Decompression Sickness

(Caisson Disease; Altitude Sickness; Dysbarism; The Bends; DCS)

Definition

Decompression sickness (DCS) occurs when the body is exposed to a sudden drop in surrounding pressure.

Causes

DCS is caused by the formation of gas bubbles in the blood and tissues. At normal altitudes, nitrogen and other gases are exhaled or dissolved in the blood and tissues. However, during severe changes in altitude and air pressure, nitrogen and other gases form gas bubbles. These bubbles block the flow of blood. This condition can be fatal if not treated quickly.

Risk Factors

This condition is more common in older adults. The only risk factor that increases your chance of getting DCS is a sudden reduction in pressure. This occurs as a result of:
  • Rising too quickly to the surface from deep sea scuba diving
  • A fast ascent into a high altitude from a low altitude
  • Sudden exit from a high pressure or hyperbaric chamber
  • Increased risk with increased depth of dive
  • Long duration of dive
  • Multiple dives in one day
  • Flying after diving
  • Diving in cold water
  • Fatigue
  • Exertion
  • Dehydration
  • Obesity

Symptoms

The less severe type of DCS is called DCS I. It primarily results in inflammation of muscles, joints, and tendons, resulting in pain and swelling. This is commonly referred to as the bends. Although pain may occur anywhere in the body, it is most common in or near an arm or leg joint. The pain may become more severe over time. Itching, skin mottling, weakness, and fatigue also occur. The more severe type of DCS is called DCS II. This results in more serious systemic effects, including neurological symptoms such as numbness and tingling. In the most severe form, numbness may lead to paralysis and even death. Other symptoms of DCS II include:
  • Stomach pain
  • Back pain
  • Headache
  • Lightheadedness
  • Confusion
  • Vision problems
  • Vertigo—the sensation of movement when a person is still
  • Chest pain and severe coughing
  • Shock
If an individual dives occupationally and has regular exposure to increased pressure, a mild, chronic case of the bends may occur without detection. Over time, this can result in deterioration of affected joints and bones.
Progressive Joint Damage
Damaged Joint
Copyright © Nucleus Medical Media, Inc.

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