Decompression Sickness

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This article was written by Dr. Stephen Muscat (dr.muscat@gmail.com) , an expert in the Medicine of Diving at Mater Dei Hospital in Malta

 

A common symptom after scuba diving is an itchy skin rash. Good judgement and common sense is essential in these cases as cases of decompression sickness may be missed. Always consult a diving physician or send the diver to casualty if there is any doubt. A typical scenario is an experienced diver doing one or more 30m+ dives and noticing the rash within an hour after surfacing. The rash is typically flat, irregular (like a map), reddish pink, usually itchy and fades slightly on pressure.

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Suit squeeze               Suit squeeze                 Skin DCS

The commonest places are the tummy and chest, but can also present on shoulders and thighs. Take a photo of the rash with a phone as this can be sent to a doctor or kept as record in case the rash fades away (as usually happens) with first aid 100% O2 that should be administered. A typical rash  is a sign of decompression sickness. All cases should be treated in the chamber, as DCS is a complex condition about which there is a lot we do not know yet. Other causes of rashes after diving include suit squeeze, usually with dry suits but also with tight, single lined wetsuits. The location and shape of the rash is usually a giveaway and the seam of the suit may be visible. Divers are usually not advised to take hot showers right after diving. There are 2 reasons for this:

1. Divers doing a heavy dive who have become cold, may theoretically off-gas too quickly if they take a hot shower immediately after the dive.

2 A hot shower may provoke pruritus and if the diver scratches, an accompanying rash. This may cause diagnostic confusion