# data[].attributes.body
The bends also known as decompression sickness (DCS) which can be very painful and in extreme cases result in death is a condition when the body goes from high compression to low compression to rapid causing nitrogen bubbles to form in blood streams and throughout the body causing damage to organs and tissue it can stop blood flow and cause other problems this is related to Boyle's law because when pressure decreases volume of gas will increase wile temperature stays constant. the bends is directly related to Boyle's law because the volume and presser are changing in opposite.

# data[].attributes.body
" The Bends also known as decompression sickness, occurs when a scuba diver ascends too quickly. Nitrogen bubbles form when the diver reaches seal level causing the stop of blood flow.We can relate this to Boyles law, which states that the volume of a gas will increase as the pressure decreases. So when the diver ascends from the water relieving pressure the nitrogen bubbles will escape and this is what causes "The Bends"
https://www.emedic
inehealth.com/decompression_syndromes_the_bends/article_em.htm#what_causes_the_bends

# data[].attributes.body
"The Bends" occurs when a diver ascends to quickly from the depths of the ocean. As the diver moves deeper into the ocean, pressure increases and causes gases to seep into their joints. As they resurface quickly their body tries to dispel the gases inside their joints causing pain and discomfort. To prevent this, a diver should resurface slowly in order to allow their body time to adjust to the change in pressure. https://www.emedicinehealth.com/decompression_syndromes_the_bends/article_em.htm

# data[].attributes.body
"The Bend" occurs when a diver resurfaces to quickly from high pressurized waters depths to the surface; as the diver ascends the volume of their cells in their body is so expanded from the gases seeping back into the cells from the lower of pressure that it causes pain, this increase of pressure with the decrease of volumes explains the concept of Boyle's Law

# data[].attributes.body
"The bends" is also known as decompression sickness. This occurs when dissolved gases moves into the bloodstream due to the high pressure. Given the increase of pressure as you go underwater, the pressure in your body will soon be too much for the volume of your body. Thus the pressure build up in such places causes pain.

# data[].attributes.body
"The Bends" occurs when a scuba diver ascends too quickly. This disease comes about due to the inability of blood to hold nitrogen as the pressure decreases. The further a diver goes, the higher that the pressure will be on their body. As a result of the increase in pressure, the gases in their blood are compressed.  To prevent getting "The Bends", a diver should be sure to ascend very slowly.

# data[].attributes.body
As you dive deeper when scuba diving pressure increases and this volume change in gas filled spaces and organs within your body accounts for the distortion and damage to surrounding tissues. https://www.emedicinehealth.com/barotraumadecompression_sickness/article_em.htm

# data[].attributes.body
In class, we learned that Boyle's law is when at constant temperature the volume of gas is inversely proportional to the pressure of that gas. The bends occurs when divers go deep into the water causing the pressure of gas in the blood to increase, and could be fatal if they return to the surface too fast. This relates to Boyle's Law because at the relative constant temperature of the water the pressure of the gas in the blood increases and inversely the volume decreases with the increased pressure.

# data[].attributes.attachment_link.readable_text
What is the bends (from diving)?

The bends, also known as decompression sickness (DCS) or Caisson disease occurs in scuba divers or high altitude or aerospace events when dissolved gases (mainly nitrogen) come out of solution in bubbles and can affect just about any body area including joints, lung, heart, skin and brain.

Decompression sickness (DCS) is caused by the formation of bubbles of gas that occur with changes in pressure during scuba diving. It is also experienced in commercial divers who breathe heliox (a special mixture of oxygen and helium), and astronauts and aviators that experience rapid changes in pressure from sea level. Scuba diving will be the focus of this article as it is the most common activity that may result in the bends.

Scuba diving is a sport and hobby that continues to increase in popularity each year. There are several organizations that certify individuals to become recreations divers, two of which are PADI (The Professional Association of Diving Instructors) and NAUI (The National Association of Underwater Instructors).

Data collected by Divers Alert Network (DAN) and presented in 2010 revealed 41 cases of DCS out of 137,451 dive profiles collected. It is important to know that even divers that follow decompression schedules and tables may still experience DCS.

What causes the bends?

Nitrogen or any gas from a diver's air tank increases in pressure as a diver descends. For every 33 feet in ocean water, the pressure due to nitrogen goes up another 11.6 pounds per square inch,. As the pressure due to nitrogen increases, more nitrogen dissolves into the tissues. The longer a diver remains at depth, the more nitrogen dissolves. Unlike the oxygen in the air tank a diver uses to swim underwater, the nitrogen gas is not utilized by the body and builds up over time in body tissues. The underlying cause of symptoms throughout the body is due mainly to nitrogen bubbles being released when the diver returns to sea level and blocking blood flow and disrupting blood vessels and nerves by stretching or tearing them. They may also cause emboli, blood coagulation and the release of vasoactive compounds.

A clear example to illustrate this bubble formation process is that of a bottle of carbonated soda. A bottle of carbonated soda is filled with gas (carbon dioxide), which cannot be seen because it is dissolved in solution under pressure. When the bottle is opened, the pressure is released and the gas leaves the solution in the form of bubbles. A diver returning to the surface is similar to opening the bottle of soda. As a diver swims to the surface, the pressure decreases. The nitrogen, which has dissolved in tissues, wants again to leave, because the body can hold only a certain amount based on that nitrogen pressure.

If a diver surfaces too fast, the excess nitrogen will come out rapidly as gas bubbles. Depending on which organs are involved, these bubbles produce the symptoms of decompression sickness.

The risk of decompression illness is directly related to the depth of the dive, the amount of time under pressure, and the rate of ascent. Dive tables, such as the US Navy Dive Tables, provide general guidelines as to what depths and dive times are less risky for the development of decompression sickness.

Symptoms of the Bends

The nervous and musculoskeletal system are most often affected. If a diver is going to develop symptoms they will show within 48 hours in all cases. Most have symptoms within 6 hours, while some develop within the first hour of surfacing from a dive.

DCS is often categorized into two types. Type I indicating mild symptoms and Type II with neurologic and other serious symptoms.

Symptoms of the bends include the following:

Musculoskeletal Symptoms (most common symptoms)

Pain in and around major joints with the shoulder and elbows being the most commonly affected in divers but any joint can be involved due to nitrogen being released into the joints and muscles.

Fatigue

Extreme tiredness that is out of proportion to the activity just performed.

Skin

Rashes that are red or marbled may occur. They can be very itchy also.

It is rare to have skin findings with DCS

Itching (also known as "the creeps")

Seen more commonly during decompression in hyperbaric chamber workers (see media photos).

Very itchy reaction on the skin that is exposed to pressures of the dive (i.e. not covered up by a wet suit.)

This is due to gas from the chamber dissolving into the skin and forming bubbles under the skin.

The creeps do not occur in divers

The Chokes (pulmonary or lung decompression sickness)

Rare but if it occurs can be very serious

A burning pain in the chest that is usually worse with breathing in (inspiration).

Other symptoms include cough, difficulty breathing, and cyanosis (blue lips and skin)

Divers with the chokes can progress to shock rapidly

Neurologic Decompression Sickness (these symptoms may be the only DCS signs)

The most common area affected in divers is the spinal cord.

