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SPRING 2012
RESEARCH, EDUCATION & MEDICINE
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I N C I D E N T I N S I G H T
T
he diver was a 54-year-old female. She was
experienced (approximately 400 lifetime dives)
and physically fit with no relevant medical
history.
The dives
She was on a weeklong dive vacation in the Caribbean
and had been diving for two days with four dives each
day. Her maximum depth was 90 feet. All dives were on
air, and her bottom times were within her computer’s
no-decompression limits. She spent at least one hour on
the surface between dives and at least two hours between
the morning and afternoon dives. After the last dive on
the second day she began to feel soreness in her abdomen.
She noticed areas of blotchiness that looked like bruising.
The affected areas were tender, but in the deeper tissue
rather than on the surface of her skin. She reported feeling
as though she had done “too many sit-ups.” Some slight
itching was present, but the soreness and discoloration
were most prominent. Based on their previous experience,
the dive staff believed this was the result of a sting by a
marine animal.
The blotchiness resolved within two hours, but the
soreness remained. It was mild enough, though, that she
could enjoy dinner and a casual evening walk with her
traveling companions. By the next morning the soreness
was almost completely resolved, and she decided to
participate in the morning dives.
The first dive was an uneventful drift dive to 64 feet for
55 minutes. The abdominal pain increased following that
dive. She attributed this increase to the physical activity of
the dive. The next dive was to 58 feet for 50 minutes. Upon
surfacing she experienced even more abdominal discomfort
and soreness of both breasts. Upon removing her wetsuit
she noticed the areas of blotching had returned, but they
were darker and larger than those of the previous day.
There were no blotches on her breasts, but they were very
tender. The symptoms were again attributed to a sting or
an allergic reaction to an unknown irritant. She had never
experienced any symptoms like this on previous dives.
The dive boat returned to shore for lunch before the
afternoon dives. Forty-five minutes after her last dive the
blotchy areas seemed to be diminishing, but the diver
began to complain of blurred vision, dizziness and general
B y M a R t y M
c
C a f f e R t y , e M t - P , D M t
S T E P H E N F R I N K
Skin Bends
Recognizing
the signs of
cutaneous DCS