NOTE: Article originally posted by Diver’s Alert Network and can be accessed directly here.

Diving is a physical activity so it’s not unusual for divers to experience muscle soreness or other post-dive discomfort. But sometime those aches and pains are signs of a serious medical problem. Recognizing the early signs of decompression sickness (DCS), heat stroke, and other conditions can help an injured diver get the medical attention they need.

Know the Signs

1.) CHEST PAIN
Divers who experience chest pain or discomfort when swallowing after a dive may have pulmonary barotrauma. Sharp pain on one side of the chest or feeling tightness in the chest may be signs of a pneumothorax, also known as a collapsed lung. Other symptoms include: shortness of breath, rapid heart rate, rapid breathing, cough, fatigue and/or blueish skin.

2.) PARALYSIS, PARTIAL PARALYSIS OR WEAKNESS
Paralysis of one or more parts of the body may be a sign of Type II DCS. Weakness or paralysis in the extremities may also be a sign of arterial gas embolism (AGE). Other symptoms of AGE include bloody froth from the mouth or nose and convulsions, although the most common sign of an AGE is loss of consciousness. AGE is considered extremely serious and suspicion of AGE symptoms warrants immediate evacuation to medical care.

3.) JOINT PAIN
Steady or throbbing pain particularly in larger joints such as the shoulders and elbows may be a sign of Type II DCS. The pain may feel like a muscle sprain, but it’s important to be proactive and have any symptoms evaluated by a qualified professional.

4.) SKIN ISSUES
A rash, itchy feeling, or skin marbling may be a sign of a type of Type I DCS known as a skin bend. This type of DCS has been linked to more serious neurological DCS symptoms, and should be treated as seriously as other diving related injuries.

5.) VERTIGO
Vertigo is often confused with dizziness, but true vertigo feels like the world is spinning. If vertigo occurs during or after a dive, assume the cause is related to the dive and respond accordingly. Vertigo can be caused by decompression sickness, impure breathing gas, or an imbalance in ear equalization. Persistent vertigo may be the sign of a more serious underlying condition, and evaluation by an ENT may be required.

Case Summary

What Happens When Symptoms Are Ignored

A male diver in his sixties felt weak, dizzy, and confused twenty minutes after surfacing from a dive. The man had been diving for four consecutive days, and the dives were uneventful and within the parameters of his computer. He returned to his room and, after resting, the dizziness and confusion resolved. The next day, he called DAN reporting weakness and muscle spasms in his legs and difficulty urinating.

This is an example of a diver underestimating his symptoms. The early post-dive onset of weakness, dizziness and confusion are some of the typical symptoms of DCS. First aid oxygen should have been administered from the onset of symptoms, not delayed until next day. This diver was fortunate his leg weakness did not progress to full paralysis. Several recompression treatments were needed before the diver regained full control of his bladder and strength of his legs, however, some loss of sensory functions remained.

6.) HEADACHE
A headache combined with hot, dry skin, amber-colored urine, or problems urinating are possible signs of dehydration and/or heat stroke. Other symptoms of heat stroke may include: a pronounced change in mental status, nausea or vomiting, loss of consciousness, cessation of sweating and/or a body temperature exceeding 104°F / 40°C. Read more about the symptoms and treatment of heat-related illnesses.

A headache along with other nervous system issues such as: muscle weakness, difficulty walking, confusion or impairment of cognitive functions, vertigo, dizziness and/or impaired balance may be signs of DCS II. Read more about the signs and symptoms of DCS and call EMS right away if you suspect a diver has DCS.

When in Doubt, Contact DAN
If you or another diver experience these symptoms, don’t hesitate to call DAN’s Medical Information Line (+1 919-684-2948 ext. 6222) to review your case with a medic. If you are experiencing an emergency call local emergency services first then call DAN’s Emergency Hotline (+1-919-684-9111). Delay in seeking care is a common problem in the proper treatment of diving-related accidents.