Symptoms classically include low back pain, "heaviness" of the legs, paralysis and/or numbness of the legs, and even loss of control of the sphincter (or valve) that controls urine and stool resulting in incontinence.

Other symptoms may include fatigue, weak or numb upper extremities, chest or abdominal pains.

DCS involving the brain can present with dizziness, confusion, decreased awareness, loss of consciousness, loss or limited vision and even difficulty with balance and/or walking.

Lymph nodes (glands)

The lymph glands can be swollen and painful.

Pain

Pain can occur at the head, neck, or torso. Pain at these sites versus the arms or legs carries a worse prognosis.

Staggers

Occasionally someone with decompression illness may have symptoms suggesting an inner ear problem, such as a spinning sensation, deafness, ringing in the ears, or vomiting. This group of symptoms is called the "staggers."

When to Seek Medical Care

Any victim reporting signs or symptoms of decompression illness that began within 48 hours of scuba diving should be seen by a doctor at an emergency care facility immediately.

The doctor will likely presume that a victim reporting symptoms within 48 hours of surfacing from a scuba dive to have decompression illness. It is important to inform the doctor of your recent diving experience and of your symptoms.

Treatment for the Bends

The bends are treated in a hyperbaric recompression chamber.

The Bends Self-Care at Home

Rescue the diver from the water and provide emergency care within the limits of your training.

Dry and rewarm the diver with blankets if hypothermia (drop in body temperature) develops.

If you have access to oxygen, a mask should be applied to deliver high flow oxygen to the individual with symptoms.

You can visit the Divers Alert Network Web site or call them in the United States at (919) 684-9111 to determine where the nearest hyperbaric chamber is located.

Transport the person in a supine position (horizontal, lying on their back) to an emergency care facility. If a hyperbaric chamber is available, you may coordinate to transport directly to that facility for definitive care.

If air transport is used, attempt to find an air frame that can transport the diver below 1,000 feet or is able to be pressurized to sea level pressure. Use high-flow oxygen if it is available during transport.

The Bends Medical Treatment

The doctor will first treat immediate life threats, such as breathing problems or shock, if present.

The diver will need high-flow oxygen and IV fluids. Blood and urine will be sent for laboratory tests to assess any blood clotting problems and hydration status.

The diver will likely need to go to a hyperbaric chamber for recompression. During recompression, the chamber becomes pressurized with air and oxygen based on prearranged protocols to simulate pressure depths of 30 to 60 feet. The duration of "the dive" within the chamber varies, but can be up to 12 hours and sometimes longer. At this depth or chamber pressures, bubbles are reduced in size or reabsorbed to ensure adequate blood flow. Recompression prevents further bubble formation and provides high amounts of oxygen to the injured tissues. Further treatments depend on how the diver responds to the initial treatment.

Often the person is admitted to the hospital to monitor medical condition and to ensure that there is no recurrence of symptoms.

The Bends Follow-Up

Follow up immediately for any further signs or symptoms of decompression illness within the next 7 days. After suffering decompression sickness, individuals should not dive again until cleared by a doctor. Depending on the severity of symptoms, and if the person has suffered decompression sickness before, the doctor will likely recommend not to dive again or to avoid diving for some amount of time.

The Bends Prevention

Decompression illness or the bends and other types of barotrauma (decompression sickness) may be prevented by following guidelines for diving taught in professional diving courses.

The following actions increase risk of developing decompression illness:

Diving outside dive table recommendations

Flying within 18 hours after diving: Most experts consider it reasonably safe to fly 12 hours after a person's last dive if they only once, dove easily within the dive tables, and no decompression stop was required. For more complicated diving, waits of 48 hours have been recommended. In general, the longer a person wait to fly after diving, the lower the risk of developing decompression sickness. Even long waits, however, do not reduce the risk all the way to zero.

Data collected by DAN (Divers Alert Network) from 1987 to 1999, showed that 17% of divers in the DAN injury database had their first symptoms of DCS either during or after flying.

Diving in cold water

Obesity (nitrogen is lipid-soluble)

Dehydration

Recent alcohol intoxication

Vigorous exertion while diving

Multiple repetitive dives

Jogging or other heavy exercise within 6 hours of a dive

The Bends Prognosis

Prognosis or outlook of people that develop the bends varies with the following factors:

Prognosis is good with hyperbaric oxygen treatment.

Delay to hyperbaric oxygen treatment: Although reports show that victims can do well after days of symptoms, delay in definitive treatment may cause damage that is irreversible.

Severity of symptoms: Joint pains alone do better than focal weakness or inability to urinate.

Preexisting health: Young, healthy people can tolerate a greater insult to their health than an older person with other diseases.

The Bends Pictures

State-of-the-art hyperbaric oxygen chamber by HyperTec. Click to view larger image.

State-of-the-art single person chamber by HyperTec. Click to view larger image.

Simulated dive. Click to view larger image.

Medically reviewed by Avrom Simon, MD; Board Certified Preventative Medicine with Subspecialty in Occupational Medicine

REFERENCE:

MedscapeReference.com. Decompression Sickness.

# data[].attributes.attachment_link.title
The Bends: Symptoms, Treatment & Prevention

# data[].attributes.attachment_link.description
What is the bends (from diving)? The bends, also known as decompression sickness (DCS) or Caisson disease occurs in scuba divers or high altitude or aerospace events when dissolved gases (mainly nitrogen) come out of solution in bubbles and can affect just about any body area including joints, lung, heart, skin and brain.

# data[].attributes.body
Bends occurs during rapid pressure change in the body releasing an unsafe amount of nitrogen in the blood. As the scuba divers head up to the surface (pressure decreases) more nitrogen is released into the blood stream (gas increases). Both of these  are inverse reactions. https://www.emedicinehealth.com/decompression_syndromes_the_bends/article_em.htm

# data[].attributes.body
The bends effects scuba divers in high altitude bubbles of gasses can be released into the bloodstream. As a person descends, the water pressure compresses the gasses dissolved in the bloodstream. Having the gasses in our blood stream can lead to the bends.

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How does Boyles Law relate to scuba diving? | Wyzant Ask An Expert

# data[].attributes.attachment_link.description
The law, discovered by Robert Boyle in 1662, states that at a fixed temperature, the volume of gas is inversely proportional to the pressure exerted by the gas.

# data[].attributes.body
"The bends" is a condition that is a decompression sickness that many scuba divers know about. this is caused by a change of pressure. As a diver goes deeper in the water the pressure will increase causing a increase in the amount of nitrogen in the diver tank will increase, as they ascend the body attempts to get rid of the nitrogen as pressure decreases which can be dangerous to divers because the nitrogen is released in the blood stream. This directly relates to Boyle's Law because there is a consonant temperature, and as the pressure increases the amount of nitrogen gas increases in the blood stream. this is what Boyle's Law is; at a constant temperature the volume of gas increases as the pressure decreases and as volume of gas decreases the pressure increases.
https://www.scuba-diving-smiles.com/scuba-diving-bends.html

# data[].attributes.attachment_link.readable_text
What is the bends (from diving)?

The bends, also known as decompression sickness (DCS) or Caisson disease occurs in scuba divers or high altitude or aerospace events when dissolved gases (mainly nitrogen) come out of solution in bubbles and can affect just about any body area including joints, lung, heart, skin and brain.

