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Diving Medicine
Diving medicine, also called undersea and hyperbaric medicine (UHB), is the diagnosis, treatment and prevention of conditions caused by humans entering the undersea environment. It includes the effects on the body of pressure on gases, the diagnosis and treatment of conditions caused by marine hazards and how relationships of a diver's fitness to dive affect a diver's safety. Diving medical practitioners are also expected to be competent in the examination of divers and potential divers to determine fitness to dive. Hyperbaric medicine is a corollary field associated with diving, since recompression in a hyperbaric chamber is used as a treatment for two of the most significant diving-related illnesses, decompression sickness and arterial gas embolism. Diving medicine deals with medical research on issues of diving, the prevention of diving disorders, treatment of diving accidents and diving fitness. The field includes the effect of breathing gases and their contaminants under ...
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Decompression Chamber
A diving chamber is a vessel for human occupation, which may have an entrance that can be sealed to hold an internal pressure significantly higher than ambient pressure, a pressurised gas system to control the internal pressure, and a supply of breathing gas for the occupants. There are two main functions for diving chambers: * as a simple form of submersible vessel to transport divers underwater and to provide a temporary base and retrieval system in the depths; * as a land, ship or offshore platform-based hyperbaric chamber or system, to artificially reproduce the hyperbaric conditions under the sea. Internal pressures above normal atmospheric pressure are provided for diving-related applications such as saturation diving and diver decompression, and non-diving medical applications such as hyperbaric medicine. Basic types of diving chambers There are two basic types of submersible diving chambers, differentiated by the way in which the pressure in the diving chamber is p ...
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Breathing Gas
A breathing gas is a mixture of gaseous chemical elements and compounds used for respiration. Air is the most common and only natural breathing gas, but other mixtures of gases, or pure oxygen, are also used in breathing equipment and enclosed habitats such as scuba equipment, surface supplied diving equipment, recompression chambers, high-altitude mountaineering, high-flying aircraft, submarines, space suits, spacecraft, medical life support and first aid equipment, and anaesthetic machines. Oxygen is the essential component for any breathing gas, at a partial pressure of between roughly 0.16 and 1.60 bar at the ambient pressure. The oxygen is usually the only metabolically active component unless the gas is an anaesthetic mixture. Some of the oxygen in the breathing gas is consumed by the metabolic processes, and the inert components are unchanged, and serve mainly to dilute the oxygen to an appropriate concentration, and are therefore also known as diluent gases. Most ...
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Decompression Illness
Decompression Illness (DCI) comprises two different conditions caused by rapid decompression of the body. These conditions present similar symptoms and require the same initial first aid. Scuba divers are trained to ascend slowly from depth to avoid DCI. Although the incidence is relatively rare, the consequences can be serious and potentially fatal, especially if untreated. Classification DCI can be caused by two different mechanisms, which result in overlapping sets of symptoms. The two mechanisms are: * Decompression sickness (DCS), which results from metabolically inert gas dissolved in body tissue under pressure precipitating out of solution and forming bubbles during decompression. It typically afflicts underwater divers on poorly managed ascent from depth or aviators flying in inadequately pressurised aircraft. * Arterial gas embolism (AGE), which is perfusion blockage caused by gas bubbles in the arterial bloodstream. In the context of DCI these may form either as a resu ...
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Conjunctival
The conjunctiva is a thin mucous membrane that lines the inside of the eyelids and covers the sclera (the white of the eye). It is composed of non-keratinized, stratified squamous epithelium with goblet cells, stratified columnar epithelium and stratified cuboidal epithelium (depending on the zone). The conjunctiva is highly vascularised, with many microvessels easily accessible for imaging studies. Structure The conjunctiva is typically divided into three parts: Blood supply Blood to the bulbar conjunctiva is primarily derived from the ophthalmic artery. The blood supply to the palpebral conjunctiva (the eyelid) is derived from the external carotid artery. However, the circulations of the bulbar conjunctiva and palpebral conjunctiva are linked, so both bulbar conjunctival and palpebral conjunctival vessels are supplied by both the ophthalmic artery and the external carotid artery, to varying extents. Nerve supply Sensory innervation of the conjunctiva is divided into fou ...
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Cutaneous
Skin is the layer of usually soft, flexible outer tissue covering the body of a vertebrate animal, with three main functions: protection, regulation, and sensation. Other animal coverings, such as the arthropod exoskeleton, have different developmental origin, structure and chemical composition. The adjective cutaneous means "of the skin" (from Latin ''cutis'' 'skin'). In mammals, the skin is an organ of the integumentary system made up of multiple layers of ectodermal tissue and guards the underlying muscles, bones, ligaments, and internal organs. Skin of a different nature exists in amphibians, reptiles, and birds. Skin (including cutaneous and subcutaneous tissues) plays crucial roles in formation, structure, and function of extraskeletal apparatus such as horns of bovids (e.g., cattle) and rhinos, cervids' antlers, giraffids' ossicones, armadillos' osteoderm, and os penis/ os clitoris. All mammals have some hair on their skin, even marine mammals like whales, dolphin ...
