How Long After Diving Can You Get Decompression Sickness?

Decompression sickness, also known as bends, is a serious injury that can occur during scuba diving or flying. It is a condition where rapid pressure reduction occurs, and symptoms usually appear within 1 hour of surfacing but can be delayed up to 6 hours. In some cases, symptoms may not appear for up to 24 hours after surfacing, especially due to exposure to altitude after diving.

Symptoms of decompression sickness can occur immediately after surfacing or up to 24 hours later. On average, a diver with DCS will experience symptoms between 15 minutes and 12 hours after a dive. However, it is important to note that decompression sickness does not typically occur by scuba diving after flying, but rather by flying too soon after diving.

Recompression therapy may be beneficial for up to 48 hours or longer after diving and should be given even if reaching the nearest chamber requires significant effort. If you have completely recovered from mild decompression sickness, it is best to refrain from diving for at least 2 weeks. After serious decompression sickness, it is best to wait for clearance by a doctor.

In general, decompression sickness becomes more of a risk the deeper you dive, but it can occur after a dive of any depth. Asymptomatic divers should wait before flying at an altitude or cabin pressure -2,000 ft (610 m) for at least 12 hours after surfacing from a single no-decompression dive or ≥18 hours after surfacing.

How do I know if I got the bends?

The most common signs and symptoms of the bends include:joint pain,fatigue,low back pain,paralysis or numbness of the legs, and.weakness or numbness in the arms.

Doctor’s Notes on The Bends (Decompression Sickness). The bends, also known as decompression sickness (DCS) or Caisson disease is a condition that occurs in scuba divers when dissolved gases (mainly nitrogen) come out of solution in the bloodstream, forminggasbubbles in the circulation. It is caused by rapid changes in pressure during scuba diving. The bends can affect almost any area of the body or any organ, including thelungs, heart, brain, joints, and skin.

The most common signs and symptoms of the bends include:

• Joint pain,
• fatigue,
• low back pain,
• paralysis or numbness of the legs, and
• weakness or numbness in the arms.

How far down before you get the bends?

The bends generally aren’t a concern unless you go deeper than 30 feet (9.1m), but the amount of time you spend in the water is a big factor here. If you’re diving in shallow water that’s deeper than 10 feet (3.0m) for more than 30 minutes, you could potentially run into the bends if you surface too quickly. Swim up slowly and take a 5-minute break when you’re 5 feet (1.5m) from the surface just to be safe if you’ve been in shallow water for a while.

It’s exceptionally rare for the bends to occur in water shallower than 30 feet (9.1m), so don’t panic if you haven’t been taking decompression breaks on the shallow dives you’ve completed in the past. If you’ve never had symptoms before, you have nothing to worry about.;

How quickly does decompression sickness start?

DCS. Note: Signs and symptoms usually appear within 15 minutes or up to 12 hours after surfacing. In severe cases, symptoms may appear before surfacing or immediately afterward. Delayed onset of symptoms is rare but can happen, especially if air travel follows diving.

Decompression illness, or DCI, is associated with a reduction in the ambient pressure surrounding the body. DCI encompasses two diseases, decompression sickness (DCS) and arterial gas embolism (AGE). DCS results from bubbles in body tissues causing local damage. AGE occurs when bubbles enter arterial circulation, traveling through the arteries and potentially causing tissue damage by blocking blood flow at the small vessel level.

Who Gets Decompression Illness?. Decompression illness affects scuba divers, aviators, astronauts and compressed-air workers. The main risk factor for DCI is a reduction in ambient pressure, but other risk factors will increase the likelihood of DCI occurring. The known risk factors for divers are deep or long dives, cold water, heavy exercise at depth, and rapid ascents.

Rapid ascents contribute significantly to the risk of AGE. Other factors that may increase DCI risk but lack conclusive evidence of association are obesity, dehydration, heavy exercise immediately after surfacing, and pulmonary disease. We don’t yet fully understand possible individual risk factors. Some divers get DCI more frequently than others despite following the same dive profile.

Can you have the bends and not know it?

Divers who do not have obvious symptoms or whose symptoms develop slowly over multiple days may have a “timely” case of the bends. Common signs and symptoms may include vague complaints of pain or abnormal sensations.

Follow the steps described previously under “Urgent DCS” to conduct a neurological assessment and collect information about the diver’s recent activity. Next, contact DAN or a medical professional, or go to the nearest medical facility for advice and further evaluation.

