Every diver should be prepared to recognize symptoms decompression illness (DCI). Are you?

The term DCI actually encompasses two separate conditions: decompression sickness (DCS) and arterial gas embolism (AGE). Both conditions should get the same treatment, which in most cases is oxygen first aid and hyperbaric oxygen therapy. You probably learned most of this in your entry level diving courses, but it never hurts to review this essential information as it could save a life.

Symptoms of DCI

• DCS symptoms include muscle or joint pain that does not subside, rash, dizziness, numbness or tingling, paralysis, muscle weakness, bladder or bowel dysfunction and fatigue disproportionate to the diver’s exertion. The diver may also have trouble walking.

• AGE symptoms typically occur while the diver is surfacing or immediately afterward. The diver may suddenly go unconscious or exhibit neurological symptoms, such as confusion, disorientation, personality changes, unsteady gait, weakness and paralysis. AGE may be associated with pulmonary barotrauma (a condition that occurs when air sacs in the lung rupture, typically during a rapid or breath-hold ascent) which generally manifests as difficulty breathing and may also involve a bloody froth in the mouth or nose.

Symptoms generally occur from within 10 minutes to up to 12 hours after surfacing. If any new symptoms appear after 24 hours, DCI is not likely to be the cause. If the diver flies after diving, it is possible for delayed symptoms of DCS to occur during flight. The recommended preflight surface interval after multiple dives or multiple days of diving is a minimum of 18 hours.

Responding to suspected DCI

If you suspect a diver has DCI, assess and continuously monitor vital signs (circulation, airway and breathing), activate emergency services (911 or the local equivalent), administer oxygen first aid if you are a trained oxygen provider and call the DAN Emergency Hotline at +1-919-684-9111.

Remember, if you need some help or are unsure how to respond you can always call DAN or take the diver to the nearest emergency department. It is not advisable to take an injured diver directly to a chamber without first contacting DAN because the closest chamber may not be open, operating, staffed or properly equipped to meet the injured diver’s needs. DAN maintains a continually updated database of chambers to determine the most appropriate chamber for treatment and the coordination of care.

While DAN cannot make a diagnosis over the phone, DAN can be an essential resource for helping recognize the signs and symptoms of DCI, advising you and emergency medical personnel on proper management and coordinating transportation to get an injured diver to a higher level of emergency care as quickly and safely as possible.

Be prepared

There are a lot of ways you can prepare to handle a diving emergency. If you are not a trained oxygen provider, enroll in the DAN Oxygen First Aid for Scuba Diving Injuries course. You can also complete the DAN Dive Emergency Management Provider (DEMP) program, which encompasses automated external defibrillators, emergency oxygen including bag valve mask and manually triggered ventilator, and the treatment of hazardous marine life injuries. Or enhance your knowledge with DAN online seminars, such as the Pathophysiology of Decompression Illness and test yourself with the DCI Quiz on www.AlertDiver.com. Dive safely, and remember, DAN is here for you.

Divers Alert Network (DAN) is a nonprofit organization dedicated to the safety and health of scuba divers. DAN operates a 24-hour emergency hotline (+1-919-684-9111) to help divers in need of medical emergency assistance for diving or nondiving incidents.