Title:Medical Management and Risk Reduction of the Cardiovascular Effects of Underwater Diving
Volume: 16
Issue: 4
Author(s): Thomas F. Whayne*
Affiliation:
- Department of Medicine (Cardiology), Division of Cardiovascular Medicine, Gill Heart and Vascular Institute, University of Kentucky, Lexington, KY 40506,United States
Keywords:
Air embolus, Breathhold diving, decompression sickness, dive reflex, hyperbaric medicine, self-contained underwater
breathing apparatus (SCUBA).
Abstract: Undersea diving is a sport and commercial industry. Knowledge of potential problems began
with Caisson disease or “the bends”, first identified with compressed air in the construction of tunnels
under rivers in the 19th century. Subsequently, there was the commercially used old-fashioned diving
helmet attached to a suit, with compressed air pumped down from the surface. Breathhold diving, with
no supplementary source of air or other breathing mixture, is also a sport as well as a commercial fishing
tool in some parts of the world. There has been an evolution to self-contained underwater breathing
apparatus (SCUBA) diving with major involvement as a recreational sport but also of major commercial
importance. Knowledge of the physiology and cardiovascular plus other medical problems associated
with the various forms of diving have evolved extensively. The major medical catastrophes of SCUBA
diving are air embolism and decompression sickness (DCS). Understanding of the essential referral to a
hyperbaric recompression chamber for these problems is critical, as well as immediate measures until
that recompression is achieved. These include the administration of 100% oxygen and rehydration with
intravenous normal saline. Undersea diving continues to expand, especially as a sport, and a basic understanding
of the associated preventive and emergency medicine will decrease complications and save
lives.
