Common Signs of Decompression Illness (the bends)

• joint and muscle aches and pains – when these are not severe, there is a tendency to put them down to aches and strains from lifting dive equipment, holding onto the boarding ladder and so on.  An examination by a hyperbaric doctor is able to distinguish between strains and decompression illness in most cases.
• neurological symptoms, ranging from the impossible to ignore, such as hemiplegia (paralysis, particularly of the lower limbs) or unconsciousness to others such as loss of bladder function, deafness, visual disturbances, dizziness, tingling – particularly of fingers/hands and feet.  Tight cuff seals can often cause some tingling in the finger tips – it is often a question of considering what is usual for you, as a diver and looking at the dive profiles.  If rapid ascents, missed stops or other factors are involved which increase the possibility of decompression illness, then assessment by a dive doctor is worthwhile.
• respiratory distress (known as the “chokes”), including chest pain, a burning sensation in the chest and sometimes a cough that is hard to shake off. 
• other symptoms such as skin rashes, or subcutaneous marmorata – a mottled patchy appearance, particularly over the shoulders, upper arms and on the torso.  It can be distinguished from suit squeeze due to the absence of regular lines which characterise the latter.  Extreme fatigue can be one of the more subtle symptoms that often goes unnoticed.  Another one sometimes seen is swelling, particularly from lymphatic bends.

In all cases where symptoms are noted, specialist medical advice should be sought.  How this is done depends on the location of the dive, but in the UK access to these services whilst at sea should be made through HM Coastguard.

Rapid recompression is necessary in cases of decompression illness to minimise and reverse damage caused by gas bubbles in the system following the dive.  Sufficient treatment provided rapidly decreases the risk of any longer term problems significantly. 

If presenting to an Accident and Emergency department at a Hospital following a dive, when some of the signs and symptoms noted above are present, do ensure that staff are made aware of your dives.  You may well be more knowledgeable about decompression illness than the staff attending you and making them aware of your dive profiles can ensure that specialist medical advice is obtained, leading to swifter diagnosis and treatment if required.