Denial: The WorstSymptom of DCS. Denial is arguably the worst “symptom” of DCS. Delayed treatment can lead to permanent injury and prolong (or even prevent) the diver’s full recovery. Emergency oxygen can cause symptoms to temporarily improve only to reappear later — it is no substitute for a medical evaluation. Alwayscontact DAN or a medical professional with training in dive medicine in cases of suspected DCS — even if the symptoms and signs appear to have resolved.

At what depth does decompression sickness become an issue?

Because the amount of dissolved gas is related to the time as well as the ambient pressure increase, it is necessary to address both components. As depth increases, the probability of decompression sickness increases exponentially. A diver at 15 feet of saltwater, typically, can stay indefinitely with almost no chance of decompression sickness while a diver at 60 feet can only remain for about an hour before needing to stop and decompress prior to direct return to the surface. The same diver at 100 feet of saltwater would only have 25 minutes and only about 5 minutes at 150 feet. Once a diver remains beyond these limits, direct return to the surface would mean a statistically significant increase in the probability of decompression sickness via bubble formation in the bloodstream or tissues and must be mitigated with stops on the way back to the surface to provide the diver with the opportunity to breath out inert gas and thereby prevent bubble formation. Once bubbles have formed and then become symptomatic, recompression is required for resolution. Recompression in a chamber is safest, but if recompression in a chamber is unavailable or will be delayed many hours due to travel time, recompression in the water can be considered.

Divers experiencing decompression sickness (DCS) require recompression on pure oxygen to dissolve the gas bubbles in their blood and tissues, allow excess nitrogen to diffuse out, and oxygenate ischemic tissues, thereby treating the disease process. Recompression has classically been achieved with a special chamber allowing a controlled increase in ambient pressure as well as a treating physician or technician to care for the stricken diver. There has been an alarming decrease in the number of recompression chambers available for 24-hour emergency care across the nation, resulting in divers with DCS facing long transit times to available chambers. This delay in care negatively affects the diver’s probability of complete recovery, resulting in many divers considering the alternative known as in-water recompression (IWR). IWR involves intentionally placing the stricken diver back in the water on pure oxygen, typically with a prolonged oxygen-breathing period at 30 FSW or less, with a gradual ascent to the surface. In water, recompression has been used for decades by several navies throughout the world as well as globally in remote areas where local recompression chambers are simply not available. The Australians developed and have used a relatively standardized protocol for several years, as has the United States Navy for use in extraordinary circumstances, as it is normal navy policy to have a chamber on-site for diving operations.

Disclosure: J Walker, III declares no relevant financial relationships with ineligible companies.

What happens if you don’t decompress after diving?

Quick ascents can lead to decompression illness. During a dive, a diver’s body absorbs nitrogen gas. The nitrogen gas compresses due to water pressure following Boyle’s Law, and slowly saturates his body tissues. If a diver ascends too quickly, the nitrogen gas in his body will expand at such a rate that he is unable to eliminate it efficiently, and the nitrogen will form small bubbles in his tissues. This is known as decompression sickness, and can be very painful, lead to tissue death, and even be life threatening. In a worst-case scenario, a diver who ascends quite rapidly may rupture small structures in his lungs known as alveoli. In this case, bubbles may enter his arterial circulation and travel through his body, eventually lodging in blood vessels and blocking blood flow. This sort of decompression illness is called an arterial gas embolism (AGE), and is very dangerous. A bubble may lodge in an artery feeding the spinal column, in the brain, or in a host of other areas, causing loss or impediment of function. Maintaining a slow ascent rate greatly reduces the risk of all forms of decompression illness.Additional Safety Precautions — Safety Stops and Deep Stops:In addition to slow ascents, scuba diving training organizations also recommend making a safety stop at 15 feet/ 5 meters for 3-5 minutes. A safety stop allows a diver’s body to eliminate additional nitrogen from the body before his final ascent. When making deep dives (let’s say 70 feet or deeper for the sake of argument) studies have also shown that a diver who makes a deep stop based on his dive profile (for example a 50-foot stop on a dive with a maximum depth of 80 feet) as well as a safety stop will have significantly less nitrogen in his body upon surfacing than a diver who does not. A Diver’s Alert Network (DAN) study, measured the amount of nitrogen remaining in a diver’s system after a series of ascent profiles. Without getting too technical, the study measured the nitrogen saturation of tissues that become quickly filled with nitrogen, such as the spinal column. DAN ran a series of tests on divers who ascended at a rate of 30 feet/minute from repetitive dives to 80 feet. The results were fascinating:• A diver who ascended at a rate of 30 feet/minute without stops surfaced with his “fast saturation tissues” 60% saturated.• If the same diver made a safety stop of 5 minutes at 18 feet, these fast saturation tissues decreased to only 35% saturation.• If the same diver made an additional deep stop of 5 minutes at 48 feet, he surfaced with his fast saturation tissues further decreased to only 25% saturation.Making deep stops and safety stops, even on dives within the no-decompression limits (dives that do not require decompression stops), will significantly reduce the amount of nitrogen in a diver’s body upon surfacing. The less nitrogen in his system, the lower the risk of decompression sickness. Making deep and safety stops makes sense!The Final Ascent Should Be the Slowest:The greatest pressure change per a foot of depth is near the surface. The more shallow a diver is, the more rapidly the surrounding pressure changes as he ascends. A diver should ascend most slowly from his safety stop to the surface, even more slowly than 30 feet per a minute. Nitrogen in a diver’s body will expand most quickly during the final ascent, and allowing his body additional time to eliminate this nitrogen will further reduce the diver’s risk of decompression sickness.The Take Home-Message About Ascent Rates and Scuba Diving:Divers should slowly ascend from all dives to avoid decompression sickness and AGE. Mastering a slow ascent requires good buoyancy control and a method of monitoring the ascent rate (such as a dive computer or timing device and depth gauge). In addition, making a safety stop at 15 feet for a minimum of 3 minutes during every ascent, and deep stops when appropriate, will further reduce the amount of nitrogen in a diver’s body upon ascent, which reduces his risk of decompression sickness.Here in Omega Divers we recommend you that the safe rule of thumb, (and the most commonly published maximum ascent rate at this time) is:

