Diving medicine is the name given to a branch of occupational and sports medicine. It deals with the effects of water on the human organism during dives.
What is diving medicine?
Diving medicine represents a sub-area of occupational and sports medicine. In addition, it is an important component of diver training. Its areas of responsibility include all medical aspects of diving. In addition to diving fitness, this also includes the therapy and prevention of diving accidents. Other important criteria are the diagnosis and treatment of poisoning and injuries in the water. The psychological effects of diving also play a role. For example, it is possible that diving accidents may reveal various traumas that interact with each other.
Treatments and therapies
The human body is subject to different stresses when diving underwater than on the surface of the earth. Thus, as depth increases, there is an increase in pressure, which in turn requires special ventilation with the help of appropriate equipment. Diving medicine is concerned with problems associated with this as well as with illnesses that set in after a diving operation. The most important area of diving medicine is hyperbaric medicine. It deals with the effects of physical conditions that occur underwater. The most common applications of diving medicine are decompression sickness and barotrauma. Decompression sickness is also called diver’s sickness. It manifests itself when the diver’s ascent to the water surface is too rapid. This results in the formation of nitrogen bubbles in the tissues, which in turn can have the potential to seriously affect the lungs or other organs. The characteristic symptoms of diver’s sickness include dizziness and nausea. It is not uncommon for symptoms to appear several days later. They can be harmless and limited to itching, but can also result in impaired consciousness or paralysis. In the worst case, the diver may even die. Likewise, chronic damage is within the realm of possibility for professional divers. To treat decompression sickness, the patient is quickly given pure oxygen. In some cases, a stay in a decompression chamber may also be necessary. There, doctors expose him to higher pressure, which is then gradually lowered. In this way, the gases that have passed into solution can be exhaled. Barotrauma is caused by changes in the pressure conditions in the adjacent surrounding area. As a result, certain regions of the body, such as the inner ear or the lungs, can be injured because the pressure cannot be equalized quickly enough. Other areas of application of diving medicine include the heat balance of divers, the psychological effects of diving, and poisoning by poisonous fish, sea urchins, starfish, cnidarians, amphibians and octopuses. These secrete nerve toxins that can even achieve a lethal effect. However, antidotes are available to diving medicine for some species. Harmful effects on health are also conceivable through breathing gases. At elevated pressures, nitrogen produces a narcotic effect, which in turn causes the so-called deep intoxication. In higher concentrations as well as at high pressure, nitrogen develops a toxic effect, which becomes noticeable during diving through tinnitus, dizziness, nausea, vomiting, anxiety, convulsions and confusion, among other things. Diving physicians then speak of oxygen poisoning. For this reason, diving medicine also deals with the effects of gas mixtures as well as the duration of dives. Another important area of diving medicine is diving fitness testing. It serves to counteract diving accidents. The examination therefore determines whether diving can be carried out without problems or whether certain risks are present. To this end, diving physicians examine the diver’s general state of health as well as his or her lung functions, cardiovascular system and chest. To ensure that diving does not cause any discomfort in the future, it is recommended to have the diving fitness examination performed regularly. Professional divers are even obliged to have this examination once a year.If the diving physician determines health risks such as a dysfunction of the inner ear or a cardiovascular disease, diving must be avoided.
Diagnosis and examination methods
In its various fields of activity, diving medicine relies on different examination and diagnostic methods. These are also applied in other medical departments. Of particular importance is the pulmonary function test. In this procedure, spirometry is used to record the volume of the lungs. A measurement of the respiratory volume also takes place, which gives the physician indications of possible lung diseases. Sound threshold audiometry is also one of the most important procedures in diving medicine. It is used to examine the hearing power and is presented with a special hearing threshold curve. Equally important is sonography (ultrasound examination) of the heart and organs. It helps to identify possible dysfunctions that pose a risk to diving. In turn, an X-ray examination can detect lung diseases that can have life-threatening consequences when diving. To check the cardiovascular system, a stress ECG is often performed. It can also be performed outside the diving fitness examination. The ECG is so important because the diver’s heart and circulatory system are under severe stress under water. The body’s heat balance also plays an important role, as the temperature of the organism drops more and more the deeper one dives. The assumption of costs for diving medicine examinations depends on which procedure is carried out. For example, the diver must normally pay for a diving fitness examination himself. However, if the treatment is of medical necessity, health insurance companies will cover the costs. This includes, for example, examination and therapy of the diver’s disease or of other diseases that arise as a result of diving.
