The bends or decompression sickness occurs among scuba divers or hiking in high altitudes. The condition occurs if the dissolved gases, usually nitrogen turn into bubbles that can affect any body part including the lungs, joints, heart, skin and the brain.
What are the indications?
The musculoskeletal and nervous systems are typically affected. If a scuba diver develops symptoms, they manifest within 48 hours in most cases. Generally, most have symptoms within 6 hours while some experience them during the initial hour of surfacing after a dive.
The bends is often classified into 2 types. With type I, it includes mild symptoms while the type II is accompanied by neurological and other serious symptoms.
The usual symptoms of the bends generally include the following:
- Pain in and around the major joints in which the elbows and shoulders are typically affected but any joint can be affected since nitrogen is released into the muscles and joints.
- Excessive tiredness or fatigue
- Skin rashes that are reddened or marbled in appearance
Pain in and around the major joints in which the elbows and shoulders are typically affected but any joint can be affected since nitrogen is released into the muscles and joints. - Itchiness or “the creeps” which is common during decompression in hyperbaric chamber workers
- “Chokes” or pulmonary decompression sickness is rare but can be serious if it occurs. This is defined by a burning chest pain that is aggravated by breathing. Other symptoms might include difficulty breathing, coughing and cyanosis.
- Neurological decompression sickness typically affects the spinal cord and characterized by low back pain, heavy sensation in the legs, numbness or paralysis of the legs and loss of control over the urine and stool. If the brain is affected, it can cause confusion, dizziness, limited or loss of vision, diminished awareness, difficulty with balance or walking and loss of consciousness.
- Swollen and painful lymph nodes
- Pain at the neck, head or torso
- Staggers or a group of symptoms which includes spinning sensation, vomiting, deafness and ringing in the ears.
Management of bends
Generally, the bends is managed in a hyperbaric recompression chamber.
Self-care measures at home
- Dry and rewarm the diver by placing blankets in case hypothermia develops.
- If oxygen is available, place a mask on the individual to administer high flow oxygen.
- During transport of the individual to the nearest emergency department, he/she must be in a supine position.
Medical treatment
- High-flow oxygen along with intravenous fluids are administered. Urine and blood samples are assessed in the laboratory to evaluate for any blood clotting issues and hydration status.
- Hyperbaric chamber for recompression which prevents further formation of bubbles and provides large amounts of oxygen to the damaged tissues.
Quick Note / Disclaimer
The material posted on this page on the bends is for learning and educational purposes only. To learn to recognize the symptoms and how it is managed, register for a first aid and CPR course with Saskatoon First Aid.