DIVING

2. Dive Injuries
Cardiopulmonary risk factors
Table 2.1.5.4-1 Cardiovascular risk factors
Hypertension or undefined heart disease 7
Elevated cardiac enzymes 4
Atrial fibrillation 3
Hypotension 2
Diabetes 2
Cardiomyopathy 1
Asthma 1
Number of cases (N)
Note: Total does not equal 17 due to cases with multiple risk factors.
Of note, six patients reported having had a rapid ascent following symptom onset which can result in additional issues
and further complicate the diagnosis.
One case was an experienced diver participating in her third day of diving. She conducted a dive to a maximum depth
of 100 fsw (30 msw) and felt like she was inhaling water. She attempted to purge her regulator, then switched to her
alternate regulator and finally to her buddy’s with no improvement. She described feeling as if she was choking. She
made an emergency ascent, and her computer indicated it was too rapid. At the surface she lost consciousness, was
rescued to the dive boat, and then transported to the local emergency department. Chest x-ray revealed pulmonary
edema. She was placed on continuous positive airway pressure (CPAP), treated with a diuretic, and monitored until
symptoms resolved. Subsequent inspection of scuba gear by the police revealed no malfunctions.
One caller retrospectively reported a case of shortness of breath and coughing up blood during a cave dive a week
prior. He had experienced similar symptoms on another dive approximately three and a half years ago. Both dives were
conducted on a rebreather. He had a history of hypertension and reported fluid-loading prior to the first episode. He was
advised that this condition may have been IPE and that it may return in a more severe form. He was advised to not dive
before consulting with a diving medicine specialist.
Another case was a middle-aged woman participating in a dive rescue course. She made a cold-water dive to a maximum
depth of 15 fsw (5 msw) for an unknown amount of time followed by a controlled ascent. During surface drills the diver
experienced shortness of breath, chest discomfort, and coughed up blood. She was placed on oxygen and transported
to the local emergency department. CT scan revealed fluid in the lungs. She was monitored until symptom resolution.
2.1.5.5 Boat Related Injuries
DAN Medical Services Call Center (MSCC) received a total of 8 calls with incidents related to boat propellers from 2010-
2013. In 2013, The Florida Fish and Wildlife Conservation Commission (FWCC) reported out of 1,012 vessels involved
in an accident, four vessels reported scuba diving as the activity engaged in at the time of incident. The highest reported
activity was recreational cruising, with 550 vessels (Boating Accidents Statistical Report 2013, Florida Fish and Wildlife
Conservation Commission). The US Coast Guard reported a US total of 58 injuries sustained from a person being struck
by a propeller as the primary accident type; however, it is unknown how many of these occurred during scuba diving
(2013 Recreational Boating Statistics, USCG).
Organizations outside of DAN focus their efforts to raise awareness of boat propeller injuries in swimmers and boaters,
as boating injuries is a broader injury prevention issue not just affecting divers. Some propeller incidents may not be
captured by DAN due to the traumatic nature of these injuries and the emphasis on immediate emergency medical care.
Reporting a dive related incident to DAN using the online diving incident reporting system (https://www.diversalertnetwork.org/research/incidentReport/)
is a means for divers to help educate others about near-misses, accidents, or injuries
experienced or witnessed, including boating incidents while scuba diving.
To prevent injuries by death and propeller and vessel strikes, divers and boaters are encouraged to proactively be aware
of one another. Boaters are encouraged to stay a safe distance away from diver down flags (300 feet / 90 meters in
54
Annual Diving Report – 2012-2015 Edition