Decompression sickness

Decompression sickness

Decompression sickness is a condition when nitrogen or other gases form bubbles that block blood vessels or organ tissue. This condition occurs when the body experiences changes in water pressure or air pressure that are too fast.

Symptoms that arise due to decompression sickness can include dizziness, fatigue, and pain in muscles and joints. In severe cases, the symptoms that arise can be similar to those of a stroke, such as numbness, tingling, vertigo, chest pain, and shortness of breath.

Causes of Decompression sickness

Decompression sickness is a result of changes in water or air pressure that are too fast. This disease generally occurs in divers, astronauts, climbers, or workers in airplanes.

Basically, the body needs time to adapt to changes in existing pressure. If the change in pressure occurs too quickly, the nitrogen contained in the blood will form bubbles. These bubbles can clog blood vessels or accumulate in organ tissue.

In divers, decompression sickness occurs if the process of rising back to the surface is not carried out gradually according to safety rules in diving.

Several factors can increase a person's risk of developing decompression sickness, including:

  • Over 30 years old
  • Have a history of injury to the muscles or bones
  • Suffering from a congenital heart defect
  • Get dehydrated
  • Take flight immediately after diving
  • Diving in cold waters or in extreme ocean conditions
  • Experiencing fatigue and lack of sleep
  • Are overweight or suffer from obesity
  • Suffer from heart disease or lung disease
  • Smoking or consuming alcoholic beverages

Decompression sickness symptoms

Symptoms of decompression sickness can be different for each patient, depending on the location of the blockage. Some of the common symptoms of this disease are:

  • The body feels very tired
  • Rash or itching on the skin
  • Pain in joints or muscles
  • Dizzy
  • Ringing ears
  • Hard to breathe
  • Tingling or numbness
  • Difficulty urinating
  • Confusion or changes in behavior
  • Memory loss
  • Bleeding cough
  • Faint

In divers, decompression sickness usually occurs within 15 minutes or more than 12 hours after surfacing. In severe cases, symptoms may occur before surfacing or shortly after surfacing.

When to see a doctor

Immediately consult a doctor if you experience symptoms of decompression sickness within 48 hours after you dive or fly. The sooner the treatment is given, the more optimal the recovery from decompression sickness will be.

Diagnosis of Decompression sickness

The doctor will first ask whether the patient has risk factors for decompression sickness and when was the last time the patient dived. After that, the doctor will examine the symptoms, medical history, oxygen saturation, and the patient's general condition.

To confirm the diagnosis, the doctor will perform a scan with an X-ray, CT scan, or MRI. This procedure aims to see if there are abnormalities in the patient's organs after diving.

Apart from scanning, the doctor will also do a complete blood test which includes:

  • Blood cells
  • Electrolyte levels
  • Blood sugar levels
  • Kidney function
  • Carboxyhemoglobin level
  • Blood lactic acid level
  • Blood clotting function

Decompression sickness treatment

If you see a diver developing symptoms of decompression sickness, the first thing to do is call an ambulance. Next, perform the following steps:

  • Lay the diver on his left side and place his feet higher than his head.
  • Dry the diver's body and warm him with blankets if his body temperature drops.
  • Give the diver pure oxygen via a mask.
  • Position the patient on their back and perform CPR if the patient is unconscious, not breathing, or has no pulse.

After being given the first treatment above, the patient needs to be immediately taken to a hospital that has hyperbaric oxygen therapy facilities . This therapy is carried out in a special room or using a special tube.

Hyperbaric oxygen therapy aims to apply artificial pressure to the body so that the bubbles shrink and disappear. However, the consideration for carrying out this therapy depends on the severity of the symptoms experienced by the patient.

Decompression sickness complications

Decompression sickness that is not treated immediately has the risk of causing the following complications:

  • Sleep disorders
  • Blockage of veins
  • Residual paralysis
  • Heart attack
  • ischemia

Decompression sickness prevention

Decompression sickness is a preventable condition. For divers, take the following steps to prevent decompression sickness:

  • Obey safety rules and orders from dive instructors.
  • Consult with the instructor regarding depth and duration limitations of dives.
  • Use  a dive computer  or special tools that can help divers measure the depth and duration of the dive.
  • Apply  a safety stop  or stop for a few minutes at a certain depth (generally 4-5 meters), before returning to the surface.
  • Avoid flying or traveling to high altitudes for at least 24 hours after the dive
  • Postpone diving if recovering from decompression sickness, for at least 2 weeks.
  • Avoid consuming alcoholic beverages before and after diving.
  • Avoid saunas or hot baths after diving.
  • Make sure the body fluids are sufficient or not dehydrated

If you have a condition that puts you at high risk for decompression sickness, such as heart disease and asthma, don't dive before consulting your doctor.

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