Never exceed an ascent rate of 30 feet/ 9 meters per a minute.

Does DCS go away on its own?

Breath 100% Oxygen (usually at the dive site or on the dive boat).Drink Fluids to help with Dehydration.Call DAN for advice – even if you are not a member, advice is free.Seek specialist medical treatment as soon as possible.

Remember DCS symptoms can appear up to 24 hours after diving, also in mild cases breathing 100% Oxygen can make the symptoms go away, only to come back after a few hours.

Severe cases of DCS are likely to be treated in a Hyperbaric facility “the Chamber” where, to put it very simply, you are put back under pressure to clear the bubbles and then slowly returned to ambient pressure. Many courses of this treatment may be required and full recovery can sometimes take many months.

Putting it in perspective. Recreational Diving, done with proper training and staying within recommended depth limits is “Hazardous” rather than “Dangerous”. DCS is actually quite rare, research from DAN shows between 3 and 4 cases per 10,000 divers, approx 1,000 cases per year.In over 4,000 dives I have only ever seen a handful of divers suffering from DCS.

How do you tell if you have decompression sickness?

The symptoms of DCI may include:fatigue.joint and muscle aches or pain.clouded thinking.numbness.weakness.paralysis.rash.poor coordination or balance.

What is decompression illness?. Decompression illness (DCI) usually refers to one of 2 related conditions and both are most commonly associated with scuba and deep sea divers.

When underwater, divers breathecompressed air that contains nitrogen gas at the same pressure as the surrounding water. This accumulates in the diver’s body tissue, and is breathed out on ascent, providing that ascent occurs at a safe rate.

When a diver swims to the surface too quickly (a rapid ascent), the nitrogen can form tiny bubbles in the blood and/or body tissues, causing decompression sickness (DCS).

Can you get decompression sickness days after diving?

Severe symptoms may manifest within minutes of surfacing, but in most patients, symptoms begin gradually, sometimes with a prodrome of malaise, fatigue, anorexia, and headache. Symptoms occur within 1 hour of surfacing in about 50% of patients and by 6 hours in 90%. Rarely, symptoms can manifest 24 to 48 hours after surfacing, particularly by exposure to altitude after diving (such as air travel).

Type I decompression sickness typically causes pain in the joints (most commonly elbows and shoulders) and occasionally muscles; the pain typically does not intensify during movement and is described as “deep” and “boring.” Other manifestations include lymphedema, skin mottling, itching, and rash.

Type II decompression sickness consists of neurologic and sometimes respiratory symptoms. It typically manifests with paresis, numbness and tingling, difficulty urinating, and loss of bowel or bladder control. Headache and fatigue may be present but are nonspecific. Dizziness, tinnitus, and hearing loss may result if the inner ear is affected. Severe symptoms include seizures, slurred speech, vision loss, confusion, and coma. Death can occur.