Decompression sickness (DCS) is caused by the formation of bubbles of gas that occur with changes in pressure during scuba diving. It is also experienced in commercial divers who breathe heliox (a special mixture of oxygen and helium), and astronauts and aviators that experience rapid changes in pressure from sea level. Scuba diving will be the focus of this article as it is the most common activity that may result in the bends.

Scuba diving is a sport and hobby that continues to increase in popularity each year. There are several organizations that certify individuals to become recreations divers, two of which are PADI (The Professional Association of Diving Instructors) and NAUI (The National Association of Underwater Instructors).

Data collected by Divers Alert Network (DAN) and presented in 2010 revealed 41 cases of DCS out of 137,451 dive profiles collected. It is important to know that even divers that follow decompression schedules and tables may still experience DCS.

What causes the bends?

Nitrogen or any gas from a diver's air tank increases in pressure as a diver descends. For every 33 feet in ocean water, the pressure due to nitrogen goes up another 11.6 pounds per square inch,. As the pressure due to nitrogen increases, more nitrogen dissolves into the tissues. The longer a diver remains at depth, the more nitrogen dissolves. Unlike the oxygen in the air tank a diver uses to swim underwater, the nitrogen gas is not utilized by the body and builds up over time in body tissues. The underlying cause of symptoms throughout the body is due mainly to nitrogen bubbles being released when the diver returns to sea level and blocking blood flow and disrupting blood vessels and nerves by stretching or tearing them. They may also cause emboli, blood coagulation and the release of vasoactive compounds.

A clear example to illustrate this bubble formation process is that of a bottle of carbonated soda. A bottle of carbonated soda is filled with gas (carbon dioxide), which cannot be seen because it is dissolved in solution under pressure. When the bottle is opened, the pressure is released and the gas leaves the solution in the form of bubbles. A diver returning to the surface is similar to opening the bottle of soda. As a diver swims to the surface, the pressure decreases. The nitrogen, which has dissolved in tissues, wants again to leave, because the body can hold only a certain amount based on that nitrogen pressure.

If a diver surfaces too fast, the excess nitrogen will come out rapidly as gas bubbles. Depending on which organs are involved, these bubbles produce the symptoms of decompression sickness.

The risk of decompression illness is directly related to the depth of the dive, the amount of time under pressure, and the rate of ascent. Dive tables, such as the US Navy Dive Tables, provide general guidelines as to what depths and dive times are less risky for the development of decompression sickness.

Symptoms of the Bends

The nervous and musculoskeletal system are most often affected. If a diver is going to develop symptoms they will show within 48 hours in all cases. Most have symptoms within 6 hours, while some develop within the first hour of surfacing from a dive.

DCS is often categorized into two types. Type I indicating mild symptoms and Type II with neurologic and other serious symptoms.

Symptoms of the bends include the following:

Musculoskeletal Symptoms (most common symptoms)

Pain in and around major joints with the shoulder and elbows being the most commonly affected in divers but any joint can be involved due to nitrogen being released into the joints and muscles.

Fatigue

Extreme tiredness that is out of proportion to the activity just performed.

Skin

Rashes that are red or marbled may occur. They can be very itchy also.

It is rare to have skin findings with DCS

Itching (also known as "the creeps")

Seen more commonly during decompression in hyperbaric chamber workers (see media photos).

Very itchy reaction on the skin that is exposed to pressures of the dive (i.e. not covered up by a wet suit.)

This is due to gas from the chamber dissolving into the skin and forming bubbles under the skin.

The creeps do not occur in divers

The Chokes (pulmonary or lung decompression sickness)

Rare but if it occurs can be very serious

A burning pain in the chest that is usually worse with breathing in (inspiration).

Other symptoms include cough, difficulty breathing, and cyanosis (blue lips and skin)

Divers with the chokes can progress to shock rapidly

Neurologic Decompression Sickness (these symptoms may be the only DCS signs)

The most common area affected in divers is the spinal cord.

Symptoms classically include low back pain, "heaviness" of the legs, paralysis and/or numbness of the legs, and even loss of control of the sphincter (or valve) that controls urine and stool resulting in incontinence.

Other symptoms may include fatigue, weak or numb upper extremities, chest or abdominal pains.

DCS involving the brain can present with dizziness, confusion, decreased awareness, loss of consciousness, loss or limited vision and even difficulty with balance and/or walking.

Lymph nodes (glands)

The lymph glands can be swollen and painful.

Pain

Pain can occur at the head, neck, or torso. Pain at these sites versus the arms or legs carries a worse prognosis.

Staggers

Occasionally someone with decompression illness may have symptoms suggesting an inner ear problem, such as a spinning sensation, deafness, ringing in the ears, or vomiting. This group of symptoms is called the "staggers."

When to Seek Medical Care

Any victim reporting signs or symptoms of decompression illness that began within 48 hours of scuba diving should be seen by a doctor at an emergency care facility immediately.

The doctor will likely presume that a victim reporting symptoms within 48 hours of surfacing from a scuba dive to have decompression illness. It is important to inform the doctor of your recent diving experience and of your symptoms.

Treatment for the Bends

The bends are treated in a hyperbaric recompression chamber.

The Bends Self-Care at Home

Rescue the diver from the water and provide emergency care within the limits of your training.

Dry and rewarm the diver with blankets if hypothermia (drop in body temperature) develops.

If you have access to oxygen, a mask should be applied to deliver high flow oxygen to the individual with symptoms.

You can visit the Divers Alert Network Web site or call them in the United States at (919) 684-9111 to determine where the nearest hyperbaric chamber is located.

Transport the person in a supine position (horizontal, lying on their back) to an emergency care facility. If a hyperbaric chamber is available, you may coordinate to transport directly to that facility for definitive care.

If air transport is used, attempt to find an air frame that can transport the diver below 1,000 feet or is able to be pressurized to sea level pressure. Use high-flow oxygen if it is available during transport.

The Bends Medical Treatment

The doctor will first treat immediate life threats, such as breathing problems or shock, if present.

The diver will need high-flow oxygen and IV fluids. Blood and urine will be sent for laboratory tests to assess any blood clotting problems and hydration status.

The diver will likely need to go to a hyperbaric chamber for recompression. During recompression, the chamber becomes pressurized with air and oxygen based on prearranged protocols to simulate pressure depths of 30 to 60 feet. The duration of "the dive" within the chamber varies, but can be up to 12 hours and sometimes longer. At this depth or chamber pressures, bubbles are reduced in size or reabsorbed to ensure adequate blood flow. Recompression prevents further bubble formation and provides high amounts of oxygen to the injured tissues. Further treatments depend on how the diver responds to the initial treatment.

Often the person is admitted to the hospital to monitor medical condition and to ensure that there is no recurrence of symptoms.

The Bends Follow-Up

Follow up immediately for any further signs or symptoms of decompression illness within the next 7 days. After suffering decompression sickness, individuals should not dive again until cleared by a doctor. Depending on the severity of symptoms, and if the person has suffered decompression sickness before, the doctor will likely recommend not to dive again or to avoid diving for some amount of time.

