injuries and poisoning
Decompression Sickness
Symptoms of Decompression Sickness
Symptoms of decompression sickness usually develop more slowly than do those of Arterial Gas Embolism and Fatigue Loss of appetite Headache Vague feeling of illness The less severe type (or musculoskeletal form) of decompression sickness, often called the bends, typically causes pain. The pain usually occurs in the joints of the arms or legs, back, or muscles. Sometimes the location is hard to pinpoint. The pain may be mild or intermittent at first but may steadily grow stronger and become severe. The pain may be sharp or may be described as “deep” or “like something boring into bone.” It is worse when moving. Less common symptoms include itching, skin mottling, rash, swelling of the arm, chest, or abdomen, and extreme fatigue. These symptoms do not threaten life but may precede more dangerous problems. The more severe type of decompression sickness most commonly results in neurologic symptoms, which range from mild numbness to paralysis and death. The spinal cord is especially vulnerable. Symptoms of spinal cord involvementcan include numbness, tingling, weakness, or a combination in the arms, legs, or both. Mild weakness or tingling may progress over hours to irreversible paralysis. Inability to urinate or inability to control urination or defecation may also occur. Pain in the abdomen and back also is common. Symptoms of brain involvement,most of which are similar to those of air embolism, include Headache Confusion Trouble speaking Double vision Loss of consciousness is rare. Symptoms of inner ear involvement,such as severe vertigo, ringing in the ears, and hearing loss, occur when the nerves of the inner ear are affected. Symptoms of lung involvementcaused by gas bubbles that travel through the veins to the lungs, produce cough, chest pain, and progressively worsening difficulty breathing (the chokes). Severe cases, which are rare, may result in shock and death. (sometimes called avascular bone necrosis) can be a late effect of decompression sickness, or can occur in the absence of decompression sickness. It involves the destruction of bone tissue, especially in the shoulder and hip. can produce persistent pain and disability due to osteoarthritis resulting from the injury. These injuries rarely occur among recreational divers but are more common among people who work in a compressed-air environment and divers who work in deep underwater habitats. There is often no specific initiating event the person can identify as the source of symptoms once they do appear. These workers are exposed to high pressure for prolonged periods and may have an undetected case of the bends. Technical divers, who dive to greater depths than recreational divers, may be at higher risk than recreational divers. Dysbaric osteonecrosis usually produces no symptoms but if it occurs close to a joint it may gradually progress over months or years to severe, disabling arthritis. By the time severe joint damage has occurred, the only treatment may be joint replacement. Permanent neurologic problems,such as partial paralysis, often result from delayed or inadequate treatment of spinal cord symptoms. However, sometimes the damage is too severe to correct, even with appropriate and timely treatment. Repeated treatments with oxygen in a high-pressure chamber seem to help some people recover from spinal cord damage. 