Advanced Diving Medicine and Emergency Response

Diving medicine, or underwater medicine, deals with preventing and treating health problems related to diving. Both freediving and scuba diving are increasingly popular sports, allowing us to explore the unknown, embark on adventures, and have unique experiences. Additionally, technological advancements have made diving much safer than in its early days. However, let’s be honest, there is no such thing as zero risk for humans when diving underwater. Hence the importance of diving medicine.

Some individuals may have past or present health conditions that make diving contraindicated for them. That’s why those within a higher-risk group are advised to consult with a specialist in diving medicine. They will assess their health status for diving. But let’s not get ahead of ourselves.

What are we going to learn about diving medicine in this article?

1. What Is Diving Medicine?

Diving Medicine or diving medicine focuses on the physiological changes and health problems related to diving. There are organs particularly affected by this sport, which must be in optimal health for safe diving. Some of these are the ears, sinuses, lungs, and vascular system.

Hyperbaric Medicine also focuses on treating diving-related illnesses, aviation, and aerospace, known as dysbaric pathologies. A branch of diving medicine is Hyperbaric Medicine, which involves administering oxygen at high pressure to treat various illnesses. Hyperbaric chambers are used to create this environment, and their effects are so beneficial to health that they are now used to treat other diseases.

Specialized training and specific qualifications obtained through a university master’s degree are required to practice Underwater Medicine.

2. Diving Medicine Physician

Diving doctors are specialists in a unique area of medicine that encompasses both underwater and hyperbaric health. Their expertise ranges from understanding how the human body reacts underwater and at different pressure levels to mastering the equipment and procedures used in diving. Becoming a diving doctor requires specialized training and, in many cases, completing a doctorate in diving medicine. These professionals not only assess whether a person is fit to dive but they are also trained to diagnose and treat diving-related accidents, such as decompression sickness.

Additionally, they can provide emergency medical care both on the surface and within recompression chambers, making them a vital component in ensuring divers’ safety and health.

3. Pre-Dive Medical Examination

Recreational diving, whether SCUBA or freediving, poses very few health risks for most people, but certain physical conditions can increase risks, sometimes not obvious to those wishing to become divers.

Therefore, it is crucial for diving doctors to conduct a thorough examination to detect these conditions. Some of them include:

Mental health: It is crucial to assess whether a candidate has the capacity to learn and apply theoretical diving knowledge, as well as observe their behavior in the training environment.

The otorhinolaryngological system is vital for divers, as any pressure imbalance during ascent and descent can cause anything from discomfort to injuries. The middle ear and paranasal sinuses must be properly equalized to avoid complications. Additionally, it is crucial that the larynx and pharynx are free from obstructions to ensure proper breathing underwater.

Medical conditions related to the cardiovascular, gastrointestinal, hematological, endocrine, and neurological systems, as they can affect the diver’s safety. For example, heart diseases, coagulation disorders, or epilepsy can pose risks to health during diving.

In summary, the medical evaluation of potential divers should be comprehensive and personalized, considering all these aspects to ensure the safety and well-being of individuals during dives.

Therefore, a diving fitness assessment includes a complete medical history and a detailed physical examination, a resting electrocardiogram, pulmonary function tests, and an assessment of exertion, usually performed with a bicycle ergometer or a treadmill.

Remember: most insurance companies and diving operators require a medical certification for diving.

4. Medical Emergencies in Diving

Medical emergencies in diving are extremely rare. It is estimated that they occur only 2 out of every 10,000 dives. However, one must be prepared. Among these emergencies are decompression illness, nitrogen narcosis (in deep diving), oxygen toxicity (at extreme depths), and barotrauma (during rapid ascents). Their treatment often involves providing oxygen immediately upon surfacing and hyperbaric oxygen therapy in decompression chambers once on land.

However, it is important to note that treatment availability may be limited in some places, emphasizing the importance of prevention and education in the diving community. For this reason, recreational diving instructors and divemasters are required to have rescue and first aid knowledge and skills, including certification in cardiopulmonary resuscitation and normobaric oxygen administration. At Dressel Divers, we have a comprehensive plan for emergencies and our diving boats and centers are equipped with oxygen kits.

In commercial diving, the team typically includes a diving doctor or diving medical technician, who is responsible for providing advanced first aid. They are prepared to administer emergency treatment, assist in decompression procedures, and provide care in a hyperbaric chamber in case of an emergency.

5. Diving Medical Insurance

Technological advancements in the field of diving have led to heightened safety standards, making it a highly popular recreational activity. However, risks persist. Therefore, having diving medical insurance is not only recommended but also mandatory in many parts of the world.

In these areas, dive centers do not authorize submerging without the presentation of the respective diving medical insurance, along with certification and medical clearance.

Although the risks of experiencing decompression sickness, barotrauma, or gas embolism in recreational diving are minimal, facing medical costs in the event of such an emergency could pose an economic challenge.

For instance, according to the Divers Alert Network (DAN) and the Undersea and Hyperbaric Medical Society, hyperbaric chamber treatment can cost between $330 and $1000 per hour, in addition to medication expenses and medical fees. Having medical insurance in case of an unforeseen event is always recommended.

The specifics of diving insurance coverage vary from one company to another, so it is advisable to review the terms before purchasing insurance. Some crucial aspects that your insurance should include are:

• Cost of transportation from the dive site to the hospital or hyperbaric chamber.
• Medical expenses and duration of assistance.
• Travel expenses following a diving accident.
• Loss, theft, or damage to equipment.

It is essential to consider the limitations of your diving insurance. For example, some policies do not cover individuals over 70 years old or divers with pre-existing medical conditions such as diabetes or asthma, even with an up-to-date medical clearance for diving.

In summary, recreational diving is an exciting and rewarding activity that must be enjoyed with health in mind. Divers with past or existing medical issues need to be properly evaluated and advised by experienced medical professionals in diving medicine to ensure a safe and satisfying experience underwater.