The Bends Prevention

Decompression illness or the bends and other types of barotrauma (decompression sickness) may be prevented by following guidelines for diving taught in professional diving courses.

The following actions increase risk of developing decompression illness:

Diving outside dive table recommendations

Flying within 18 hours after diving: Most experts consider it reasonably safe to fly 12 hours after a person's last dive if they only once, dove easily within the dive tables, and no decompression stop was required. For more complicated diving, waits of 48 hours have been recommended. In general, the longer a person wait to fly after diving, the lower the risk of developing decompression sickness. Even long waits, however, do not reduce the risk all the way to zero.

Data collected by DAN (Divers Alert Network) from 1987 to 1999, showed that 17% of divers in the DAN injury database had their first symptoms of DCS either during or after flying.

Diving in cold water

Obesity (nitrogen is lipid-soluble)

Dehydration

Recent alcohol intoxication

Vigorous exertion while diving

Multiple repetitive dives

Jogging or other heavy exercise within 6 hours of a dive

The Bends Prognosis

Prognosis or outlook of people that develop the bends varies with the following factors:

Prognosis is good with hyperbaric oxygen treatment.

Delay to hyperbaric oxygen treatment: Although reports show that victims can do well after days of symptoms, delay in definitive treatment may cause damage that is irreversible.

Severity of symptoms: Joint pains alone do better than focal weakness or inability to urinate.

Preexisting health: Young, healthy people can tolerate a greater insult to their health than an older person with other diseases.

The Bends Pictures

State-of-the-art hyperbaric oxygen chamber by HyperTec. Click to view larger image.

State-of-the-art single person chamber by HyperTec. Click to view larger image.

Simulated dive. Click to view larger image.

Medically reviewed by Avrom Simon, MD; Board Certified Preventative Medicine with Subspecialty in Occupational Medicine

REFERENCE:

MedscapeReference.com. Decompression Sickness.

# data[].attributes.attachment_link.title
The Bends: Symptoms, Treatment & Prevention

# data[].attributes.attachment_link.description
What is the bends (from diving)? The bends, also known as decompression sickness (DCS) or Caisson disease occurs in scuba divers or high altitude or aerospace events when dissolved gases (mainly nitrogen) come out of solution in bubbles and can affect just about any body area including joints, lung, heart, skin and brain.

# data[].attributes.body
The bends is an illness that arises from the rapid release of nitrogen gas from the bloodstream. This is caused by bubbles forming in the blood whenever a diver ascends to the surface of the ocean rapidly. This represents Boyles Law because when the volume of the ocean increases, the pressure in the brain decreases.  https://www.emedicinehealth.com/decompression_syndromes_the_bends/article_em.htm

# data[].attributes.attachment_link.description
Decompression sickness: Decompression sickness, physiological effects of the formation of gas bubbles in the body because of rapid transition from a high-pressure environment to one of lower pressure. Pilots of unpressurized aircraft, underwater divers, and caisson workers are highly susceptible to the sickness because

# data[].attributes.attachment_link.readable_text
What is the bends (from diving)?

The bends, also known as decompression sickness (DCS) or Caisson disease occurs in scuba divers or high altitude or aerospace events when dissolved gases (mainly nitrogen) come out of solution in bubbles and can affect just about any body area including joints, lung, heart, skin and brain.

Decompression sickness (DCS) is caused by the formation of bubbles of gas that occur with changes in pressure during scuba diving. It is also experienced in commercial divers who breathe heliox (a special mixture of oxygen and helium), and astronauts and aviators that experience rapid changes in pressure from sea level. Scuba diving will be the focus of this article as it is the most common activity that may result in the bends.

Scuba diving is a sport and hobby that continues to increase in popularity each year. There are several organizations that certify individuals to become recreations divers, two of which are PADI (The Professional Association of Diving Instructors) and NAUI (The National Association of Underwater Instructors).

Data collected by Divers Alert Network (DAN) and presented in 2010 revealed 41 cases of DCS out of 137,451 dive profiles collected. It is important to know that even divers that follow decompression schedules and tables may still experience DCS.

What causes the bends?

Nitrogen or any gas from a diver's air tank increases in pressure as a diver descends. For every 33 feet in ocean water, the pressure due to nitrogen goes up another 11.6 pounds per square inch,. As the pressure due to nitrogen increases, more nitrogen dissolves into the tissues. The longer a diver remains at depth, the more nitrogen dissolves. Unlike the oxygen in the air tank a diver uses to swim underwater, the nitrogen gas is not utilized by the body and builds up over time in body tissues. The underlying cause of symptoms throughout the body is due mainly to nitrogen bubbles being released when the diver returns to sea level and blocking blood flow and disrupting blood vessels and nerves by stretching or tearing them. They may also cause emboli, blood coagulation and the release of vasoactive compounds.

A clear example to illustrate this bubble formation process is that of a bottle of carbonated soda. A bottle of carbonated soda is filled with gas (carbon dioxide), which cannot be seen because it is dissolved in solution under pressure. When the bottle is opened, the pressure is released and the gas leaves the solution in the form of bubbles. A diver returning to the surface is similar to opening the bottle of soda. As a diver swims to the surface, the pressure decreases. The nitrogen, which has dissolved in tissues, wants again to leave, because the body can hold only a certain amount based on that nitrogen pressure.

If a diver surfaces too fast, the excess nitrogen will come out rapidly as gas bubbles. Depending on which organs are involved, these bubbles produce the symptoms of decompression sickness.

The risk of decompression illness is directly related to the depth of the dive, the amount of time under pressure, and the rate of ascent. Dive tables, such as the US Navy Dive Tables, provide general guidelines as to what depths and dive times are less risky for the development of decompression sickness.

Symptoms of the Bends

The nervous and musculoskeletal system are most often affected. If a diver is going to develop symptoms they will show within 48 hours in all cases. Most have symptoms within 6 hours, while some develop within the first hour of surfacing from a dive.

DCS is often categorized into two types. Type I indicating mild symptoms and Type II with neurologic and other serious symptoms.

Symptoms of the bends include the following:

Musculoskeletal Symptoms (most common symptoms)

Pain in and around major joints with the shoulder and elbows being the most commonly affected in divers but any joint can be involved due to nitrogen being released into the joints and muscles.

Fatigue

Extreme tiredness that is out of proportion to the activity just performed.

Skin

Rashes that are red or marbled may occur. They can be very itchy also.

It is rare to have skin findings with DCS

Itching (also known as "the creeps")

Seen more commonly during decompression in hyperbaric chamber workers (see media photos).

Very itchy reaction on the skin that is exposed to pressures of the dive (i.e. not covered up by a wet suit.)

This is due to gas from the chamber dissolving into the skin and forming bubbles under the skin.

The creeps do not occur in divers

The Chokes (pulmonary or lung decompression sickness)

Rare but if it occurs can be very serious

A burning pain in the chest that is usually worse with breathing in (inspiration).

Other symptoms include cough, difficulty breathing, and cyanosis (blue lips and skin)

Divers with the chokes can progress to shock rapidly

Neurologic Decompression Sickness (these symptoms may be the only DCS signs)

The most common area affected in divers is the spinal cord.

