hen to Seek Medical Care

Any victim reporting signs or symptoms of decompression illness that began within 48 hours of scuba diving should be seen by a doctor at an emergency care facility.

The doctor will likely presume that a victim reporting symptoms within 48 hours of surfacing from a scuba dive to have decompression illness. It is important to inform the doctor of your recent diving experience and its temporal relation to your symptoms.

 

The Bends Treatment

Self-Care at Home

Rescue the diver from the water and provide emergency care within the limits of your training.

  • Dry and rewarm the diver with blankets if hypothermic (drop in body temperature).
  • You can visit the Divers Alert Network Web site or call them in the United States at (919) 684-8111 to determine where the nearest hyperbaric chamber is located.
  • Transport the person in a supine position (horizontal, lying on their back) to an emergency care facility. If a hyperbaric chamber is available, you may coordinate to transport directly to that facility for definitive care.
  • If you must use air transport, attempt to find an air frame that can transport the diver at below 1,000 feet or pressurize the cabin to sea level pressure. Use high-flow oxygen if it is available during transport.

Medical Treatment

The doctor will first treat immediate life threats, such as breathing problems or shock, if present.

  • The diver will need high-flow oxygen and IV fluids. Blood and urine will be sent for laboratory tests to assess any blood clotting problems and hydration status.
  • The diver will need to go to a hyperbaric chamber (for many divers or a single chamber) for recompression. During this process the chamber becomes pressurized with air and oxygen based on prearranged protocols to simulate pressure depths of 30-60 feet. Typical dives last 140-270 minutes, but may last longer. At this depth or chamber pressures, bubbles are reduced in size or reabsorbed to ensure adequate blood flow. Recompression prevents further bubble formation and provides high amounts of oxygen to the injured tissues. Further treatments depend on how the diver responds to the initial treatment.
  • Often the person is admitted to the hospital to monitor medical condition and to ensure that there is no recurrence of symptoms.

Follow-up

Follow up immediately for any further signs or symptoms of decompression illness within the next 7 days. After suffering decompression sickness, you should not dive again until cleared by a doctor. Depending on the severity of symptoms, and if you have suffered decompression sickness before, your doctor will likely recommend not to dive again or to avoid diving for some amount of time.


Outlook

Prognosis varies with the following factors:

  • Prognosis is good with hyperbaric oxygen treatment.
  • Delay to hyperbaric oxygen treatment: Although reports show that victims can do well after days of symptoms, delay in definitive treatment may cause damage that is irreversible.
  • Severity of symptoms: Joint pains alone do better than focal weakness or inability to urinate.
Preexisting health: Young, healthy people can tolerate a greater insult to their health than an older person with other disease