for DCS. It immediately reduces the amount of bubbles in the bloodstream, fills the tissues with oxygen, and reduces dangerous swelling. In most instances, it's critical to get treatment as soon as possible, because the symptoms of DCS can be life-threatening.
What is the difference between DCS and decompression sickness?
Experts have classified DCS as Type I with symptoms involving only the skin, musculoskeletal system, or lymphatic systems; and Type II with symptoms that involve the central nervous system. Decompression sickness (DCS) occurs when dissolved gasses (usually nitrogen or helium, used in mixed gas diving) exit solution and form bubbles inside ...
Can a gas embolism affect the midbrain?
Cerebral arterial gas embolism affecting the midbrain or cere bellum can also present as inner ear decompression sickness but receives similar treatment. [1] The differential diagnosis for divers should also consider that the stress of diving can exacerbate chronic medical problems.
What does it mean when you have vertigo?
Vertigo can indicate inner ear or vestibular decompression sickness wherein bubbles form in the perilymph fluid of the cochlea. [6] . However, other diving-related causes merit consideration, as recompression and hyperbaric oxygen can cause worsening of some of these conditions.
Is decompression sickness a long term condition?
Complications. Decompression sickness can cause long-term damage. Central nervous system lesions in the spine and brain may occur.
Can oxygen be used on air tables?
The use of oxygen-enriched gas can also ameliorate risk if used on "air tables.". Using a more conservative dive table or dive computer setting will likewise reduce risk. Isobaric decompression, breathing oxygen at depth, likewise can lessen the inert gas burden and reduce decompression sickness risk.
What is DCS in chemistry?
DCS is bubble formation, growth, and elimination caused by a reduction in ambient pressure that results in inert gasses, usually nitrogen, that are dissolved in solution within tissues of the body. Individuals that breathe air in a pressurized environment reach a state of equilibrium/saturation of gas.
Where does DCS occur?
DCS occurs most frequently in the shoulders, elbows, knees, and ankles. Joint pain ("the bends") accounts for most cases, with the shoulder being the most prevalent site. Neurological symptoms present in 10% to 15% of DCS cases with a headache and visual disturbances being the most common symptoms.
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What is the treatment for DCS?
The definitive treatment for DCS is hyperbaric oxygen (HBO) therapy, or the delivery of pure oxygen at a pressure substantially higher than that of atmospheric pressure. HBO therapy reduces the size of any bubbles and improves gradients which promote oxygen delivery and inert gas elimination. HBO therapy is typically delivered in recompression chambers.
What is the first aid measure for DCS?
The foundation of first aid is basic life support. The primary first aid measure for DCS is delivery of supplemental oxygen in the highest concentration, or fraction, that is practical (Longphre et al. 2007). High oxygen fractions, if provided rapidly and over a sustained period, can reduce or even eliminate symptoms of DCS, albeit often only temporarily if definitive treatment is not secured. Continuous-flow oxygen systems, using non-rebreather or pocket masks, are frequently available in diving environs; however, such equipment delivers modest oxygen fractions. Much higher fractions can be achieved with demand masks, though they are appropriate only for conscious individuals able to breathe on their own.
What is decompression sickness?
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.
What are the symptoms of decompression illness?
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.
How long after diving can you fly?
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.
What is hyperbaric oxygen chamber?
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.
Can you drink alcohol while scuba 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.
Can an air embolism cause a stroke?
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.
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.
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How to diagnose decompression illness?
If possible, obtain and document the following information for all suspected cases of decompression illness: 1 All dives (depth, time, ascent rates, surface intervals, breathing gases) for 48 hours preceding the injury. Also note problems or symptoms at any time before, during or after the dive. 2 Symptom onset times and progression after surfacing from the last dive 3 All first aid measures (including times and method of emergency oxygen delivery) and their effect on symptoms 4 Results of an on-site neurological examination 5 All joint or other musculoskeletal pain including location, intensity and changes with movement or weight-bearing maneuvers 6 Description and distribution of any rashes 7 Any traumatic injuries before, during or after the dive.
What is DCS in medical terms?
DCS (also called the bends or caisson disease) results from inadequate decompression following exposure to increased pressure. In some cases, it is mild and not an immediate threat. In other cases, a serious injury occurs. The sooner the treatment of an injury begins, the better the chance for a full recovery.
Can diving cause DCI?
Almost any dive profile can result in DCI, no matter how safe it seems. The risk factors, both known and un known, can influence the probability of D CI in many ways. Evaluation of a diver for possible decompression illness is done on a case-by-case basis.