Symptoms classically include low back pain, "heaviness" of the legs, paralysis and/or numbness of the legs, and even loss of control of the sphincter (or valve) that controls urine and stool resulting in incontinence.

Other symptoms may include fatigue, weak or numb upper extremities, chest or abdominal pains.

DCS involving the brain can present with dizziness, confusion, decreased awareness, loss of consciousness, loss or limited vision and even difficulty with balance and/or walking.

Lymph nodes (glands)

The lymph glands can be swollen and painful.

Pain

Pain can occur at the head, neck, or torso. Pain at these sites versus the arms or legs carries a worse prognosis.

Staggers

Occasionally someone with decompression illness may have symptoms suggesting an inner ear problem, such as a spinning sensation, deafness, ringing in the ears, or vomiting. This group of symptoms is called the "staggers."

When to Seek Medical Care

Any victim reporting signs or symptoms of decompression illness that began within 48 hours of scuba diving should be seen by a doctor at an emergency care facility immediately.

The doctor will likely presume that a victim reporting symptoms within 48 hours of surfacing from a scuba dive to have decompression illness. It is important to inform the doctor of your recent diving experience and of your symptoms.

Treatment for the Bends

The bends are treated in a hyperbaric recompression chamber.

The Bends Self-Care at Home

Rescue the diver from the water and provide emergency care within the limits of your training.

Dry and rewarm the diver with blankets if hypothermia (drop in body temperature) develops.

If you have access to oxygen, a mask should be applied to deliver high flow oxygen to the individual with symptoms.

You can visit the Divers Alert Network Web site or call them in the United States at (919) 684-9111 to determine where the nearest hyperbaric chamber is located.

Transport the person in a supine position (horizontal, lying on their back) to an emergency care facility. If a hyperbaric chamber is available, you may coordinate to transport directly to that facility for definitive care.

If air transport is used, attempt to find an air frame that can transport the diver below 1,000 feet or is able to be pressurized to sea level pressure. Use high-flow oxygen if it is available during transport.

The Bends Medical Treatment

The doctor will first treat immediate life threats, such as breathing problems or shock, if present.

The diver will need high-flow oxygen and IV fluids. Blood and urine will be sent for laboratory tests to assess any blood clotting problems and hydration status.

The diver will likely need to go to a hyperbaric chamber for recompression. During recompression, the chamber becomes pressurized with air and oxygen based on prearranged protocols to simulate pressure depths of 30 to 60 feet. The duration of "the dive" within the chamber varies, but can be up to 12 hours and sometimes longer. At this depth or chamber pressures, bubbles are reduced in size or reabsorbed to ensure adequate blood flow. Recompression prevents further bubble formation and provides high amounts of oxygen to the injured tissues. Further treatments depend on how the diver responds to the initial treatment.

Often the person is admitted to the hospital to monitor medical condition and to ensure that there is no recurrence of symptoms.

The Bends Follow-Up

Follow up immediately for any further signs or symptoms of decompression illness within the next 7 days. After suffering decompression sickness, individuals should not dive again until cleared by a doctor. Depending on the severity of symptoms, and if the person has suffered decompression sickness before, the doctor will likely recommend not to dive again or to avoid diving for some amount of time.

The Bends Prevention

Decompression illness or the bends and other types of barotrauma (decompression sickness) may be prevented by following guidelines for diving taught in professional diving courses.

The following actions increase risk of developing decompression illness:

Diving outside dive table recommendations

Flying within 18 hours after diving: Most experts consider it reasonably safe to fly 12 hours after a person's last dive if they only once, dove easily within the dive tables, and no decompression stop was required. For more complicated diving, waits of 48 hours have been recommended. In general, the longer a person wait to fly after diving, the lower the risk of developing decompression sickness. Even long waits, however, do not reduce the risk all the way to zero.

Data collected by DAN (Divers Alert Network) from 1987 to 1999, showed that 17% of divers in the DAN injury database had their first symptoms of DCS either during or after flying.

Diving in cold water

Obesity (nitrogen is lipid-soluble)

Dehydration

Recent alcohol intoxication

Vigorous exertion while diving

Multiple repetitive dives

Jogging or other heavy exercise within 6 hours of a dive

The Bends Prognosis

Prognosis or outlook of people that develop the bends varies with the following factors:

Prognosis is good with hyperbaric oxygen treatment.

Delay to hyperbaric oxygen treatment: Although reports show that victims can do well after days of symptoms, delay in definitive treatment may cause damage that is irreversible.

Severity of symptoms: Joint pains alone do better than focal weakness or inability to urinate.

Preexisting health: Young, healthy people can tolerate a greater insult to their health than an older person with other diseases.

The Bends Pictures

State-of-the-art hyperbaric oxygen chamber by HyperTec. Click to view larger image.

State-of-the-art single person chamber by HyperTec. Click to view larger image.

Simulated dive. Click to view larger image.

Medically reviewed by Avrom Simon, MD; Board Certified Preventative Medicine with Subspecialty in Occupational Medicine

REFERENCE:

MedscapeReference.com. Decompression Sickness.

# data[].attributes.attachment_link.title
The Bends: Symptoms, Treatment & Prevention

# data[].attributes.attachment_link.description
What is the bends (from diving)? The bends, also known as decompression sickness (DCS) or Caisson disease occurs in scuba divers or high altitude or aerospace events when dissolved gases (mainly nitrogen) come out of solution in bubbles and can affect just about any body area including joints, lung, heart, skin and brain.

# data[].attributes.attachment_link.readable_text
Imagine this scenario: a snorkeler or free diver approaches you and asks for a hit of your air - what do you do? Giving strangers compressed air may not actually be doing them a favor if you don't know enough dive science to be safe. Last week, we discussed the aspects of Charles' Law and how it applies to SCUBA diving. This week we'll look at the similar Boyle's Law and how its principles relate to our favorite activity.

Boyle's Law states that at constant temperature, pressure and volume are inversely proportional; as one increases, the other decreases. A balloon pushed underwater, for example, shrinks as its volume is compressed. Conversely, a balloon inflated underwater and released expands and may burst as it rises and its volume expands. This principle is the foundation of SCUBA safety training to prevent barotrauma, or injury to the body from changing pressure. Here are some SCUBA diving rules related to Boyle's Law.
Clear ears and descend slowly
Divers gently force air into their Eustachian tubes so that their eardrums do not burst inward from the vacuum created when the volume of air in the inner ear shrinks. They descend slowly, stopping as needed to adjust. Ascending too rapidly can cause the eardrum to burst outward if the air cannot escape back through the Eustachian tubes as it expands. Diving with a cold or allergy flare that swells the tubes and prevents clearing is ill-advised.
Breathe steadily
Controlled by the regulator, compressed air fills the lungs according to ambient pressure, allowing more oxygen in a breath as the lungs compress. Its volume expands or contracts with even a few feet of depth change, so Boyle's Law means it's important to breathe in and out without trying to save tank air by breath-holding. It's vital to release compressed air while ascending to prevent lung damage.
Ascend slowly
Nitrogen enters the bloodstream during descent compression and is usually released unnoticed over time when normal dive precautions are followed. According to Boyle's Law, a sudden ascension can create gas bubbles large enough to cause several types of injuries, depending on where the bubbles develop. Safe divers return to the surface at a slow pace to minimize the risk of decompression sickness, and they observe the no-fly rule to give their bodies time to release any accumulated nitrogen before undergoing rapid altitude changes.
Images via lobe.ca, grc.nasa.gov

# data[].attributes.attachment_link.title
Dive Science: How Boyle's Law Applies to SCUBA Diving

# data[].attributes.attachment_link.description
Imagine this scenario: a snorkeler or free diver approaches you and asks for a hit of your air - what do you do? Giving strangers compressed air may not actually be doing them a favor if you don't know enough dive science to be safe.