How do I know if I have DCS?

The most common symptoms of depression sickness include local joint pain and arm and leg symptoms. There are two types of DCS, type 1 and type 2. Type 1 generally includes aches and skin symptoms while type 2 is considered to be more serious and can affect the brain, inner ear, and lungs.

Feeling the onset ofdecompression sickness symptomsis one of those scenarios that terrify most divers. Most new and experienced divers alike have heard ofdecompression sickness, but not all of us really understand it or know how to properly identify its symptoms. We all can agree scuba diving is an incredible experience but, occasionally an accident or emergency may occur, and knowing how to properly manage it can be the difference between a great anecdote or a fatality.

What is decompression sickness?Decompression illness, also known asDCI, is the condition that results from a reduction in the pressure surrounding the body. It actually includes two ailments,decompression sickness(DCS) andarterial gas embolism(AGE). It is believed thatDCS is caused by bubbles growing in tissue and causing local damage, whileAGE is caused by bubbles entering the lungs, traveling through the arteries andcausing tissue damage from a distance by blocking blood flow in small vessels.

Aviators, astronauts, people who work in compressed-air and scuba divers are all at risk for decompression illness.Activities that can cause decompression illnessin divers include deep or long dives, diving in cold water, strenuous activity in deep water and ascending too quickly. Otherfactors thought to increase the risk of DCIare obesity, dehydration,scuba diving while pregnant, strenuous exercise immediately after surfacing and lung disease.Some people seem to be more at risk than others, which is why some divers seem to get DCI more easily even though the circumstances of the dive are the same.Why is decompression sickness called the bends?Decompression sickness is also known asdivers’ disease,aerobullosis, generalizedbarotrauma,caisson diseaseand our personal favorite,”the bends”. The name the bends came about during the construction of the Brooklyn Bridge in New York City when a person with decompression sickness assumed a bent-over posture due to joint pain.

Can you get DCS at 3 meters?

DCS can also occur in relatively shallow depths—in fact there have been isolated cases in children in very shallow, 1 meter depths. Usually depths of about 20 feet are more common for DCS.

• Journal List
• Mo Med
• v.116
• May-Jun 2019
• PMC6690281

Hyperbaric oxygen therapy (HBO2) remains the primary treatment for decompression sickness (DCS)—which can be obviously serious or infrequently more minor and can get missed outside of centers that routinely handling diving medicine. This review will point out the salient items for how sport or amateur divers might present for HBO2.

Overview. Currently, HBO2 is so commonly used for wound healing applications that outside of hyperbaric centers near water that often treat DCS, lower grade or sport diving cases of DCS can get missed. Even though treatment with HBO2 for DCS is one of the most accepted indications and historically has some of the strongest data supporting its use.1 Cases of DCS can be obvious due to their preceding diving history and classic, immediate symptoms of joint pain and neurologic deficits, but they can also present with atypical symptoms.2.

Will DCS go away on its own?

Divers in denial will assign the symptoms to another cause — tight exposure suits, heavy lifting, or even sea sickness often blamed rather than a possible instance of DCS. However, denial simply delays assitance as the diver hopes the symptoms will subside on their own. In some cases, symptoms may remain mild or even go away by themselves. Often, however, they strengthen in severity until you must seek medical attention, and they may have longer-term repercussions.

Treating DCS. If you feel unwell after a dive, tell someone. You may simply have a headache after a dive, most likely a symptom of overexertion, heavy breathing or dehydration. But if you’re experiencing any of the DCS symptoms outlined above following a dive, acknowledge them. If you’re diving independently with buddies, let them know your symptoms and consider if DCS might be to blame. If you’ve planned your dive trip correctly you’ll have oxygen, first aid kit and an emergency assistance plan in place. Now is the time to enact it. If you have any doubts, call DAN or your local emergency-assistance provider.

If you’re on a dive boat such as a liveaboard, tell the dive crew. The vessel’s trip leader will make an initial assessment of the situation. If they suspect DCS it will often be classified as an ‘emergency,’ (immediately life-threatening), ‘urgent’ (the diver is in severe pain but is stable) or ‘timely’ (symptoms are either inconsistent or have progressed slowly for several days). A responsible dive operator will have an emergency assistance plan onboard, administer immediate first aid and monitor the patient’s condition. They will simultaneously gather dive data for the past 48 hours and liaise with DAN and/or local EMS or chamber facilities to arrange the evacuation of the patient as required.