If you notice health changes during or soon after a dive, you should assume that it is related to diving. The most likely culprit is decompression illness (DCI), the likelihood of which increases with the severity of the dive. If DCI is suspected, you should receive first aid surface oxygen and a proper medical evaluation. Even if your condition is not DCI, first aid oxygen may still help and will not worsen your condition. If the medical exam indicates that DCI is likely, the next step may be hyperbaric oxygen therapy (HBOT) treatment in a recompression chamber. It is also important to drink plenty of liquid once back on the surface.
Some divers, however, may have symptoms during or after diving that ultimately are not related to diving. If you had health issues before the dive, it is possible that postdive symptoms are related to your preexisting condition. Distinguishing between DCI and unrelated health issues in postdive symptoms is often made more difficult because DCI may occur even after innocuous dives, or acute health issues unrelated to the dive may occur in divers who are unaware of any previous health issues.
In any case, the best thing you can do for the most accurate diagnosis is to be honest about all your symptoms, no matter how insignificant they may seem.
Heart Attack and Stroke
Beware of chest pain or pain radiating in the left arm or chin, which may indicate a heart attack. Severe headache, weakness and numbness on one side of the face and body, confusion or slurred speech may indicate a stroke. If any of these symptoms are present, immediately call emergency medical services (EMS) or transport the victim to the nearest emergency care facility.
In most cases, especially with DCI, HBOT treatment of postdive symptoms in a recompression chamber will help and will not cause harm. Recompression treatment is most effective if it is available locally and can be started soon after the onset of symptoms. Unfortunately, hyperbaric chambers often are not nearby or readily available for divers. DAN advises divers to first go to the nearest medical facility for a professional evaluation and initial treatment and to call DAN if HBOT treatment is deemed necessary. DAN is always available to consult with physicians and to help them with establishing the diagnosis.
The local medical authority, with input from DAN medics, will determine if someone needs to be evacuated to either a higher level of care or a hyperbaric facility. DAN members must arrange evacuations through the DAN emergency hotline to receive TravelAssist coverage benefits. While the patient is waiting for travel to be arranged, the local medical facility may provide various treatments and support measures to stabilize vital functions and alleviate symptoms, which in some cases results in a complete resolution.
Postdive Symptoms Indicating DCI
DCI is a possible cause of the following symptoms:
- pain in major joints
- skin mottling
- numbness and tingling of legs and arms
- difficulty walking
- loss of muscle strength
- weakness of one half of the face or body
- vision or hearing problems
- loss of equilibrium and nausea
- difficulty breathing
- abdominal pain
Whether or not you have been diving, the following symptoms represent an emergency situation and require immediate medical care:
- chest pain or difficulty breathing
- weakness or numbness on one side
- sudden inability to speak, see, walk or move
- slurred speech
- severe headache or head injury, especially if the individual is on aspirin or blood thinners
- fainting or change in mental state
- serious burns
- head or eye injury
- concussion or confusion
- broken bones and dislocated joints
- fever with a rash
- severe cuts that may require stitches
- facial lacerations
- abdominal pain (especially intense localized pain)
- blood in the urine or bloody diarrhea
- vaginal bleeding while pregnant
Drive Yourself or Call EMS?
You should never drive yourself if you are having severe chest pain or bleeding, if you feel like you might faint or if your vision is impaired. When in doubt, call 911 or the local emergency number for your location. For emergencies such as a heart attack or stroke, paramedics often can begin delivering life-saving treatment on the way to the hospital.
— Petar Denoble, M.D.
© Alert Diver — Q4 Fall 2019