Responding to Neurological DCS

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Neurological symptoms are not the most common symptoms of DCS, but their onset can be rapid and their consequences serious. These symptoms can also be difficult to manage in the field. Much like a stroke, neurological DCS requires a rapid response, so it’s critical for you to be able to identify and respond quickly and correctly. These symptoms can be both highly variable and undetectable to the person experiencing them, so knowing how to assess a diver after a dive can make all the difference.

Signs and Symptoms

The symptoms of and proper response to neurological DCS are very similar to dealing with a stroke. DCS that affects the brain and nervous system can manifest in many ways, but here is a list of the most common neurological symptoms:

  • Confusion
  • Numbness
  • Paresthesia (a “pins and needles” sensation)
  • Muscle weakness
  • Difficulty walking
  • Problems with physical coordination or bladder control

You’ll notice that many of these are also symptoms of stroke, so following the FAST (face, arm, speech, time) model for identifying a stroke is an effective way to begin analyzing someone with suspected neurological DCS. Whenever you suspect a stroke or neurological DCS, assume the worst-case scenario and respond accordingly.


Once you’ve identified symptoms of suspected neurological DCS, your first response should always be to activate emergency medical services. Whether you’re offshore and need a complex evacuation or you’re diving minutes from the nearest hospital, it’s critical that the injured diver reaches qualified treatment as quickly as possible.

The American Heart Association (AHA) currently recommends a 60-minute door-to-door policy for suspected strokes. For example, no more than one hour should pass from the time a stroke is identified to the time that stroke victim receives treatment in a hospital. This same window of time — or an even smaller one — should be the goal for injured divers. The biggest factor in promoting positive outcomes for injured divers is rapid access to definitive care.

After emergency services are activated, provide care for the injured diver to the best of your ability. Administer emergency oxygen and make the diver comfortable while waiting for help, and if you have additional training, perform a neurological assessment and provide a detailed report to first responders. As long as you act within the limits of your training, your quick response and care will ultimately help the injured diver get the best possible outcome.

For information on neurological assessments, DCS response, or advanced first aid training visit

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