What are the risk factors for DCI?
The main risk factor for DCI is a reduction in ambient pressure, but other risk factors will increase the likelihood of DCI occurring. The known risk factors for divers are deep or long dives, cold water, heavy exercise at depth, and rapid ascents. Rapid ascents contribute significantly to the risk of AGE.
How long does it take for a scuba diver to show symptoms?
Note: Signs and symptoms usually appear within 15 minutes or up to 12 hours after surfacing. In severe cases, symptoms may appear before surfacing or immediately afterward. Delayed onset of symptoms is rare but can happen, especially if air travel follows diving.
What causes a bend in the spine?
Bubbles forming in or near joints are the presumed cause of joint pain (the bends). With high levels of bubbles, complex reactions can take place in the body. The spinal cord and brain are usually affected, causing numbness, paralysis, impaired coordination and disorders of higher cerebral function.
How long does it take for a DCI to resolve?
There may be residual symptoms after treatment. Soreness in and around an affected joint is common and usually resolves in a few hours. If the DCI was severe, there could be significant residual neurological dysfunction. Follow-up treatments, along with physical therapy, can help.
What is decompression sickness?
Decompression sickness (DCS) is caused by the formation of bubbles of gas that occur with changes in pressure during scuba diving. It is also experienced in commercial divers who breathe heliox (a special mixture of oxygen and helium), and astronauts and aviators who experience rapid changes in pressure from sea level.
What are the symptoms of decompression?
Occasionally someone with decompression illness may have symptoms suggesting an inner ear problem, such as a spinning sensation, deafness, ringing in the ears, or vomiting. This group of symptoms is called the "staggers."
How long after decompression sickness can you dive?
Follow up immediately for any further signs or symptoms of decompression illness within the next 7 days. After suffering decompression sickness, individuals should not dive again until cleared by a doctor. Depending on the severity of symptoms, and if the person has suffered decompression sickness before, the doctor will likely recommend not to dive again or to avoid diving for some amount of time.
How long after diving can you fly?
Flying within 18 hours after diving: Most experts consider it reasonably safe to fly 12 hours after the last dive if the person only dove once, dove easily within the dive tables, and no decompression stop was required. For more complicated diving, waits of 48 hours have been recommended.
What is scuba diving?
Scuba diving is a sport and hobby that continues to increase in popularity each year. There are several organizations that certify individuals to become recreational divers, two of which are PADI (The Professional Association of Diving Instructors) and NAUI (The National Association of Underwater Instructors).
How does nitrogen affect the body?
As the pressure due to nitrogen increases, more nitrogen dissolves into the tissues. The longer a diver remains at depth, the more nitrogen dissolves. Unlike the oxygen in the air tank a diver uses to swim underwater, the nitrogen gas is not utilized by the body and builds up over time in body tissues.
How long does it take for a diver to show symptoms?
The nervous and musculoskeletal system are most often affected. If divers are going to develop symptoms, they will show within 48 hours in all cases. Most have symptoms within 6 hours, while some develop them within the first hour of surfacing from a dive.
What is the medical term for scuba diving?
In scuba diving, the more widely used term is Decompression Illness. This term encompasses both Decompression Sickness as well as Lung Over Expansion Injuries. This makes it easy to understand and removes the need for an exact diagnosis among first responders.
What injury can a diver get?
Another injury a diver can get is an over expansion injury . In this case, the diver has either held their breath while ascending or had a considerable blockage in their lung.
Can you drink alcohol while scuba diving?
Scuba diving and drinking alcohol is a no-no. But why and what are the risks involved? And can you drink alcohol after a dive? Scuba Diving and Drinking Alcohol It is well-known that alcohol affects us. Sometimes positively, and sometimes negatively. It can affect our bodies, emotions, and the way we think. This can lead ]
What Is Decompression Sickness?
Symptoms
- Symptoms of decompression sickness include: 1. Joint pain 2. Dizziness 3. Headache 4. Difficulty thinking clearly 5. Extreme fatigue 6. Tingling or numbness 7. Weakness in arms or legs 8. 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.
Prevention
- To minimize the risk of decompression sickness while diving: 1. 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. 2. Do not fly within 24 hours after diving. 3. Don't drink alcohol before diving. 4. Avoid hot tubs, saunas or hot baths after diving. 5. …
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 pa...
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.
Further Information
- Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Medical Disclaimer