DECOMPRESSION SICKNESS

(Bends)

 Basic information

description

Decompression sickness is a condition caused by the formation of nitrogen bubbles in the blood or body tissues as the result of a sudden lowering of atmospheric pressure. It can develop in deep-sea divers, astronauts, and pilots ascending too quickly. Symptoms may occur right away or up to 24 hours after the pressure change.

FREQUENT SIGNS & SYMPTOMS

• Mild to severe joint and/or muscle pain (arms, legs, or torso).
• Numbness, tingling or burning sensation.
• Muscular weakness.
• Difficulty urinating.
• Unusual fatigue.
• Skin itch, blotchy rash.
• Dizziness, vertigo, tremors.
• Ringing in the ears.
• Shortness of breath.
• Paralysis, muscle weakness, staggering.
• Confusion, amnesia, personality changes, or bizarre behavior.
• Coughing up bloody, frothy sputum.
• Paralysis, collapse or unconsciousness.

causes

Formation of nitrogen bubbles in the blood. Nitrogen is a normal blood component. If the pressure around the body drops rapidly, as in surfacing too quickly while scuba diving, or climbing too rapidly in a non-pressurized aircraft, the nitrogen collects in bubbles in the blood vessels. This blocks the normal blood flow and deprives the body of blood and oxygen.

risk increases with

• Commercial diving or recreational scuba diving. Repeated dives in one day increase the risk.
• Some kinds of high-performance aircraft.
• Working in compression chambers.

PREVENTIVE MEASURES

• Obtain certified instruction before scuba diving.
• Don't dive if you are not in good general health. You are at risk if you are obese or have a medical history of:
  • Lung conditions, such as asthma.
  • Pneumothorax.
  • Heart disease.
  • Chronic sinusitis.
  • Alcoholism.
• Allow for a slow, gradual change to normal air pressure when scuba diving. (The U.S. Navy has tested and set up guidelines.).
• Avoid air travel for 24 hours after diving.

expected outcomes

Usually good for patients who receive early treatment. In others, it depends on duration and severity of symptoms prior to treatment.

possible complications

• Arterial gas embolism (gas bubbles block airflow to vital organs such as the brain).
• Rarely, there may be permanent damage to the lungs, bones, brain, or heart, possible paralysis, or death.

 diagnosis & treatment

general measures

• Self-care is impossible for this condition. If you observe someone with symptoms of decompression sickness, get emergency medical care immediately.
• Treatment involves time in a decompression chamber to force nitrogen bubbles to dissolve into the blood.
• Treatment is best when it is done early. However, some patients may benefit even at 6 to 9 days after the incident. Medical care is critical even if symptoms resolve because 25% of patients will relapse.
• For assistance in locating the nearest treatment chamber in your area, call the emergency Divers Alert Network (DAN) at any hour, (919) 684-4326 (accepts collect calls). For non-emergency information, call (919) 684-2948; website: www.diversalertnetwork.org.

medications

Drugs are usually not needed for this disorder. Don't take pain relievers. These may further decrease normal breathing function.

activity

Resume your normal activities as soon as symptoms improve after treatment.

diet

No special diet.

 notify our office if

You have symptoms (or observe them in another person) of decompression sickness within 24 hours after scuba diving or rapid ascent without pressurization.

Special Notes: