Scuba diving sickness encompasses a range of medical conditions specific to the underwater environment, primarily arising from physics affecting the body. Understanding these risks is essential for every diver, from the novice exploring a shallow reef to the experienced professional conducting deep dives. The most common issues stem from pressure changes, gas absorption, and environmental factors, all of which require specific knowledge to prevent. This overview details the primary illnesses and injuries divers face, focusing on recognition, prevention, and appropriate response.
Understanding Decompression Sickness
Decompression sickness (DCS), often called "the bends," remains the most feared scuba diving sickness. It occurs when dissolved gases, primarily nitrogen, form bubbles in the tissues and bloodstream during or after ascent. This happens when a diver spends too long at depth or ascends too quickly, exceeding the safe limits defined by decompression models. Symptoms can range from joint pain and skin rashes to paralysis and respiratory failure, making immediate recognition and treatment critical for survival.
Types and Symptoms
Type I (Minor): Primarily affects the skin and joints, causing itching, rashes, and joint pain.
Type II (Major): Involves the neurological or cardiopulmonary systems, leading to numbness, weakness, difficulty breathing, or unconsciousness.
Immediate oxygen administration and emergency medical evacuation are the standard first responses to suspected DCS. Hyperbaric oxygen therapy in a recompression chamber is the definitive treatment, aiming to reduce bubble size and facilitate safe gas elimination.
Arterial Gas Embolism: A Critical Emergency
Arterial Gas Embolism (AGE) is another acute diving sickness often discussed alongside DCS but with a distinct origin and urgency. It typically happens during ascent, where an over-expanded lung tissue ruptures, injecting air directly into the arterial bloodstream. This air bubble can travel to the brain or heart, causing stroke-like symptoms such as paralysis, confusion, or loss of consciousness almost immediately after surfacing.
Because AGE and DCS can present similarly and occur together, the treatment protocol is identical: administer 100% oxygen and seek immediate recompression therapy. Rapid recognition and transport to a hyperbaric facility are vital, as neurological damage can occur within minutes.
Barotrauma: Pressure-Related Injuries
Barotrauma refers to injuries caused by the inability to equalize pressure between an air space in the body and the surrounding water pressure. This common scuba diving sickness affects air spaces such as the ears, sinuses, and lungs. Ear barotrauma is particularly frequent, leading to pain, pressure, and potential eardrum rupture if not managed with proper equalization techniques throughout the descent.
Prevention and Management
Descend feet first to help equalize sinus pressure.
Never force an equalization if it causes pain; ascend slightly to allow pressure to equalize naturally.
Avoid diving with a congested head cold or sinus infection.
Lung overpressure injuries, though rare, are severe and can occur if a diver holds their breath while ascending, causing air to expand and rupture lung tissue. Continuous, normal breathing is the fundamental rule to prevent this specific injury.
Thermal and Environmental Illnesses
Beyond gas-related issues, scuba diving sickness includes conditions caused by the thermal and chemical environment. Hypothermia is a significant risk even in warm water, as water conducts heat away from the body much faster than air. Symptoms include intense shivering, confusion, and loss of coordination, which can impair judgment and motor skills, leading to poor dive decisions.
