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“The Bends” & Scuba Diving

The thought of getting “The Bends” or “Bent” has likely turned more potential scuba divers away from the hobby than anything else, including sharks!

But with all of this talk around The Bends, we should first identify what it actually is.

The Bends, also known as decompression sickness or Caisson disease, is a disorder most commonly known to result from scuba diving.

Excess nitrogen bubbles that remain inside the tissues, expand during an ascent, blocking blood flow, and potentially organs.

Let’s jump into a more scientific definition of what actually goes on.

It’s caused when the body does not adjust properly to changes in pressure, typically due to rapid changes in depth.

What causes Decompression Sickness (The Bends)?

To get more in-depth into why exactly this happens, we need to go into a bit of chemistry and physics.

Humans are used to breathing air at or around sea level. According to Weather.Gov, this air comes at a partial pressure of 14.7 pounds per square inch.

Due to water being heavier than air, while we’re diving the water around us exerts a higher pressure on our bodies, especially as we descend deeper. 

To give you an example, if we descend to just 33 feet (10m), our lungs are now compressed to half of their original size. At 100 feet (30m), our lungs are just 25% of their normal size. The air in our tanks is undergoing the same effect.

If we remember from our open water course, the air we breathe normally on land and in our tanks is 78% nitrogen and 21% oxygen. 

As we dive, nitrogen and oxygen are absorbed into our bodies with each breath. The human body has a use for oxygen, but not so much nitrogen.

As a diver ascends, any lingering gas bubbles expand. The nitrogen in our bodies off-gasses over time, which is why scuba divers do safety stops and decompression stops.

But if they are not done when required, it can lead to bubbles inside our tissues that are larger than normal, at a given pressure. This is a rare occurrence and typically happens due to a rapid ascent or diver negligence

If this occurs, the diver is now bent. This has differing levels of severity and symptoms, which we’ll cover in the next section.

What are Symptoms of Decompression Sickness?

Signs and symptoms of the Bends include:

  • Fatigue
  • Pain and discomfort in the joints and extremities
  • Issues breathing
  • Numbness
  • Weakness
  • Itchy or irritable skin

How to Treat Decompression Sickness (DCS)?

Depending on the severity of the symptoms, you’ll want to take differing steps with a diver. We’ll break down the ideal treatments for the following types of cases:

  • Emergency DCS
  • Serious DCS
  • Mild DCS

Emergency DCS

Nasa decompression chamber

The most urgent decompression sickness cases are when a diver has extreme nausea, difficulty breathing, inability to walk properly, or extreme pain and discomfort. This diver should be given emergency oxygen right away.

Call for emergency services, and then speak with your diving insurance provider (hopefully you have one) for further instruction.

Protocol will involve the diver being monitored and stabilized at a medical facility and then taken to a compression chamber.

Serious DCS

Diver feeling unwell after a dive

This type of Decompression Sickness is any diver who is experiencing high levels of pain and discomfort after surfacing from a dive. Emergency oxygen should be administered right away. In most cases, an emergency air evacuation is not needed.

Mild DCS

Mild decompression sickness cases occur when a diver expresses slight discomfort in their bodies, a rash, or fatigue. Giving this diver emergency oxygen is wise. They should still seek medical attention, but an airlift is not needed.

How to Prevent the Bends

Plan the Dive, Dive the Plan

Preventing DCS starts with sticking to your dive plan. Always follow the most conservative dive computer in your group. Have safeguards in place in the event of getting lost, strong current, or other issues that could arise.

Do Your Safety and Decompression Stops

This goes without saying. These measures were put into place specifically to protect yourself against decompression sickness and is the most effective way to prevent it from happening in the first place.

Avoid Symptom Denial

One of the most dangerous things you can do when you have a suspected case of DCS, is denying that you are experiencing DCS symptoms.

Dive With People You Trust

Whether you’re among friends or with a dive charter, you want to make sure whoever you’re with are competent in dealing with a potential DCS situation. Looking at a dive charter’s reviews and asking about their safety equipment and procedures are a good idea.

Get Diving Insurance

Making sure you’re covered by your insurance is key for peace of mind. You’ll be much less likely to deny your symptoms out of fear of not being able to pay your medical bills.

Recompression chambers and emergency airlifts are not cheap. Dive insurance will cover these, for a fraction of the price.

Concluding Thoughts

Overall, the Bends or “getting bent” is not something that happens often but is always in the back of the mind of every diver

Safety stops and decompression stops were researched and put into place by navies and dive professionals to prevent this exact issue.

Most dive professionals will go their entire careers without ever getting bent.

Don’t let the fear of getting bent stop you from experiencing everything the scuba diving hobby has to offer.

Welcome to our blog!
I am a PADI Divemaster based in South Florida. With nearly 10 years of diving experience, I have accumulated the knowledge to help readers become better divers, buy their next piece of gear, and plan their dream dive vacation! Please contact me if you have any questions.

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