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Otolaryngology
Otorhinolaryngology ( , abbreviated ORL and also known as otolaryngology, otolaryngology–head and neck surgery (ORL–H&N or OHNS), or ear, nose, and throat (ENT)) is a surgical subspeciality within medicine that deals with the surgical and medical management of conditions of the head and neck. Doctors who specialize in this area are called otorhinolaryngologists, otolaryngologists, head and neck surgeons, or ENT surgeons or physicians. Patients seek treatment from an otorhinolaryngologist for diseases of the ear, nose, throat, base of the skull, head, and neck. These commonly include functional diseases that affect the senses and activities of eating, drinking, speaking, breathing, swallowing, and hearing. In addition, ENT surgery encompasses the surgical management of cancers and benign tumors and reconstruction of the head and neck as well as plastic surgery of the face and neck. Etymology The term is a combination of New Latin combining forms ('' oto-'' + '' rhino-' ...
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Barotrauma
Barotrauma is physical damage to body tissues caused by a difference in pressure between a gas space inside, or contact with, the body and the surrounding gas or liquid. The initial damage is usually due to over-stretching the tissues in tension or shear, either directly by an expansion of the gas in the closed space or by pressure difference hydrostatically transmitted through the tissue. Tissue rupture may be complicated by the introduction of gas into the local tissue or circulation through the initial trauma site, which can cause blockage of circulation at distant sites or interfere with the normal function of an organ by its presence. Barotrauma generally manifests as sinus or middle ear effects, lung overpressure injuries and injuries resulting from external squeezes. Decompression sickness is indirectly caused by ambient pressure reduction, and tissue damage is caused directly and indirectly by gas bubbles. However, these bubbles form out of supersaturated solution f ...
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List Of Diving Hazards And Precautions
Divers face specific physical and health risks when they go underwater with scuba or other diving equipment, or use high pressure breathing gas. Some of these factors also affect people who work in raised pressure environments out of water, for example in caissons. This article lists hazards that a diver may be exposed to during a dive, and possible consequences of these hazards, with some details of the proximate causes of the listed consequences. A listing is also given of precautions that may be taken to reduce vulnerability, either by reducing the risk or mitigating the consequences. A hazard that is understood and acknowledged may present a lower risk if appropriate precautions are taken, and the consequences may be less severe if mitigation procedures are planned and in place. A hazard is any agent or situation that poses a level of threat to life, health, property, or environment. Most hazards remain dormant or potential, with only a theoretical risk of harm, and when a h ...
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Fitness To Dive
Fitness to dive, specifically the medical fitness to dive, is the medical and physical suitability of a diver to function safely in the underwater environment using underwater diving equipment and procedures. Depending on the circumstances it may be established by a signed statement by the diver that they do not have any of the listed disqualifying conditions and is able to manage the ordinary physical requirements of diving, to a detailed medical examination by a physician registered as a medical examiner of divers following a procedural checklist, and a legal document of fitness to dive issued by the medical examiner. The most important medical is the one before starting diving, as the diver can be screened to prevent exposure when a dangerous condition exists. The other important medicals are after some significant illness, where medical intervention is needed there and has to be done by a doctor who is competent in diving medicine, and can not be done by prescriptive rules ...
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Saturation Diving
Saturation diving is diving for periods long enough to bring all tissues into equilibrium with the partial pressures of the inert components of the breathing gas used. It is a diving mode that reduces the number of decompressions divers working at great depths must undergo by only decompressing divers once at the end of the diving operation, which may last days to weeks, having them remain under pressure for the whole period. A diver breathing pressurized gas accumulates dissolved inert gas used in the breathing mixture to dilute the oxygen to a non-toxic level in his or her tissues, which can cause decompression sickness ("the bends") if permitted to come out of solution within the body tissues; hence, returning to the surface safely requires lengthy decompression so that the inert gases can be eliminated via the lungs. Once the dissolved gases in a diver's tissues reach the saturation point, however, decompression time does not increase with further exposure, as no more inert g ...
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Dive Computer
A dive computer, personal decompression computer or decompression meter is a device used by an underwater diver to measure the elapsed time and depth during a dive and use this data to calculate and display an ascent profile which according to the programmed decompression algorithm, will give a low risk of decompression sickness. Most dive computers use real-time ambient pressure input to a decompression algorithm to indicate the remaining time to the no-stop limit, and after that has passed, the minimum decompression required to surface with an acceptable risk of decompression sickness. Several algorithms have been used, and various personal conservatism factors may be available. Some dive computers allow for gas switching during the dive. Audible alarms may be available to warn the diver when exceeding the no-stop limit, the maximum operating depth for the gas mixture, the recommended ascent rate or other limit beyond which risk increases significantly. The display provides da ...
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Dive Tables
The practice of decompression by divers comprises the planning and monitoring of the profile indicated by the algorithms or tables of the chosen decompression model, to allow asymptomatic and harmless release of excess inert gases dissolved in the tissues as a result of breathing at ambient pressures greater than surface atmospheric pressure, the equipment available and appropriate to the circumstances of the dive, and the procedures authorized for the equipment and profile to be used. There is a large range of options in all of these aspects. Decompression may be continuous or staged, where the ascent is interrupted by stops at regular depth intervals, but the entire ascent is part of the decompression, and ascent rate can be critical to harmless elimination of inert gas. What is commonly known as no-decompression diving, or more accurately no-stop decompression, relies on limiting ascent rate for avoidance of excessive bubble formation. Staged decompression may include deep st ...
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