Dr. MJ Bazos MD,
Patient Handout
Scuba Diving
Safety
What is recreational scuba
diving?
Recreational scuba diving is defined as pleasure
diving to a depth of 130 feet without decompression stops.
Several scuba-certifying agencies offer training
for divers, from beginners to experts. Three of the agencies are the
Professional Association of Diving Instructors (PADI), the National Association
of Underwater Instructors (NAUI) and Scuba Schools International (SSI). Basic
classes involve classroom instruction and training in a pool and open water
settings. The most popular courses last from 4 to 8 weeks.
What are the most common problems of
scuba diving?
The most common medical problems are simple
middle ear "squeezes." Squeezes cause pain in your ears. The pain is caused by
the difference in pressure between the air spaces of your ears and mask,
and higher water pressure as you go deeper into the water. Squeezes that
affect the inner ear or sinuses are less common.
Cuts, scrapes and other injuries to the arms and
legs can be caused by contact with fish and other marine animals, certain
species of coral and hazards such as exposed sharp metal on wrecks or
fishing line.
What dangerous medical conditions
are possible when I am diving?
- Inner ear barotrauma. This condition may
happen if you had trouble clearing during a dive. The result is severe
dizziness and hearing loss.
- Pulmonary barotrauma. This condition is
the result of improper breathing during the ascent to the surface, or
occasionally, from diving with a respiratory tract infection. Symptoms include
chest pain, shortness of breath and hoarseness.
- Arterial gas embolism (AGE). This is
a type of pulmonary barotrauma in which bubbles enter the circulation and
travel to the brain. Symptoms such as numbness or tingling of the skin,
weakness, paralysis or even loss of consciousness may occur. This is a very
serious diving injury.
- Decompression sickness ("the bends"). This
condition occurs during ascent and on the surface of the water. Inert nitrogen
gas that is dissolved in body tissues and blood comes out of solution and forms
bubbles in the blood. The bubbles can injure various body tissues and may block
blood vessels. The most common signs of severe decompression sickness
are dysfunction of the spinal cord, brain and
lungs.
Remember: If you
should develop any of the symptoms on this list during a dive or after a
dive, you should get medical care
immediately.
How common are medical problems in
scuba diving?
Fortunately, serious medical problems are not
common in recreational scuba divers. While there are millions of dives each
year in the Unites States, only about 90 deaths are reported each year
worldwide. In addition, fewer than 1,000 divers worldwide require recompression
therapy to treat severe dive-related health problems.
How can I lower my risk of medical
problems?
Most severe dive-related injuries and deaths
happen in beginning divers. To be safe, always dive within the limits of your
experience and level of training. Good rules to follow for safe diving
include:
- Never try a dive you're not comfortable with.
During descent, you should gently equalize your ears and mask. At depth, never
dive outside the parameters of the dive tables or your dive computer.
- Never hold your breath while ascending. You
should always ascend slowly while breathing normally.
- Become familiar with the underwater area and its
dangers. Learn which fish, coral and other hazards to avoid so that injuries do
not occur. Be aware of local tides and currents.
- Never panic under water. If you become confused
or afraid during a dive, stop, try to relax and think the problem through. You
can also get help from your dive buddy or dive master.
- Never dive without a buddy.
- Always plan your dive, then always dive your
plan.
- Always stay within the no-decompression limits.
- Be sure that your diving equipment can handle the
dive you have planned and that the equipment is working well.
- Don't drink alcohol before diving.
- Never dive while taking medicine unless your
doctor has said it's safe.
- Diving can be dangerous if you have certain
medical problems. Ask your doctor how diving may affect your health.
- Cave diving is dangerous and should only be
attempted by divers with proper training and equipment.
- If you don't feel well or if you are in pain
after diving, go to the nearest emergency room immediately.
- Don't fly for 12 hours after a no-decompression
dive, even in a pressurized airplane. If your dive required decompression stops,
don't fly for at least 24 hours.
What should I do in
a diving emergency?
If you or one of your dive buddies has an
accident while diving, or if you would like to discuss a potential
diving-related health problem, call the Divers Alert Network (DAN) emergency
telephone line (919-684-8111). DAN is located at Duke University Medical Center
in Durham, N.C. Doctors, emergency medical technicians and nurses are available
24 hours a day to answer your questions. If needed, they will direct you to the
nearest hyperbaric chamber or other appropriate medical
facility.
What is a hyperbaric
chamber?
A hyperbaric chamber is a facility where you are
placed under increased pressure. It's similar to being underwater. This can
often help injury from arterial gas embolism or decompression sickness by
shrinking bubbles and allowing them to pass through your blood
vessels.
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