Diving sickness or decompression sickness has been fatal to many divers in the past because its causes were not sufficiently researched and known. With today’s knowledge and state-of-the-art technology, diving sickness can be defeated and prevented.
What is diving sickness?
The colloquial term diving sickness is used for a health impairment that is much more meaningful under the term decompression sickness. For what does bacterial endocarditis stand for, please visit ezhoushan.net.
Diver’s sickness, or decompression sickness, isn’t unique to divers. It can also be fatal when exiting into a vacuum, such as in space. Other names for diving sickness are compressed air or caisson sickness.
The causative factors that lead to diving sickness have only been known since the middle of the 20th century. The name caisson disease goes back to so-called caissons, with which the caisson workers were lowered into the depths of water and pulled up again. In medicine, diving sickness is considered a trauma.
Causes
The causes of diving sickness are based on the fact that after a stay at a certain depth, surfacing causes an anesthetic-like trauma in the neurological area.
When people dive and reach enormous depths, the nitrogen in the compressed air is pushed into individual tissues of the body. If the water pressure decreases while surfacing, the gases suddenly rise into the brain because they cannot be exhaled through the lungs, causing diving sickness.
This process takes place in diving sickness when there is a hasty ascent.
Symptoms, Ailments & Signs
Diving sickness is divided into two classes depending on the severity of the symptoms. Type I causes only slight symptoms, typical is pain in the joints and muscles. Due to the blockage of small blood vessels (microembolism), the skin on the face, ears, upper body and arms begins to itch and skin patches develop that resemble insect bites (diving fleas).
The formation of edema is possible. Air can accumulate in the hypodermis, which is clearly visible through deformations. These accumulations of air crackle or crunch when palpated. In addition to the symptoms of type I, type II of the disease shows other severe symptoms that can become life-threatening. The central nervous system is affected and neurological deficits occur. Paralysis and sensory disturbances are possible.
Nitrogen bubbles in the vessels or in the organ itself can interrupt the oxygen supply to the brain and heart. Clouding of consciousness can occur, leading to unconsciousness and respiratory arrest. Other complaints are severe headaches, chest pains, heart and circulatory disorders and dizziness.
Shortness of breath occurs and the patient has the feeling of suffocating. Coordination disorders arise and the ability to speak is impaired. In severe cases, tissue and bone necrosis may occur. If left untreated, the disease can lead to death.
Diagnosis & History
If the divers rise from a great depth and too quickly after a long dive, the microbubbles in the tissue not only lead to a state of intoxication, but can also destroy individual tissue regions in which they were stored in the case of diving sickness.
Diving sickness can cause people to become disoriented and even unconscious, which used to be a common cause of drowning. Symptoms typical of the course of diving disease include pain in the joints and muscles, oedema, persistent itching, tiredness and weakness, disturbances in skin perception and coordination, nausea, vomiting, loss of hearing and vision and, after loss of consciousness, breathing stops.
There are mild and severe, fatal forms of diving disease. When diagnosing diving disease, the focus is on the condition of those affected.
Complications
Depending on the type of diving disease, different complications and long-term effects can occur. Type 1 diving disease causes pain in the muscles of the arms and legs and in the joints. Under certain circumstances, these are associated with restricted movement and incorrect posture, which can result in joint damage and, as a result, premature joint wear.
Type 2 diver’s disease almost always causes serious complications, which can be life-threatening. When nitrogen bubbles clog blood vessels, the central nervous system, heart, and lungs suffer significant damage. The supply to the brain can also be blocked, which can quickly lead to irreversible damage.
Typical subsequent symptoms include speech disorders, paralysis, damage to the inner ear, pain and loss of consciousness. As a complication of diving disease, gas embolism can occur in the lungs, causing death of lung tissue and eventual organ failure. Symptoms of a stroke can also occur.
Improperly performed first aid measures can cause serious complications. Medical treatment is always associated with the risk that the medication administered will cause side effects and interactions or that an allergic reaction will occur.
When should you go to the doctor?
If divers have pain in their muscles, bones or joints, they need a medical examination. Itching in the upper body, changes in the usual complexion and swelling are signs of health problems. A doctor’s visit is necessary because complications can occur in severe cases. Sensitivity disorders, accumulation of air in the organism and loss of memory are alarm signals from the organism.
