Decompression Illness
Getting the bends doesn’t have to be anyone’s fault, but it’s important to recognise the symptoms as soon as possible. Tony Day reports

Steve Bartley, a diver of some years, booked a day’s diving off Plymouth with his buddy Mike. All went very well during the first two dives and the pair were in good spirits.

On surfacing from the second dive, the two friends found they were about 50m from their boat, which was manoeuvring to pick up another pair of divers. Rather than wait for the boat to come to them, they decided to swim the relatively short distance. As they climbed aboard, though, Steve felt a strange, stiffening sensation in his legs and only just managed to crawl on to the boat before he fell flat on his face. For a moment, he lay motionless on the cold, wet deck. ‘Are you all right?’ somebody asked.

Terrified and almost in tears, Steve whispered, ‘I can’t move.’ He was paralysed from the neck down.

The other divers moved Steve into a more comfortable position and immediately gave him oxygen. Very quickly, he began to feel a little better and, surprisingly (considering the initial severity of his symptoms), by the time the coast guard arrived in a whirr of helicopter blades he was able to move. Five minutes later, the helicopter, now with Steve on board, touched down at the Diving Diseases Research Centre (DDRC) in Plymouth and, with a little help, Steve was able to walk in.

After an initial examination by doctors, Steve was placed inside a decompression chamber and carefully monitored. Amazingly, after a second treatment, he was subsequently released, having completely recovered and showing no residual symptoms of decompression illness. He was lucky.

So, what had he done wrong to get decompression illness in the first place? Well, actually, nothing at all. It’s a common misconception that you get DCI only if you do something stupid, such as dive beyond the accepted limits. According to Steve’s dive computer, his profiles were okay. He hadn’t drunk any alcohol before going diving, wasn’t overweight, didn’t smoke and wasn’t dehydrated. So, why did he get bent? Unfortunately, there’s no obvious answer.

All-encompassing: decompression illness refers to both lung overexpansion injuries and decompression sickness. Both involve the formation of bubbles in the body (air and nitrogen, respectively) and require prompt attention

All dive computers and tables are based on mathematical models designed to mimic the uptake and wash-out of nitrogen in theoretical body tissues. They can offer no more than a guide to diving depths and times. If you stay within these limits, the chances are relatively small that you’ll be affected by DCI, but the risk is present with every dive nonetheless and it’s important to be aware of this.

For many people, the difficult part is admitting they could have DCI – and recognising the early signs. Instead, they blame a heavy weight belt for a dull ache in the lower spine, or explain away the pain in their shoulder as being the result of shifting heavy tanks about. In a lot of cases, divers wait until more serious symptoms appear – such as numbness, weakness or paralysis – before seeking help.

Admitting that you think you may have DCI doesn’t mean you’ve done anything wrong. And getting treatment as soon as possible increases the chances of a complete recovery. Research shows that divers who receive treatment within six hours of the incident usually have the best chance of making a full recovery. Equally, victims of DCI who receive 100 per cent oxygen as soon as symptoms are recognised tend to fare a lot better than those who don’t.

In the UK, all divers should know the telephone numbers of the coast guard and the nearest recompression facility. Seeking treatment for suspected DCI from a local hospital or GP is a waste of your time and theirs. Diving medicine is a very small and specialised field. It is your responsibility as a diver to know whom to contact in the case of an emergency.

When going abroad, try to find out the location and telephone number of the nearest chamber. Bear in mind that, in exotic destinations, facilities may not exist and emergency evacuation methods can be slow and rudimentary. In such cases, use caution and dive conservatively.

Also remember that you have to pay for health care in other countries. Make sure your travel insurance covers you for scuba diving, or purchase a specific insurance policy from one of the specialist firms that advertise in the dive press. A full treatment for DCI in the US may cost anything from $28,000 to $57,000 (that’s about £17,500 to £35,625), not including extras such as emergency evacuation and repatriation to your home country. As they say, it’s much better to be safe than sorry.
• All names have been changed to protect the identity of the divers.

© COPYRIGHT Dive International Publishing Ltd, - for personal use only
About us | Disclaimer & terms of use | Contact us | Site News | Suggestions | Link to us | Advertising Info