Managing Decompression Sickness in a Low-Resource Setting, a Clarion Call to Improve Systems: A Case Report

Decompression sickness (DCS) is a life-threatening clinical condition that occurs following an uncontrolled rapid ascent after a deep dive, leading to the formation of gas bubbles in the blood occurring due to the rapid decline in environmental pressure. We report the case of a 32-year-old male who presented with bilateral lower limb numbness eight hours following a diving session. He was diagnosed with neurological DCS and transported 365 km to the Naval Hospital, Eastern Command where he received hyperbaric oxygen treatment and made a full recovery. This individual developed DCS after repetitive dives within a week despite having planned ascents with advice from a diving instructor. He switched between different rented diving computers; consequently, these devices lacked cumulative dive history to indicate minimum surface time required for sufficient nitrogen gas washout. Both the diver and instructors had a suboptimal assessment of the cumulative dive exposure and worked with a false reassurance of having planned ascents under supervision. In addition, this report highlights critical delays in the diagnosis of DCS and complexities involved in accessing the country's only hyperbaric treatment facility. It also emphasizes the need for empowering diving centers and medical professionals for early identification and facilitating access to prompt treatment.