# data[].attributes.attachment_link.readable_text
What is the bends (from diving)?

The bends, also known as decompression sickness (DCS) or Caisson disease occurs in scuba divers or high altitude or aerospace events when dissolved gases (mainly nitrogen) come out of solution in bubbles and can affect just about any body area including joints, lung, heart, skin and brain.

Decompression sickness (DCS) is caused by the formation of bubbles of gas that occur with changes in pressure during scuba diving. It is also experienced in commercial divers who breathe heliox (a special mixture of oxygen and helium), and astronauts and aviators that experience rapid changes in pressure from sea level. Scuba diving will be the focus of this article as it is the most common activity that may result in the bends.

Scuba diving is a sport and hobby that continues to increase in popularity each year. There are several organizations that certify individuals to become recreations divers, two of which are PADI (The Professional Association of Diving Instructors) and NAUI (The National Association of Underwater Instructors).

Data collected by Divers Alert Network (DAN) and presented in 2010 revealed 41 cases of DCS out of 137,451 dive profiles collected. It is important to know that even divers that follow decompression schedules and tables may still experience DCS.

What causes the bends?

Nitrogen or any gas from a diver's air tank increases in pressure as a diver descends. For every 33 feet in ocean water, the pressure due to nitrogen goes up another 11.6 pounds per square inch,. As the pressure due to nitrogen increases, more nitrogen dissolves into the tissues. The longer a diver remains at depth, the more nitrogen dissolves. Unlike the oxygen in the air tank a diver uses to swim underwater, the nitrogen gas is not utilized by the body and builds up over time in body tissues. The underlying cause of symptoms throughout the body is due mainly to nitrogen bubbles being released when the diver returns to sea level and blocking blood flow and disrupting blood vessels and nerves by stretching or tearing them. They may also cause emboli, blood coagulation and the release of vasoactive compounds.

A clear example to illustrate this bubble formation process is that of a bottle of carbonated soda. A bottle of carbonated soda is filled with gas (carbon dioxide), which cannot be seen because it is dissolved in solution under pressure. When the bottle is opened, the pressure is released and the gas leaves the solution in the form of bubbles. A diver returning to the surface is similar to opening the bottle of soda. As a diver swims to the surface, the pressure decreases. The nitrogen, which has dissolved in tissues, wants again to leave, because the body can hold only a certain amount based on that nitrogen pressure.

If a diver surfaces too fast, the excess nitrogen will come out rapidly as gas bubbles. Depending on which organs are involved, these bubbles produce the symptoms of decompression sickness.

The risk of decompression illness is directly related to the depth of the dive, the amount of time under pressure, and the rate of ascent. Dive tables, such as the US Navy Dive Tables, provide general guidelines as to what depths and dive times are less risky for the development of decompression sickness.

Symptoms of the Bends

The nervous and musculoskeletal system are most often affected. If a diver is going to develop symptoms they will show within 48 hours in all cases. Most have symptoms within 6 hours, while some develop within the first hour of surfacing from a dive.

DCS is often categorized into two types. Type I indicating mild symptoms and Type II with neurologic and other serious symptoms.

Symptoms of the bends include the following:

Musculoskeletal Symptoms (most common symptoms)

Pain in and around major joints with the shoulder and elbows being the most commonly affected in divers but any joint can be involved due to nitrogen being released into the joints and muscles.

Fatigue

Extreme tiredness that is out of proportion to the activity just performed.

Skin

Rashes that are red or marbled may occur. They can be very itchy also.

It is rare to have skin findings with DCS

Itching (also known as "the creeps")

Seen more commonly during decompression in hyperbaric chamber workers (see media photos).

Very itchy reaction on the skin that is exposed to pressures of the dive (i.e. not covered up by a wet suit.)

This is due to gas from the chamber dissolving into the skin and forming bubbles under the skin.

The creeps do not occur in divers

The Chokes (pulmonary or lung decompression sickness)

Rare but if it occurs can be very serious

A burning pain in the chest that is usually worse with breathing in (inspiration).

Other symptoms include cough, difficulty breathing, and cyanosis (blue lips and skin)

Divers with the chokes can progress to shock rapidly

Neurologic Decompression Sickness (these symptoms may be the only DCS signs)

The most common area affected in divers is the spinal cord.

Symptoms classically include low back pain, "heaviness" of the legs, paralysis and/or numbness of the legs, and even loss of control of the sphincter (or valve) that controls urine and stool resulting in incontinence.

Other symptoms may include fatigue, weak or numb upper extremities, chest or abdominal pains.

DCS involving the brain can present with dizziness, confusion, decreased awareness, loss of consciousness, loss or limited vision and even difficulty with balance and/or walking.

Lymph nodes (glands)

The lymph glands can be swollen and painful.

Pain

Pain can occur at the head, neck, or torso. Pain at these sites versus the arms or legs carries a worse prognosis.

Staggers

Occasionally someone with decompression illness may have symptoms suggesting an inner ear problem, such as a spinning sensation, deafness, ringing in the ears, or vomiting. This group of symptoms is called the "staggers."

When to Seek Medical Care

Any victim reporting signs or symptoms of decompression illness that began within 48 hours of scuba diving should be seen by a doctor at an emergency care facility immediately.

The doctor will likely presume that a victim reporting symptoms within 48 hours of surfacing from a scuba dive to have decompression illness. It is important to inform the doctor of your recent diving experience and of your symptoms.

Treatment for the Bends

The bends are treated in a hyperbaric recompression chamber.

The Bends Self-Care at Home

Rescue the diver from the water and provide emergency care within the limits of your training.

Dry and rewarm the diver with blankets if hypothermia (drop in body temperature) develops.

If you have access to oxygen, a mask should be applied to deliver high flow oxygen to the individual with symptoms.

You can visit the Divers Alert Network Web site or call them in the United States at (919) 684-9111 to determine where the nearest hyperbaric chamber is located.

Transport the person in a supine position (horizontal, lying on their back) to an emergency care facility. If a hyperbaric chamber is available, you may coordinate to transport directly to that facility for definitive care.

If air transport is used, attempt to find an air frame that can transport the diver below 1,000 feet or is able to be pressurized to sea level pressure. Use high-flow oxygen if it is available during transport.

The Bends Medical Treatment

The doctor will first treat immediate life threats, such as breathing problems or shock, if present.

The diver will need high-flow oxygen and IV fluids. Blood and urine will be sent for laboratory tests to assess any blood clotting problems and hydration status.

