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Diving Precautions and Prevention of Diving Injuries

By

Richard E. Moon

, MD, Duke University Medical Center

Last full review/revision Jun 2021| Content last modified Jun 2021
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Diving is a relatively safe recreational activity for healthy people who have been appropriately trained and educated. Diving safety courses offered by national diving organizations are widely available.

Safety precautions

Incidence of barotrauma can be decreased through active equalization of various air spaces, including the face mask (by blowing out air from the nose into the mask) and the middle ear (by yawning, swallowing, or performing a Valsalva maneuver). Divers should avoid holding their breath and breathe normally during ascent, which should be no faster than 0.15 to 0.3 m/sec (0.5 to 1 ft/sec), a rate that allows for gradual offloading of nitrogen and emptying of air-filled spaces (eg, lungs, sinuses). Divers should ascend with decompression stops as specified in published guidelines (eg, the decompression table in Diagnosis and Treatment of Decompression Sickness and Arterial Gas Embolism, a chapter in the US Navy Diving Manual). Current recommendations also include a 3- to 5-minute safety stop at 3 to 4 m (10 to 15 ft) for further equilibration. Also, divers should not fly for 12 hours after a single no-stop dive or 18 to 24 hours after multiple dives or dives requiring decompression stops.

Divers should be aware of and avoid certain diving conditions, including the following:

  • Poor visibility

  • Currents requiring excessive effort

  • Cold temperatures

  • Diving alone

  • After use of recreational or sedative drugs and alcohol

Cold temperatures are a particular hazard because hypothermia Hypothermia Hypothermia is a core body temperature 35° C. Symptoms progress from shivering and lethargy to confusion, coma, and death. Mild hypothermia requires a warm environment and insulating blankets... read more can develop rapidly and affect judgment and dexterity or induce fatal cardiac arrhythmias in susceptible people. Diving alone is not recommended.

Recreational or sedative drugs and alcohol in any amount may have unpredictable or unanticipated effects at depth and should be strictly avoided. Otherwise, prescription drugs rarely interfere with recreational diving, but if the disorder being treated is a contraindication to diving, the dive should not be pursued.

Contraindications to diving

Because diving can involve heavy exertion, divers should not have a functionally significant cardiovascular or pulmonary disorder and should have above-average aerobic capacity. Disorders that can impair consciousness, alertness, or judgment generally contraindicate diving. If there is any doubt as to whether diving is contraindicated by a specific disorder, a recognized expert should be consulted. For specific diving contraindications, see table Specific Medical Contraindications to Diving Specific Medical Contraindications to Diving Diving is a relatively safe recreational activity for healthy people who have been appropriately trained and educated. Diving safety courses offered by national diving organizations are widely... read more .

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The following English-language resources may be useful. Please note that THE MANUAL is not responsible for the content of these resources.

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