DECOMPRESSION SICKNESS

General Information

DEFINITION--A painful, sometimes life-threatening condition of blood gases that is caused by a sudden drop in environmental pressure.

BODY PARTS INVOLVED--Blood in all body parts.

SEX OR AGE MOST AFFECTED--Both sexes; all ages. Usually occurs in young males.

SIGNS & SYMPTOMS--

The following may occur immediately or up to 24 hours after the pressure change:

• Mild to severe joint pain, especially in the shoulders, elbows, hips and knees.
• Chest pain; shortness of breath; a burning sensation behind the breastbone.
• Chokes (severe breathing difficulty experienced by scuba divers and others who go from high to normal air pressure too rapidly. Bubbles of nitrogen develop in the bloodstream and obstruct blood supply to vital organs, sometimes resulting in severe injury or death).
• Coughing.
• Weakness, loss of normal sensation, paralysis, loss of consciousness and coma (rare).
• Inability to speak, see or hear.
• Abdominal pain.
• Difficult urination.

CAUSES--Formation of nitrogen bubbles in the blood. Nitrogen is a normal blood component. If the pressure around the body drops rapidly--as in surfacing too quickly while scuba diving or climbing too rapidly in a non-pressurized aircraft--the nitrogen collects in bubbles in the blood vessels, blocking them and depriving the body of essential blood nutrients.

RISK INCREASES WITH

• Commercial diving or recreational scuba diving. Repeated dives in one day increase the risk.
• Some kinds of high-performance aircraft.
• Working in compression chambers; tunnel work (caisson disease).

HOW TO PREVENT

Obtain professional instruction before scuba diving. > Don't dive if you are not in good general health. You are at risk if you are obese or have a medical history of:

Lung conditions, such as asthma. Spontaneous pneumothorax. Heart disease. Chronic sinusitis. Emotional instability. Alcoholism.

• Allow for a slow, gradual change to normal air pressure in situations listed above. (The U.S. Navy has tested and established guidelines.)
• Avoid air travel for 24 hours after diving.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory blood studies, oxygen levels, EEG (See Glossary), chest x-ray, CT scan (See Glossary).

APPROPRIATE HEALTH CARE

• Self-care is impossible for this condition. If you observe someone with symptoms of decompression sickness, obtain emergency medical care immediately.
• Hospitalization in a decompression chamber to force nitrogen bubbles to dissolve into the blood.
• Treatment is best when it is accomplished early; however some patients may benefit even at 6 to 9 days after the incident. Referral is critical even if symptoms resolve since 25% of patients will relapse.

POSSIBLE COMPLICATIONS

• Permanent brain damage.
• Permanent bone destruction caused by inadequate nourishment from the blood.

PROBABLE OUTCOME--Excellent for patients who receive early treatment; in others, it depends on duration and severity of symptoms prior to treatment.

How To Treat

GENERAL MEASURES----Self-care is impossible for this condition. If you observe someone with symptoms of decompression sickness, obtain emergency medical care immediately.

MEDICATION--Medicine usually is not necessary for this disorder. Don't take pain relievers. These may further decrease normal breathing efficiency.

ACTIVITY--Resume your normal activities as soon as symptoms improve after treatment.

DIET--No special diet.

Call Your Doctor If

You develop any symptoms of decompression sickness within 24 hours after scuba diving or rapid ascent without pressurization.