San Diego Freediving Decompression Sickness: Symptoms and Emergency Response
Decompression sickness—commonly called “the bends”—is rare in recreational freediving but remains a serious risk that San Diego divers need to understand. Unlike scuba diving, where rapid pressure changes cause nitrogen buildup, freediving typically avoids this issue because divers hold a single breath. However, repetitive dives, aggressive ascent profiles, and pushing depth limits can create conditions where decompression stress becomes a real threat.
How Decompression Sickness Happens in Freediving
Most freediving decompression incidents occur during repetitive deep dives or when divers make multiple passes at depth without adequate surface intervals. The repeated pressure exposure and breathing patterns during surface recovery can introduce nitrogen supersaturation—especially if you’re performing constant weight or variable weight dives at spots like The Wreck off Point Loma or Sunset Cliffs.
The risk escalates with:
- Multiple dives to 40+ meters in a single session
- Inadequate surface intervals between dives
- Rapid or uncontrolled ascents
- Altitude diving after sea-level sessions
- Dehydration or fatigue
San Diego’s year-round diving conditions—particularly the cold water off La Jolla Shores and Mission Beach—can mask early symptoms because cold exposure itself causes vasoconstriction and can delay symptom onset.
Recognizing Decompression Sickness Symptoms
Symptoms appear within minutes to 12 hours post-dive, though most manifest within the first hour. Know what to watch for in yourself and your dive partner:
Type I (Skin and Joint Bends):
- Itching, rash, or mottled skin (often on the torso)
- Joint or limb pain, typically in shoulders, elbows, knees, and hips
- Fatigue or mild malaise
Type II (Serious):
- Neurological symptoms: tingling, numbness, weakness, paralysis
- Respiratory symptoms: chest pain, shortness of breath (“the chokes”)
- Vertigo or balance issues
- Loss of bladder or bowel control
- Confusion or altered consciousness
Even mild symptoms—a subtle itch that won’t quit, a dull shoulder ache after a deep session at Kelp Forest—warrant immediate attention. Do not assume symptoms will resolve on their own.
Immediate Response Protocol
If you suspect decompression sickness:
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Stop diving immediately. No more water time.
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Move the affected person to a safe location away from the water and lay them flat or in a semi-recumbent position.
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Administer oxygen. If available on the beach or boat, provide 100% oxygen via a non-rebreather mask. Oxygen dramatically reduces bubble size and accelerates nitrogen elimination.
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Call 911 or have someone radio the Coast Guard. San Diego County has excellent emergency response infrastructure. Clearly state:
- Your location (beach name, pier, or coordinates if offshore)
- Nature of the emergency
- Symptoms observed
- Dive depth and duration
- Time since surfacing
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Keep the person warm and hydrated while awaiting help. Do not give alcohol or stimulants.
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Do not re-pressurize by returning to depth—this is a myth and dangerous.
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Provide all dive details to paramedics: depth, dive profile, surface intervals, number of repetitive dives.
Getting to a Recompression Chamber
San Diego’s primary recompression chamber is at UC San Diego Medical Center in Hillcrest, approximately 15–20 minutes by ambulance from most coastal diving spots. This facility operates 24/7 and handles diving emergencies with protocols specific to decompression illness.
Paramedics will transport the patient directly. Do not delay transport hoping symptoms improve—recompression therapy is the definitive treatment, and early intervention significantly improves outcomes.
Prevention: The Real Priority
The best response is prevention:
- Respect depth limits. Recreational freediving stays well above 40 meters for most divers.
- Surface intervals matter. Between repetitive dives, spend at least 3–5 minutes on the surface breathing normally.
- Ascend slowly and deliberately. Never rush to the surface, especially on deep dives at The Wreck or Bird Rock.
- Stay hydrated before and between sessions.
- Know your fitness level. Cold water, fatigue, and dehydration compound risk.
- Dive with a partner who watches for signs of distress or unusual behavior.
- Avoid altitude travel for 24 hours after diving.
Local Dive Safety Resources
San Diego has an active freediving community. Connect with established clubs and training organizations that emphasize safety protocols. Many local instructors and experienced divers can mentor you through proper ascent techniques and repetitive dive management specific to our cold-water conditions.
Decompression sickness is preventable through disciplined dive practices and respect for your body’s limits. Stay informed, dive conservatively, and never hesitate to seek medical help if symptoms appear. Use the Element app to check water conditions and plan conservative dive profiles suited to San Diego’s seasonal temperature and visibility changes—knowing what to expect topside helps you make better decisions underwater.