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All About Decompression Sickness

Causes, Types, and Symptoms

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Also known as The Bends and Caisson Disease, Decompression Sickness is an illness that can affect divers or other people (such as miners) who are in a situation that involves pressure rapidly decreasing around the body.

DCS, as it is commonly know, is caused by a build up of nitrogen bubbles in the body. When we breathe, approximately 79 of the air we're breathing is nitrogen. As we descend in water, the pressure around our bodies increases, causing nitrogen to be absorbed into our body tissues. This is not actually harmful and it's quite possible for the body to continue to absorb nitrogen until it reaches a point called saturation, which is the point at which the pressure in the tissues equals the surrounding pressure.

The problem arises when this pressure needs to be released. In order to release the nitrogen slowly from the body, a diver must ascend slowly and carry out decompression stops if necessary - this allows the nitrogen to slowly seep out of the body tissues and either immediately revert to being a gas or to become tiny harmless bubbles which will eventually become revert to gas. This process is called "Off-gassing" and is normally carried out through the lungs.

If a diver ascends too fast and the nitrogen escapes the body tissue too quickly it becomes bubbles in the body and this leads to Decompression Sickness. The bubbles must normally be on the arterial side of the circulatory system to be harmful - they are usually harmless on the venous side. There are several types of Decompression Sickness:

Type I Decompression Sickness

Type I Decompression Sickness is the least serious form of Decompression Sickness. It normally involves only pain in the body and is not immediately life threatening. It is important to note that symptoms of Type I Decompression Sickness may be warning signs of more serious problems.

  • Cutaneous Decompression Sickness
    This is when the nitrogen bubbles come out of solution in skin capillaries. This normally results in a red rash, often on the shoulders and chest.
  • Joint and Limb Pain Decompression Sickness
    This type is characterized by aching in the joints. It is not known exactly what causes the pain as bubbles in the joint would not have this effect. The common theory is that it is caused by the bubbles aggravating bone marrow, tendons, and joints. The pain can be in one place or it can move around the joint. It is unusual for bisymmetrical symptoms to occur.

Type II Decompression Sickness

Type II Decompression Sickness is the most serious and can be immediately life-threatening. The main effect is on the nervous system.

  • Neurological Decompression Sickness
    When nitrogen bubbles affect the nervous system they can cause problems throughout the body. This type of Decompression Sickness normally shows as tingling, numbness, respiratory problems, and unconsciousness. Symptoms can spread quickly and if left untreated can lead to paralysis or even death.
  • Pulmonary Decompression Sickness
    This is a rare form of Decompression Sickness that occurs when bubbles form in lung capillaries. Fortunately, the majority of the time bubbles dissolve naturally through the lungs. However, it is possible for them to interrupt blood flow to the lungs which can lead to serious and life-threatening respiratory and heart problems.
  • Cerebral Decompression Sickness
    It is possible for bubbles that make their way into the arterial blood stream to move to the brain and to cause an arterial gas embolism. This is extremely dangerous and can be identified by symptoms such as blurred vision, headaches, confusion, and unconsciousness.

Other Forms of Decompression Sickness

Extreme tiredness is very common in cases of Decompression Sickness and can sometimes be the only symptom of Decompression Sickness present. It is not know what causes this but you should be aware that extreme fatigue could be a sign of more serious problems. It is also possible for Decompression Sickness to occur in the inner-ear. This is caused by bubbles forming in the cochlea's perilymph during decompression. The result can be hearing loss, dizziness, ringing of the ears, and vertigo.

Symptoms

Decompression Sickness can manifest itself in many different ways and has many different symptoms, but the most common symptoms are:

  • Extreme Fatigue
  • Joint and Limb Pain
  • Tingling
  • Numbness
  • Red Rash on Skin
  • Respiratory Problems
  • Heart Problems
  • Dizziness
  • Blurred Vision
  • Headaches
  • Confusion
  • Unconsciousness
  • Ringing of the Ears
  • Vertigo
  • Stomach Sickness
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