The diver will likely need to go to a hyperbaric chamber for recompression. During recompression, the chamber becomes pressurized with air and oxygen based on prearranged protocols to simulate pressure depths of 30 to 60 feet. The duration of "the dive" within the chamber varies, but can be up to 12 hours and sometimes longer. At this depth or chamber pressures, bubbles are reduced in size or reabsorbed to ensure adequate blood flow. Recompression prevents further bubble formation and provides high amounts of oxygen to the injured tissues. Further treatments depend on how the diver responds to the initial treatment.

Often the person is admitted to the hospital to monitor medical condition and to ensure that there is no recurrence of symptoms.

The Bends Follow-Up

Follow up immediately for any further signs or symptoms of decompression illness within the next 7 days. After suffering decompression sickness, individuals should not dive again until cleared by a doctor. Depending on the severity of symptoms, and if the person has suffered decompression sickness before, the doctor will likely recommend not to dive again or to avoid diving for some amount of time.

The Bends Prevention

Decompression illness or the bends and other types of barotrauma (decompression sickness) may be prevented by following guidelines for diving taught in professional diving courses.

The following actions increase risk of developing decompression illness:

Diving outside dive table recommendations

Flying within 18 hours after diving: Most experts consider it reasonably safe to fly 12 hours after a person's last dive if they only once, dove easily within the dive tables, and no decompression stop was required. For more complicated diving, waits of 48 hours have been recommended. In general, the longer a person wait to fly after diving, the lower the risk of developing decompression sickness. Even long waits, however, do not reduce the risk all the way to zero.

Data collected by DAN (Divers Alert Network) from 1987 to 1999, showed that 17% of divers in the DAN injury database had their first symptoms of DCS either during or after flying.

Diving in cold water

Obesity (nitrogen is lipid-soluble)

Dehydration

Recent alcohol intoxication

Vigorous exertion while diving

Multiple repetitive dives

Jogging or other heavy exercise within 6 hours of a dive

The Bends Prognosis

Prognosis or outlook of people that develop the bends varies with the following factors:

Prognosis is good with hyperbaric oxygen treatment.

Delay to hyperbaric oxygen treatment: Although reports show that victims can do well after days of symptoms, delay in definitive treatment may cause damage that is irreversible.

Severity of symptoms: Joint pains alone do better than focal weakness or inability to urinate.

Preexisting health: Young, healthy people can tolerate a greater insult to their health than an older person with other diseases.

The Bends Pictures

State-of-the-art hyperbaric oxygen chamber by HyperTec. Click to view larger image.

State-of-the-art single person chamber by HyperTec. Click to view larger image.

Simulated dive. Click to view larger image.

Medically reviewed by Avrom Simon, MD; Board Certified Preventative Medicine with Subspecialty in Occupational Medicine

REFERENCE:

MedscapeReference.com. Decompression Sickness.

# data[].attributes.attachment_link.title
The Bends: Symptoms, Treatment & Prevention

# data[].attributes.attachment_link.description
What is the bends (from diving)? The bends, also known as decompression sickness (DCS) or Caisson disease occurs in scuba divers or high altitude or aerospace events when dissolved gases (mainly nitrogen) come out of solution in bubbles and can affect just about any body area including joints, lung, heart, skin and brain.

# data[].attributes.body
 in scuba divers or high altitude or aerospace events when dissolved gases (mainly nitrogen) come out of solution in bubbles and can affect just about any body area including joints, lung, heart, skin and brain.

# data[].attributes.body
The bends is caused when too much nitrogen is released from your bloodstream at once. This is an example of boyle's law because the nitrogen bubbles are caused when the pressure decreases in the breathing apparatus and in the water the volume of the nitrogen increases causing bubbles to form
https://www.britannica.com/science/decompression-sickness

# data[].attributes.body
The bends is an illness also known as decompression sickness. It occurs  in scuba divers or high altitude or aerospace events when dissolved gases (mainly nitrogen) come out of solution in bubbles and can affect any body area. The bubbles are formed because of the changes on pressure.
Once the volume of the water in the ocean increases, the pressure in the brain decreases, and this refers to Boyle's Law.

# data[].attributes.attachment_link.readable_text
What Is the Bends (From Diving)?

The bends, also known as decompression sickness (DCS) or Caisson disease occurs in scuba divers or high altitude or aerospace events when dissolved gases (mainly nitrogen) come out of solution in bubbles and can affect just about any body area including joints, lung, heart, skin and brain.

Decompression sickness (DCS) is caused by the formation of bubbles of gas that occur with changes in pressure during scuba diving. It is also experienced in commercial divers who breathe heliox (a special mixture of oxygen and helium), and astronauts and aviators that experience rapid changes in pressure from sea level. Scuba diving will be the focus of this article as it is the most common activity that may result in the bends.

Scuba diving is a sport and hobby that continues to increase in popularity each year. There are several organizations that certify individuals to become recreations divers, two of which are PADI (The Professional Association of Diving Instructors) and NAUI (The National Association of Underwater Instructors).

Data collected by Divers Alert Network (DAN) and presented in 2010 revealed 41 cases of DCS out of 137,451 dive profiles collected. It is important to know that even divers that follow decompression schedules and tables may still experience DCS.

What Causes the Bends?

Nitrogen or any gas from a diver's air tank increases in pressure as a diver descends. For every 33 feet in ocean water, the pressure due to nitrogen goes up another 11.6 pounds per square inch,. As the pressure due to nitrogen increases, more nitrogen dissolves into the tissues. The longer a diver remains at depth, the more nitrogen dissolves. Unlike the oxygen in the air tank a diver uses to swim underwater, the nitrogen gas is not utilized by the body and builds up over time in body tissues. The underlying cause of symptoms throughout the body is due mainly to nitrogen bubbles being released when the diver returns to sea level and blocking blood flow and disrupting blood vessels and nerves by stretching or tearing them. They may also cause emboli, blood coagulation and the release of vasoactive compounds.

A clear example to illustrate this bubble formation process is that of a bottle of carbonated soda. A bottle of carbonated soda is filled with gas (carbon dioxide), which cannot be seen because it is dissolved in solution under pressure. When the bottle is opened, the pressure is released and the gas leaves the solution in the form of bubbles. A diver returning to the surface is similar to opening the bottle of soda. As a diver swims to the surface, the pressure decreases. The nitrogen, which has dissolved in tissues, wants again to leave, because the body can hold only a certain amount based on that nitrogen pressure.

If a diver surfaces too fast, the excess nitrogen will come out rapidly as gas bubbles. Depending on which organs are involved, these bubbles produce the symptoms of decompression sickness.

The risk of decompression illness is directly related to the depth of the dive, the amount of time under pressure, and the rate of ascent. Dive tables, such as the US Navy Dive Tables, provide general guidelines as to what depths and dive times are less risky for the development of decompression sickness.

Symptoms of the Bends

The nervous and musculoskeletal system are most often affected. If a diver is going to develop symptoms they will show within 48 hours in all cases. Most have symptoms within 6 hours, while some develop within the first hour of surfacing from a dive.

DCS is often categorized into two types. Type I indicating mild symptoms and Type II with neurologic and other serious symptoms.

Symptoms of the bends include the following:

Musculoskeletal Symptoms (most common symptoms)

Pain in and around major joints with the shoulder and elbows being the most commonly affected in divers but any joint can be involved due to nitrogen being released into the joints and muscles.

