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Chapter 41 All chapters, full text, free download, available at http://www.divingmedicine.info TRAINING & SAFETY CHECKLIST SAFETY INFORMATION AND BACKUP • Diving manuals and library (see Appendix A). • Diving medical and safety manuals and texts (see Appendix A). • Diving medical organisations (see Appendix B & D). • Medical Insurance — DAN has organised this for North Americans, world wide. DAN.AP covers the area from the eastern Indian ocean to the western Pacific ocean BSAC arranges insurance from the UK/Europe. Most diving shops and organisations advise on the relevent local contacts. DIVER TRAINING • Physical fitness – 200 metres unassisted swim in less than 5 minutes. • Medical examination fitness for diving by a qualified diving physician. Includes pure tone audiogram and expiratory spirometry. • Entry level diving certificate. Qualified by a diving instructor from a reputable training organisation. • Advanced level training, specialty courses such as buoyancy training. • Diving rescue and resuscitation training. • Specialised courses for the specific diving environments (cave, deep, etc.). Chapter 41 — 1
DIVE PLAN • Boat operator's safety and equipment check. • Dive plan — includes terrain information, navigation and emergency plan, maximum depth, air supply, ascent rate, safety and decompression stops. • Basic diving equipment check and maintenance. • Dive responsibility, documentation and buddy system. • Diving rescue equipment — includes BC, emergency air supplies, alarm signals, etc • Lost diver strategy, including EPIRB in open ocean. • Diving rescue plan - includes boat / buoy / diver backups. • First-Aid kit and resuscitation equipment. (See Chapters 39 and 40). • Emergency contact numbers (local and elsewhere). FOR DIVE OPERATORS • Register trip plan with local maritime or port authority • Rescue and resuscitation equipment and training • Onboard observer and recorder (diver in/out times) • Communication system. Satellite phone, radio etc • A good lawyer! Chapter 41 — 2
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Diving Medicine for Scuba Divers 4t
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ACKNOWLEDGMENTS ! For the 1 st and
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Chapter 1 All chapters, full text,
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The development of self-contained a
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Water is much denser than air and 1
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This law can easily be demonstrated
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For example, if diver has a maximum
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Stated in another way; if a gas is
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Henry's Law This law describes the
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O 2 supports combustion vigorously
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BUOYANCY It is important for divers
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the water temperature decreases wit
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Below the larynx the air passes thr
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Gas Uptake and Loss Air, which cont
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In venous blood, the haemoglobin in
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Circulation The blood flow from the
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educes the safety margin in the eve
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infections, hypothermia, panic and
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BREAK POINT Fig 4.2 . . This diagra
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MEDICAL CHECKLIST FOR SNORKELLERS H
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Some face masks are fitted with a o
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Snorkel The snorkel allows the dive
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A poorly fitting wet suit can cause
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entanglement with other equipment i
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1. Air supply, cylinder, tank 2. On
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Difficulties are still encountered
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STANDARD DRESS or HARD HAT This tra
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Closed and Semi-closed Circuit REBR
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the B.C. to be inflated using air f
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The scuba tank may be negatively bu
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Diving Watch A reliable, accurate,
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Surface detection aids include: •
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The "Half Tank Rule". The best tech
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It is important to return to the su
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The problems centre on impaired vis
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The lower surface pressure also mea
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In general, successful military div
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Factors which upset a diver's emoti
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The above story illustrates some of
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Women divers must be doing somethin
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convenience, most women today prefe
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Other Diving Diseases In a number o
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! Decompression sickness. As mentio
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vibrate. These vibrations are trans
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Fig. 9.5 If equalisation does not o
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If the ear drum was perforated, com
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The diver should then equalise ever
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If reasonable, avoid the use of hoo
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One or more of these must be presen
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There are four main groups of sinus
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TREATMENT Any case of suspected sin
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Fig. 11.2 The various clinical mani
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Fig 11.3 The location of the medias
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Occasionally a valve effect allows
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The air bubbles obstruct or damage
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Predisposing Factors ! Breath-holdi
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In many navies free ascent training
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! Out of Air (OOA) and Low on Air (
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PULMONARY BAROTRAUMA OF DESCENT (LU
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This condition is easily prevented
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SUIT BAROTRAUMA OF ASCENT ("BLOW UP
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SATURATION When tissues are subject