Crackling noises are characteristic of diving sickness as soon as slight external pressure is applied to the swelling of the body. If a noise is heard, consult a doctor as soon as possible. If you lose consciousness or stop breathing, call an ambulance. Intensive medical treatment is required because the patient is at risk of dying. Until the arrival of the emergency doctor, first aid measures must be carried out by those present.
If you experience headaches, dizziness, restricted breathing or changes in speech immediately after a dive or while surfacing, a medical examination is required. An inner weakness, a general malaise and the loss of physical performance should be presented to a doctor. Chest discomfort and incoordination are further signs of an irregularity. If the symptoms are found in people who come from a vacuum, a doctor’s visit is also necessary.
Treatment & Therapy
Immediate treatment is required to alleviate the symptoms associated with diving disease and reduce the risk of death and long-term complications.
If the condition of the person affected by a diving illness is acutely life-threatening (unconsciousness, respiratory failure), emergency care must be provided (artificial respiration, stable lateral position ).
As a further therapeutic measure, a different length of stay in a so-called pressure chamber is initiated. The purpose of this is that the gas bubbles stored in the tissue can slowly escape again as a result of the pressure adjustment. Overpressure acts on the patients in the pressure chamber. During this period, they remain in direct radio contact with the doctor in order to be able to carry out targeted observation and rule out further hazards.
In the case of diving sickness, the hyperbaric chamber gradually leads to the organism adapting to the pressure conditions prevailing on the surface of the earth. The untreated diving disease should not be underestimated in connection with the possible late effects. These affect the bone and lung tissue in particular.
Prevention
In order to prevent a diving illness, it is important to carry functional control and display instruments with you during the dive. The risk factors for diving disease increase the longer and deeper the dive. The entire diving operation should also be adapted to the given physical conditions in order to prevent decompression sickness.
The divers should not overestimate themselves in order to keep the risks as low as possible. When surfacing, you should not stay alone and you should definitely comply with the appropriate decompression times, so that a diver’s illness can be avoided.
Aftercare
A successful, completed treatment of diving sickness requires a complete elimination of the gas bubbles in the body. Depending on the severity of the disease, permanent damage cannot be ruled out. Once the treatment of a mild to mild illness is completed, no further follow-up examinations are necessary. The sufferer is free of symptoms and signs.
In the event of a serious illness with permanent damage or disabilities, appropriate follow-up treatment must be initiated. Particular caution is required if the person concerned wants to dive again. In this case, a specially trained diving doctor should be consulted. This decides whether and when diving is possible again. Depending on the severity of the disease, this varies between a few days and several months.
Since the person concerned has a previous condition, a relapse or another illness cannot be ruled out if he dives again. It is not uncommon for this to be more serious than the first illness. In the future, diving must be more conservative than before, which involves strict adherence to well-established diving rules.
No decompression dives or extremely deep dives as the risk of recurrence is significantly higher. Instead of diving with normal air mixture with oxygen-enriched mixture (Nitrox) and dive computer in air mode. Avoidance of frequently repeated dives with short surface intervals. Avoidance of any physical exertion before, after and during the dive.
You can do that yourself
Before each dive, it must be checked whether the general state of health is optimal for the project. In case of the slightest inconvenience or health impairment, the diving procedure should be canceled or postponed. Existing fears, inner insecurities or a weakening of the organism can have serious consequences during diving. Therefore, early and critical monitoring of one’s own well-being is necessary in the field of self-help.
Overestimating one’s own skills can lead to life-threatening developments. A diving project should never be undertaken alone. A partner is needed so that help can be provided immediately if irregularities arise. The emergency signals must be defined jointly in advance. In addition to checking the equipment, good consultation is one of the necessary measures before diving. Health issues should also be addressed. Experiences from the past are to be communicated to the partner. Every diver must know and respect their own physical limitations.
As soon as problems or health problems occur during the diving process, the diving buddy must be informed accordingly and the diving process must be ended as quickly as possible without hectic. It is often sufficient if the depth reached is checked in good time so that there are no impairments. The emergence must not be too fast. Care must be taken to avoid irreversible damage.