Fatigue

Extreme tiredness that is out of proportion to the activity just performed.

Skin

Rashes that are red or marbled may occur. They can be very itchy also.

It is rare to have skin findings with DCS

Itching (also known as "the creeps")

Seen more commonly during decompression in hyperbaric chamber workers (see media photos).

Very itchy reaction on the skin that is exposed to pressures of the dive (i.e. not covered up by a wet suit.)

This is due to gas from the chamber dissolving into the skin and forming bubbles under the skin.

The creeps do not occur in divers

The Chokes (pulmonary or lung decompression sickness)

Rare but if it occurs can be very serious

A burning pain in the chest that is usually worse with breathing in (inspiration).

Other symptoms include cough, difficulty breathing, and cyanosis (blue lips and skin)

Divers with the chokes can progress to shock rapidly

Neurologic Decompression Sickness (these symptoms may be the only DCS signs)

The most common area affected in divers is the spinal cord.

Symptoms classically include low back pain, "heaviness" of the legs, paralysis and/or numbness of the legs, and even loss of control of the sphincter (or valve) that controls urine and stool resulting in incontinence.

Other symptoms may include fatigue, weak or numb upper extremities, chest or abdominal pains.

DCS involving the brain can present with dizziness, confusion, decreased awareness, loss of consciousness, loss or limited vision and even difficulty with balance and/or walking.

Lymph nodes (glands)

The lymph glands can be swollen and painful.

Pain

Pain can occur at the head, neck, or torso. Pain at these sites versus the arms or legs carries a worse prognosis.

Staggers

Occasionally someone with decompression illness may have symptoms suggesting an inner ear problem, such as a spinning sensation, deafness, ringing in the ears, or vomiting. This group of symptoms is called the "staggers."

When to Seek Medical Care

Any victim reporting signs or symptoms of decompression illness that began within 48 hours of scuba diving should be seen by a doctor at an emergency care facility immediately.

The doctor will likely presume that a victim reporting symptoms within 48 hours of surfacing from a scuba dive to have decompression illness. It is important to inform the doctor of your recent diving experience and of your symptoms.

The Bends Self-Care at Home

Rescue the diver from the water and provide emergency care within the limits of your training.

Dry and rewarm the diver with blankets if hypothermia (drop in body temperature) develops.

If you have access to oxygen, a mask should be applied to deliver high flow oxygen to the individual with symptoms.

You can visit the Divers Alert Network Web site or call them in the United States at (919) 684-9111 to determine where the nearest hyperbaric chamber is located.

Transport the person in a supine position (horizontal, lying on their back) to an emergency care facility. If a hyperbaric chamber is available, you may coordinate to transport directly to that facility for definitive care.

If air transport is used, attempt to find an air frame that can transport the diver below 1,000 feet or is able to be pressurized to sea level pressure. Use high-flow oxygen if it is available during transport.

Treatment for the Bends

The bends are treated in a hyperbaric recompression chamber.

The Bends Medical Treatment

The doctor will first treat immediate life threats, such as breathing problems or shock, if present.

The diver will need high-flow oxygen and IV fluids. Blood and urine will be sent for laboratory tests to assess any blood clotting problems and hydration status.

The diver will likely need to go to a hyperbaric chamber for recompression. During recompression, the chamber becomes pressurized with air and oxygen based on prearranged protocols to simulate pressure depths of 30 to 60 feet. The duration of "the dive" within the chamber varies, but can be up to 12 hours and sometimes longer. At this depth or chamber pressures, bubbles are reduced in size or reabsorbed to ensure adequate blood flow. Recompression prevents further bubble formation and provides high amounts of oxygen to the injured tissues. Further treatments depend on how the diver responds to the initial treatment.

Often the person is admitted to the hospital to monitor medical condition and to ensure that there is no recurrence of symptoms.

The Bends Follow-Up

Follow up immediately for any further signs or symptoms of decompression illness within the next 7 days. After suffering decompression sickness, individuals should not dive again until cleared by a doctor. Depending on the severity of symptoms, and if the person has suffered decompression sickness before, the doctor will likely recommend not to dive again or to avoid diving for some amount of time.

The Bends Prevention

Decompression illness or the bends and other types of barotrauma (decompression sickness) may be prevented by following guidelines for diving taught in professional diving courses.

The following actions increase risk of developing decompression illness:

Diving outside dive table recommendations

Flying within 18 hours after diving: Most experts consider it reasonably safe to fly 12 hours after a person's last dive if they only once, dove easily within the dive tables, and no decompression stop was required. For more complicated diving, waits of 48 hours have been recommended. In general, the longer a person wait to fly after diving, the lower the risk of developing decompression sickness. Even long waits, however, do not reduce the risk all the way to zero.

Data collected by DAN (Divers Alert Network) from 1987 to 1999, showed that 17% of divers in the DAN injury database had their first symptoms of DCS either during or after flying.

Diving in cold water

Obesity (nitrogen is lipid-soluble)

Dehydration

Recent alcohol intoxication

Vigorous exertion while diving

Multiple repetitive dives

Jogging or other heavy exercise within 6 hours of a dive

The Bends Prognosis

Prognosis or outlook of people that develop the bends varies with the following factors:

Prognosis is good with hyperbaric oxygen treatment.

Delay to hyperbaric oxygen treatment: Although reports show that victims can do well after days of symptoms, delay in definitive treatment may cause damage that is irreversible.

Severity of symptoms: Joint pains alone do better than focal weakness or inability to urinate.

Preexisting health: Young, healthy people can tolerate a greater insult to their health than an older person with other diseases.

The Bends Pictures

State-of-the-art hyperbaric oxygen chamber by HyperTec.

State-of-the-art single person chamber by HyperTec.

Simulated dive.

# data[].attributes.attachment_link.title
The Bends: Prevention, Symptoms & Treatment

# data[].attributes.attachment_link.description
What Is the Bends (From Diving)? The bends, also known as decompression sickness (DCS) or Caisson disease occurs in scuba divers or high altitude or aerospace events when dissolved gases (mainly nitrogen) come out of solution in bubbles and can affect just about any body area including joints, lung, heart, skin and brain.

# data[].attributes.body
The bends is an illness also known as Decompression sickness.  It usually occurs in scuba divers or high altitude events when dissolved gases (mainly nitrogen) come out of solution in bubbles. This condition can relate to Boyle's law because as a diver descends into the water, the pressure increases which means volume decreases, as this is an inversely proportional relationship. When the diver ascends, the volume increases and gas fills up the lungs which is released into the bloodstream which causes pain.

# data[].attributes.body
The bends is a disease that creates gases mostly oxygen from high altitude that can affect joints lungs hearts and brain. This refers to Boyle's law because once the volume of the ocean water increases the pressure in the brain and lungs decrease. Boyles law has a inversely proportional reaction. https://www.leisurepro.com/blog/scuba-guides/dive-science-boyles-law-applies-scuba-diving/
https://www.emedicinehealth.com/decompression_syndromes_the_bends/article_em.htm

# data[].attributes.headline
How does the "Bends" condition relate to Boyle's Law?

# data[].attributes.subject
How does the "Bends" condition relate to Boyle's Law?