Decompression sickness

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Obesity, Sleep & Internal medicine
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Decompression sickness
Synonyms	The bends, Caisson disease
Pronounce	N/A
Specialty	Emergency medicine, Underwater diving
Symptoms	Joint pain, dizziness, headache, difficulty breathing, fatigue
Complications	Paralysis, death
Onset	Minutes to hours after surfacing
Duration	Varies, can be chronic if untreated
Types	N/A
Causes	Rapid decrease in pressure around the body
Risks	Scuba diving, high-altitude flight, spacewalks
Diagnosis	Based on symptoms and history of pressure change
Differential diagnosis	Arterial gas embolism, inner ear barotrauma
Prevention	Slow ascent, use of decompression stops, breathing oxygen
Treatment	Hyperbaric oxygen therapy, supportive care
Medication	N/A
Prognosis	Good with prompt treatment
Frequency	1,000 cases per year in the US
Deaths	N/A

Naval Base Guam dive locker (150225-N-ZB122-002)

Early diving recompression chamber at Broome, Western Australia

Decompression sickness (DCS), also commonly known as the bends, is a potentially serious condition that can occur when a scuba diver ascends too quickly from depth. It results from the formation of gas bubbles in the body's tissues, due to rapid changes in pressure during ascent.

Pathophysiology

Under pressure, gases (primarily nitrogen) are dissolved in body tissues. When a diver ascends rapidly, the decrease in pressure can cause these dissolved gases to come out of solution and form bubbles. These bubbles can disrupt normal physiological processes and cause a variety of symptoms.

Symptoms

Symptoms of DCS can vary greatly depending on the size and location of the gas bubbles. Common symptoms include joint and muscle pain (hence "the bends"), dizziness, fatigue, and skin rash. More severe symptoms can include paralysis, confusion, seizures, or respiratory and cardiac problems.

Prevention

Prevention of DCS primarily involves ascending slowly from depth to allow dissolved gases to be eliminated gradually from the body, a process known as off-gassing. Divers are also often trained to make safety stops during ascent to further reduce the risk.

Treatment

The primary treatment for DCS is recompression in a hyperbaric chamber, which increases pressure and helps to re-dissolve gas bubbles. Oxygen is also often administered to help flush out the nitrogen.

See Also

• Scuba diving
• Hyperbaric medicine
• Barotrauma
• Gas embolism

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