How does Decompression Illness present?

Bubbles can form in or move to most parts of the body and so decompression illness can present with almost any clinical picture. In 90% of cases symptoms present within 6 hours of a dive. The sooner, after ascent, that a diver notices a problem, the more likely it is to be DCI and usually the worse the prognosis.

These are some of the more common presentations:

  1. Limb or joint pain often a toothache type pain, usually not worse on movement or palpation
  2. Girdle pain– pain coming from the back and spreading to the abdomen
  3. Neurological symptoms– tingling, numbness, weakness, change in behaviour or personality, poor co-ordination, loss of bowel or bladder control, changes in hearing or vision, memory loss, unconsciousness
  4. Chest pain or breathing difficulties– this could suggest a pneumothorax, gas within the coronary vessels or immersion pulmonary oedema.
  5. Rash– often a mottled rash called cutis marmorata. This can precede a more severe neurological DCI. It is recommended to take a photograph of the rash as it can disappear quickly before the patient sees a dive physician.
  6. Audio vestibular hearing loss, balance and co-ordination problems, vertigo and vomitingAudio-vestibular bends are difficult to differentiate from inner ear barotrauma.
  7. Not quite right(Constitutional symptoms) malaise, headache, lethargy, loss of appetite, apathy etc. This can also include cognitive symptoms with a reduced MMSE score.