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DIVE PROFILES The type of dive has
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! Cold. Diving in cold conditions m
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A very short surface interval may a
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ased on modified Haldane principles
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DECOMPRESSION METERS and COMPUTERS
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! Safety suggestions (the DC Ten Co
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ONSET OF SYMPTOMS The clinical feat
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confined within the solid bone of t
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SKIN MANIFESTATIONS of DCS These ar
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The ABBREVIATED MENTAL TEST SCORE (
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Unfortunately 100% O 2 can be toxic
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Transportation in aircraft presents
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Other tables are available which in
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! Slow ascent rates. A slow ascent
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epeated minor trauma which is commo
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Prevention Avoidance of the known p
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CAUSES OF NITROGEN NARCOSIS The exa
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A diver who can "hold his liquor" i
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CLINICAL FEATURES The first sign is
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obstruction somewhere in the respir
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the lungs and body into the counter
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CAUSES OF O 2 TOXICITY For resuscit
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Pulmonary Effects These effects wil
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Clinical Features A person hyperven
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CO 2 toxicity may increase the like
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CLINICAL FEATURES Symptoms are thos
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If the compressor is operated in an
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eaches the surface. If the diver is
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TREATMENT Rescue and recovery from
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PREVENTION It is paradoxical that d
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Fig. 27.3 Graph illustrating surviv
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PREVENTION Alcohol and other drugs
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Occasionally this disorder has been
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! Treatment. All coral cuts should
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! Vibrio and other Aquatic Organism
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SWIMMING POOL GRANULOMA Also called
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Until the risk is excluded it would
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MARINE Chapter 29 All chapters, ful
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! Stop the blood loss. This must be
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The venom has its most serious effe
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IRUKANDJI SYNDROME This disorder wa
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The first aid basic life support me
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hospital as soon as possible. Serio
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The spine may produce a puncture an
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Middle Ear Disorders Disturbances o
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CAUSES OF VERTIGO Problems arising
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Nitrogen narcosis may aggravate ver
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CRAMPS Cramp is a painful spasm of
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Air emboli and bubble development i
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Cold water entering an ear canal ca
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unconsciousness have been well reco
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SEASICKNESS This is a distressing a
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EXPLOSIONS - UNDERWATER BLAST This
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In addition to these the causes ass
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COLD OR HYPOTHERMIA (SEE CHAPTERS 3
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GENERAL MEDICAL CONDITIONS A variet
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! Major Causes of Death identified
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unfortunately promoted by some inst
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Fig 34.3 But not always ! Buddy res
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Page 272 and 273: Nitrogen Narcosis This was an effec
Page 274 and 275: Other Equipment Problems In 5% or l
Page 276 and 277: SUMMARY Diving fatalities generally
Page 278 and 279: Chapter 35 All chapters, full text,
Page 280 and 281: CONTRIBUTING CAUSES There are a num
Page 282 and 283: This reflex is present to some exte
Page 284 and 285: ! Myocarditis. Some viral infection
Page 286 and 287: Flora Fisk Quiz for Recreational Di
Page 288 and 289: (50 ft) and admitted to being "bent
Page 290 and 291: is undertaken. Then a drug reaction
Page 292 and 293: Antihistamines These are usually ta
Page 294 and 295: PROPHYLACTIC (PREVENTION) DRUGS Sta
Page 296 and 297: Marijuana — Cannabis or "pot" Chr
Page 300 and 301: Some antibiotics may have no direct
Page 302 and 303: The hearing function test (pure ton
Page 304 and 305: MEDICAL EXAMINATION FORMAT There is
Page 306 and 307: Chapter 38 — 9
Page 308 and 309: Chapter 38 — 11
Page 310 and 311: RESUSCITATION EQUIPMENT • Airways
Page 312 and 313: INFORMATION NEEDED about a DIVING A
Page 314 and 315: in medicine have 100% O 2 delivered
Page 316 and 317: compatible. Otherwise the diving il
Page 318 and 319: GENERAL INFORMATION Oxygen Toxicity
Page 322 and 323: CHECK LIST FOR DIVING ACCIDENTS INF
Page 324 and 325: D and R - DANGER and RESPONSE DANGE
Page 326 and 327: If the rescuer has the equipment an
Page 328 and 329: Duration of CPR Continue CPR until:
Page 332 and 333: THE TECHNICAL DIVE 1. DIVE PROTOCOL
Page 334 and 335: For the same depth/duration dive, t
Page 336 and 337: OXYGEN ENRICHED AIR or NITROX (EANx
Page 338 and 339: likely to oxidise and have a higher
Page 340 and 341: There is also a greater conductive
Page 342 and 343: The carbon dioxide absorbent must b
Page 344 and 345: • The oxygen rebreathers are clos
Page 346 and 347: CONCLUSION There are few problems i
Page 348 and 349: The actual incidence is unknown, bu
Page 350 and 351: Appendix A All chapters, full text,
Page 352 and 353: DIVING MEDICAL TEXTS • *Diving Me
Page 354 and 355: Appendix B All chapters, full text,
Page 356 and 357: Appendix C All chapters, full text,
Page 358 and 359: Appendix D All chapters, full text,
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