Divers often report some of these symptoms in combination with other more obvious symptoms of decompression illness. During the course of treatment they find that these resolve as well, a clear sign that gas bubbles are implicated.
Gas bubbles present in sufficient number and size in the brain or the spinal cord can lead to a host of symptoms. More commonly affected is the spinal column, sometimes preceded with girdle or abdominal pain. Examination by the Diving Doctor can often determine which nerves are affected and give further insight into the type of decompression illness a diver has. In cases where the sheer number and position of gas bubbles overwhelm the gas filtering capability of the lungs, blood flow can be impaired leading to a sensation of struggling for breath.
A diver may report chest tightness or pain, difficult and rapid breathing. Such cases can frequently deteriorate very rapidly. If sufficient gas bubbles form in the inner-ear, particularly the hearing cochlea or balance organs vestibular , then inner-ear or vestibular decompression illness may result. Symptoms can include hearing loss, tinnitus or ringing in the ear s , vertigo, nausea and vomiting. Divers often want to lay down without moving the head in particular, which can minimise what can often be very significant vertigo and dizziness.
Often associated more frequently with deeper, repetitive dives, sometimes using trimix, it is very unpleasant for the diver and can require more than one treatment to resolve. A pressure injury, or barotrauma, of the ear can cause some similar symptoms and can be ruled out by the examining Doctor. The presence of shock in a diver is often an indication of serious, evolving decompression illness.
One potential cause is hypovolaemia, where fluid imbalance results from gas bubbles affecting the ease with which body fluids can pass through cell walls. Depending on the specific cause, typical symptoms include anxiety, bluish lips, chest pain, confusion, dizziness or faintness, pale clammy skin, profuse sweating. Bloody froth from mouth or nose Paralysis or weakness Respiratory arrest, not breathing Convulsions Unconsciousness, death. Dizziness Areas of reduced sensation Blurred vision Chest pain Confusion, disorientation If a diver surfaces rapidly and either does not exhale, or exhales insufficiently, then air that is present in the lungs can expand on ascent.
This is particularly apparent in the last 10 metres to surface. If the air expands enough it can rupture lung tissue — called pulmonary barotrauma — which releases gas bubbles into the arterial circulation. This then carries the bubbles around the body in the blood stream and since the brain has a high blood flow it is the main organ where bubbles may interrupt circulation if they become lodged in small arteries.
This is known as an arterial gas embolism, or AGE. Symptoms are instantaneous or within minutes. An AGE can occur from very shallow depths — even from swimming pools! While very minor symptoms of DCS may go away with just rest and over the counter pain medications, it is thought that treatment with recompression and oxygen is ideal to prevent any possible long term effects from the injury.
For cases of severe DCS, recompression therapy using hyperbaric oxygen is critical and should not be delayed.
Many clinical studies have demonstrated that a delay prior to treatment results in the need for more aggressive therapy and increases the chances of having incomplete resolution of symptoms. Treatment of decompression sickness with hyperbaric oxygen HBO has few associated risks but is both time and labor intensive. Because of this, physicians who treat divers have a low threshold for initiating treatment. Distinguishing between pain due to trauma during the dive and pain from mild DCS can be very difficult.
There is even a phenomenon that occurs when the weight belt presses on some nerves in the hips, giving the diver numbness down the thighs. The treating physician should take a very detailed history regarding the dive if time allows. Divers who present with symptoms of decompression sickness shortly after completing a dive will likely receive treatment as there is more concern for under-treatment than over-treatment.
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You are using an out of date browser. It may not display this or other websites correctly. You should upgrade or use an alternative browser. How long can DCS last? Thread starter GoingScuba Start date Aug 5,
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