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Scuba Diving
Aka: Scuba Diving, Scuba, Underwater Diving, Barotrauma, Diving Barotrauma, Dysbarism, Scuba Diving Injury
- Epidemiology
- Certified divers in United States: 9 million
- Distribution
- Coastal areas
- Inland water areas: lakes, streams, quarries
- Distant travel (e.g. island resorts)
- Annual injuries in United States
- Deaths: 90 per year
- Injuries requiring Recompression Therapy: 1,000/year
- Contraindications
- Pregnancy
- Seizure Disorder
- Prior Pneumothorax
- Diabetes Mellitus
- Causes: Injuries - Barotrauma
- Middle Ear Barotrauma (Barotitis Media)
- Otalgia
- Vertigo
- Tympanic Membrane Rupture or Hemorrhage
- Facial baroparesis resulting in Bell's Palsy
- Inner Ear Barotrauma (Round and oval window rupture)
- Causes Tinnitus, Vertigo, Hearing Loss
- Avoid strenuous activity
- Alternobaric Vertigo
- Sinus Barotrauma (Sinus Squeeze)
- Causes sinus pain and Epistaxis
- Responds to topical and Systemic Decongestants
- Gastrointestinal Barotrauma (aerogastralgia)
- Causes Colicky Abdominal Pain and Belching
- Prevent by clearing in head up position
- Tooth squeeze (Barodontalgia)
- Causes Tooth Pain while diving
- Prevent by no diving 24 hours after dental work
- Mask Squeeze
- Causes Corneal injection and Conjunctival Hemorrhage
- Prevent by ventilating mask while diving
- Pulmonary Barotrauma
- Arterial Gas Embolism
- Mediastinal Emphysema
- Subcutaneous Emphysema
- Pneumothorax
- Causes: Injuries - Decompression Sickness
- Type I Decompression Sickness (Constitutional DCS)
- Type II Decompression Sickness
- Inner Ear DCS
- Neurologic DCS (Cerebral DCS and Spinal Cord DCS)
- Causes: Injuries - Other Conditions
- Oxygen Toxicity (associated with Nitrox use)
- Symptom: Headache Approach
- General Causes
- Migraine Headache
- Tension Headache
- Sinusitis
- Scuba-specific Causes
- Cerebral Decompression Sickness
- Breathing Gas contamination with Carbon Monoxide
- Arterial Gas Embolism
- Oxygen Toxicity
- Tight Face Mask
- Sinus Barotrauma
- Prevention
- Prepare for Scuba Diving
- Avoid Alcohol before diving
- Do not dive alone
- Plan dive in advance and follow plan
- Stay within no-decompression limits
- Avoid airplane flight immediately after Scuba Diving
- No decompression dive: no flight for 12 hours
- Decompression dive: no flight for 24 hours
- Resources (from Newton, 2001 - see references)
- Divers Alert Network (DAN)
- http://www.diversalertnetwork.org
- Scubamed (Underwater Medicine Associates)
- http://www.scubamed.com
- Undersea and Hyperbaric Medical Society
- http://www.uhms.org
- Association of Commercial Diving Educators
- http://www.diveweb.com/acde/
- National Association of Undersea Instructors (NAUI)
- http://www.naui.org
- PADI
- http://www.padi.com
- Scuba Schools International
- http://www.ssiusa.com
- References
- Clenney (1996) Am Fam Physician 53(5):1761-6 [PubMed]
- Melamed (1992) N Engl J Med 326:30-5 [PubMed]
- Newton (2001) Am Fam Physician 63(11): 2211-2226 [PubMed]