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General Info

Decompression Sickness (The Bends)

While there’s always a possibility that decompression sickness (DCS) will occur, even when you do everything right, you should be aware that the primary reason divers suffer DCS is diver error.

These errors cause the diver to absorb more nitrogen than they should, or fail to release nitrogen safely before surfacing.

Predispositions for DCS include:

Excess fat;

Fat tissue holds more dissolved nitrogen.

Age.

Circulatory system becomes less efficient, slowing nitrogen elimination.

Heavy exertion;

Before, during or after a deep dive, can promote micro-bubbles that grow as excess nitrogen dissolves into them. Exertion during the dive speeds up the circulation, accumulating more nitrogen than normal.

Injuries and Illness;

Effect circulation and the ability to eliminated nitrogen.

Dehydration;

Reduces the quantity of blood circulating to eliminate nitrogen.

Use of Alcohol;

Before the dive this can cause dehydration and immediately after the dive it alters circulation, possibly promoting bubble growth.

Cold water;

To save heat, the body restricts circulation to parts of the body, thereby eliminating nitrogen less effectively.

Hot showers/Baths;

Immediately after a dive cause skin capillaries to dilate, altering circulation.

Exposure to altitude;

Lower pressures cause quicker nitrogen release.

Follow current recommendations when flying or driving to altitude.

Carbon dioxide increase;

This is usually caused by exertion or skip-breathing (breath holding) and interferes with the blood’s ability to carry nitrogen.

Prevention and Treatment

To prevent DCS, adhere to SAFE, conservative diving practices, Stay well within the limits of your dive table or computer, and make safety stops.

If it is suspected that a diver has DCS, administer 100 percent oxygen, if available. This helps eliminate nitrogen and raises the blood oxygen level to assist tissues receiving less than normal. For most cases, have the diver lie on his/her back or left side, whichever is more comfortable, but don’t let him/her sit up. An unconscious breathing diver should be laid on his/her left side.

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Signs and Symptoms

A diver suffering from DCS may show various signs and experience various symptoms, depending on where bubbles form in the body.

Signs:

Favouring an arm or leg, rubbing a joint, paralysis, unconsciousness, staggering, collapse, coughing spasms and blotchy skin rash.

Symptoms:

Pain in the limbs and joints, numbness, tingling, paralysis skin itch, unusual fatigue, weakness and shortness of breath.

In the majority of instances, DCS occurs at the surface within one or two hours, but can occur underwater at shallow depth. Symptoms can be delayed for as long as 48 hours.

Diver Errors Include

Misuse of, or failure to use dive tables or dive computer
Exceeding proper ascent rates
Omitting emergency decompression stops
Running out of air - which can lead to exceeding proper ascent rate and omitting emergency decompression/safety stops
Ignoring factors that predispose divers to DCS (See below)
Failure to follow conservative diving practices.