Decompression Illness

Decompression illness can develop during scuba diving and occurs in the following conditions:

• When gas bubbles become entrapped in the body as a result of rapid ascent
• After inadequate exhalation during ascent
• Holding your breath during scuba diving
• Air trapping in the lungs due to water inhalation or lung diseases

Risk factors for decompression illness include cold, stress, fatigue, dehydration, obesity, old age, alcohol, exercise, flying after diving, rapid ascents, deep diving, and repetitive diving.

Two types of decompression sickness exist: Type I involves the muscles, skin, and lymphatics. Type II involves the brain, ears, and lungs (typically more serious).

Record all details of recent dive profiles. To help prevent decompression illness, do not fly on an airplane for at least 12 hours after 2 hours of total dive time during the previous 2 days.

• Decompression illness symptoms generally begin within 6-48 hours after diving.
• Type I symptoms include aching of joints, most commonly the elbow and shoulder joints, mottling of the skin, itching, and rash.
• Type II symptoms include nausea, vomiting, headaches, fatigue, dizziness, numbness and tingling, and chest pain. Less common symptoms include coughing, difficulty urinating, loss of bowel or bladder control, blood in the stools, ringing in the ears, hearing loss, and shortness of breath. Very severe symptoms include paralysis, seizures, slurred speech, loss of vision, confusion, and coma. Death can occur.

• Give 100% oxygen to a person with decompression illness.
• If the person with decompression illness has nausea or is not fully conscious, place that person on his or her side.
• Administer IV fluids if possible. Otherwise, administer sips of nonalcoholic, clear liquids as tolerated.
• Administer CPR if necessary.

• Seek medical treatment in all cases of decompression illness.
• Arrange hyperbaric oxygen treatment for a person with decompression illness as soon as possible (see diving emergency contacts).
• Check with local wound clinics, as many have hyperbaric chambers.

Divers Alert Network (DAN), About DAN

MedlinePlus, Hyperbaric Oxygen Therapy