Decompression sickness

Reviewed by Dr Charlie Easmon, specialist adviser in travel medicine

Recovery after decompression sickness
Mild forms of decompression sickness can resolve themselves without treatment or by breathing 100 per cent oxygen at the site of the accident.

However, if there is any suspicion of decompression sickness, the diver must be examined by a doctor. This is because although it might not seem serious at the time, the condition may deteriorate.

If the diver receives treatment at an early stage, the chances of avoiding permanent injury are good. The longer that treatment is delayed, the greater the risk of serious consequences.

You should take a rest from diving after treatment for decompression sickness. The length of this rest depends on the severity of the decompression sickness and the effects of treatment, and should be discussed with a specialist in divers' medicine.

How is decompression sickness treated?
There is no medicine that is used as a matter of routine in treating decompression sickness.

At the diving station and during transport

100 per cent oxygen by mask, at a rate of 10-15litres/min.

Give the diver plenty of fluid to drink.

Give first aid if the diver is unconscious.

Prevent the diver from exerting himself or getting cold.

In hospital and specialised centres

A decompression chamber is a steel tank that can be pressurised. There are decompression chambers in various places in the UK - some of these are situated at naval centres. The pressure in a decompression chamber can be increased by closing the doors and pumping air in.

During treatment for decompression sickness, pressure is increased to correspond to the pressure found 18m under water. In some cases, the pressure in the chamber is set at 50m.

The diver breathes pure oxygen through a mask, which improves exhalation of nitrogen. At depths in excess of 18m, and also after adequate intervals, the mask can be removed in the chamber. Pressure in the chamber is reduced gradually until the diver reaches surface pressure again.

Treatment typically lasts between five and six hours.

Throughout treatment a specially trained helper stays with the diver in the chamber. The diver's condition is closely monitored by further examination of coordination and balance, sense of touch, etc.

If necessary, the diver's medical specialist can join the diver in the chamber, but otherwise takes charge of the treatment outside the chamber in co-operation with the specially trained helper.

After treatment, the diver will be kept for 24 hours for observation in case his condition deteriorates.

In most instances one course of treatment is adequate, but occasionally several treatments may be needed.

After treatment for decompression sickness, a diver should take a rest from diving. The length of this rest should be discussed with a specialist in divers' medicine.

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