The history of decompression Sickness is very long. It was experienced in 1670. Robert Boyle was the first person who suffered from this disease. In 1769, Giovanni Morgagni described a death due to the Cerebral Circulation. The prominent points were then established in the year 1870 to 1910.

What is Decompression Sickness?

Decompression Sickness is the disorder that occurs due to decrease in Pressure due to dissolved gases that come out of the solution as Bubbles and cause Depressurization in the body.

This condition is caused by uncontrolled climb while one is diving. It is also known as the Diver’s disease, Caisson disease or the Bends Decompression Sickness Disease.

Decompression chamber

Photo by : wikimedia

This disease is mostly experienced by the Scuba Divers on poorly managed climb or aviators who fly in Aircraft having very low pressure inside it.

Decompression Sickness is a term that is used to define the condition in which the Decompression Sickness and Lung Expansion Injury both occurs together.

This is the reason that both the diseases have same medical treatment and the conditions are also almost same.

Decompression Sickness is a diving disorder. When the divers are caught up by this disease, they may often breathe a gas that it at high pressure as compare to the gas present in the surroundings.

This condition affects those people who have undergone decompression problems.

Definition of Decompression Sickness

Decompression Sickness is serious condition that occurs due to the formation of Nitrogen Bubbles and Precipitation of dissolved gases and bubbles in the body due to low pressure.

This condition is mostly noticed in deep Sea-divers and aeronauts.

Types of Decompression Sickness

The classification of Decompression Sickness is mostly according to the symptoms.

In the previous time, people used to describe this disease by different conditions. they describe it when the pain occur in their joints, if there was some Neurological problem and Chokes, if person faces breathing problem.

Commonly there are 3 types of Decompression Sickness

1. Type 1
2. Type 2
3. Type 3

1. Decompression Sickness Type 1
   This is the least serious type of Decompression Sickness. It appears in the form of pain in joints and in body.
   This type of Decompression Sickness is not life threatening.
   Following are the characteristics of Decompression Sickness Type 1
   • Pain in joints
   • Pain in body
   • Bends in Skin
   • Itching and burning sensation in Skin
   • Skin rashes
   • Swelling of the Lymphs

   This type of sickness occurs when the Nitrogen bubbles flow out from solution and reaches to the Skin Capillaries.

   The Red rashes appear on the Chest and Shoulders of a person and pain is felt in the joints because the bubbles enter in the Bone Marrow, Tendons and Joints.

2. Decompression Sickness Type 2
   The Type 2 Decompression Sickness is a serious form of this disease. It includes the problems of Nervous System, Pulmonary System Circulatory System and Lungs.In this type of decompression, pain is reported in only 30% of cases.
   Some main symptoms of this type of decompression are
   • Back Pain
   • Paresthesia
   • Incontinence
   • Loss of control of Urine

   This condition is identified as a life threatening one as it can cause Respiratory Collapse.

3. Decompression Sickness Type 3
   This type of Sickness is the combination of age and decompression sickness with Neurological symptoms. It is a life threatening condition for an individual.

Symptoms of Decompression Sickness

Decompression Sickness is mostly seen in Knees, Shoulders, Ankles and in Joints.

The common symptoms of Decompression Sickness are

• Red rash on Skin
• Numbness
• Dizziness
• Blurred Vision
• Confusion
• Stomach Sickness
• Extreme Fatigue
• Heart Problems
• Ringing of the Ears
• Pain in Joints and Limbs
• Unconsciousness
• Headache
• Nausea
• Respiratory Problems
• Itching
• Weakness in Hands and Legs
• Tingling
• Feeling of tiredness
• Shortness of Breathe
• Paralysis
• Chest pain
• Lung rupture
• Staggering
• Amnesia
• Tremors
• Blood in cough
• Problem in UrinationPersonality Changes
• Instability
• Spasm of cough

Causes of Decompression Sickness

The main cause of Decompression Sickness is the reduction in pressure due to the formation of bubbles and inert gases inside the tissues of the body.

This condition happens when a person leaves an environment or moves from lower altitude to higher altitude.

The important causes of this disease are

1. Departure from High-Pressure Environment
   There are many regions, where this condition is very common. If a person leaves that pressure area, he may experience a reduction in atmospheric pressure. When Astronauts come out from space ship, they also experience a similar situation.
2. Climb from Depth
   This is the diver’s disease that affects the divers who breathe gas which has high pressure than surface pressure. The divers dive from greater depth and when they go for breath-holding, the risk of Decompression Sickness increases.
3. Climb to Altitude
   When suddenly an unpressurized Aircraft goes to the higher Altitude, decompression sickness is a common problem in this situation.
4. Decompression Sickness and Aviation
   This condition is mostly seen in Aeronauts and Aircraft Flights. The technology of Airplanes has become faster and the flights of planes are increased due to this reason the risk of Decompression Sickness is increased.

Diagnosis of Decompression Sickness

Normally, this condition can be detected if you notice the symptoms of the disease due to drop in pressure within 24 hours of diving.

If the symptoms remain for more than 6 hours than the Diagnosis methods are adopted like MRI scan and CT scans etc. this diagnosis is doen to identify the presence of bubbles in the body.

Prevention of Decompression Sickness

It is important to prevent the Decompression Sickness as it can lead to serious conditions in future. Some of the ways to prevent the Decompression Sickness are:

• To limit the rate of ascent in water to about 10 meters per Minute.
• The important way of preventing Decompression Sickness is pre-breathing before exposure to high altitudes or breathing in pure Oxygen.

Treatment of Decompression Sickness

Following are the treatments for Decompression Sickness

1. Hyperbaric Oxygen Therapy
   The cases if Decompression Sickness should be treated with 100% Oxygen. This process should be continued until Hyperbaric Oxygen Therapy is provided to the person suffering from this disorder.If the symptoms are mild, they can disappear on descent from the higher altitude.If symptoms get worst then only Hyperbaric Oxygen Therapy will help.
2. Recompression on Room Air
   The other effective method to treat this disease is Recompression on room air. This technique utilizes Oxygen. This technique is considered to be the standard way of care for this problem.Oxygen therapy always increases the success of the Recompression Therapy. Dehydration also helps for this technique. It is beneficial to give liquids to the patients.The Trendelenburg position and Lateral Decibitusposition helps in this treatment. This treatment is not suggested for long time as it may lead to the problems of Edema.

Prognosis of Decompression Sickness

If the correct treatment, Recompression Therapy and Oxygen Treatment is followed then the results will be perfect.
If there is any type of long term injury from this disease, it can result in Death or it can lead to Neurological problems.

Decompression Sickness and Epidemiology

Decompression Sickness is a rare disease and it affects more men than women. This disease affects the Scuba divers in United States. Some people suffering from this disease also suffer from Arterial Gas Embolism.

This can be a life-threatening condition when not treated properly, the satisfactory preventive measures should be taken to prevent this condition as soon as possible.