Merck Manual

Please confirm that you are a health care professional

Loading

Overview of Diving Injuries

By

Richard E. Moon

, MD, Duke University Medical Center

Last full review/revision Jul 2019| Content last modified Jul 2019
Click here for Patient Education
NOTE: This is the Professional Version. CONSUMERS: Click here for the Consumer Version

More than 1000 diving-related injuries occur annually in the US; > 10% are fatal. Similar injuries can befall workers in tunnels or caissons (watertight retaining structures used for construction), in which pressurized air is used to exclude water from work sites.

Many injuries are related to high pressure, which, at depth or in a caisson, results from the water weight above plus the atmospheric pressure at the surface. At a depth of 10 m (33 ft), seawater exerts a pressure equivalent to standard sea level atmospheric pressure, which is 1.03 kg/sq cm (14.7 lb/sq in), 760 mm Hg, or 1 atmosphere absolute (atm abs); thus, the total pressure at that depth is 2 atm abs. Every additional 10 m of descent adds 1 atm.

The volume of gases in body compartments is inversely related to external pressure; an increase or a decrease in gas volume due to pressure change exerts direct physical forces that can disrupt various body tissues (barotrauma). The amount of gas dissolved in the bloodstream increases as ambient pressure increases. Increased gas content can cause injury directly (eg, nitrogen narcosis, oxygen toxicity) or indirectly during ascent when decompression of the supersaturated blood or tissues releases nitrogen bubbles (decompression sickness). Arterial gas embolism can result from barotrauma or decompression.

Some medical disorders, if they cause symptoms at depth, may be disabling or disorienting and thus lead to drowning (see table Specific Medical Contraindications to Diving).

For other diving-related injuries (eg, drowning, hypothermia, trauma), see elsewhere in THE MANUAL.

Physicians caring for patients with diving or compressed air injuries may contact the Divers Alert Network: 919-684-9111 for emergencies and 919-684-2948 for other information (www.diversalertnetwork.org). Physician-to-physician consultation can be obtained through Duke Dive Medicine: 919-684-8111.

More Information

Click here for Patient Education
NOTE: This is the Professional Version. CONSUMERS: Click here for the Consumer Version
Professionals also read

Also of Interest

Videos

View All
How to Measure Compartment Pressure in the Lower Leg
Video
How to Measure Compartment Pressure in the Lower Leg
3D Models
View All
Musculoskeletal Connective Tissues
3D Model
Musculoskeletal Connective Tissues

SOCIAL MEDIA

TOP